Chances are that steroids for psoriasis have been part of your treatment plan for relieving scaling and inflammation and improving cell turnover, at least at some point in time. Doctors commonly recommend steroid sprays, lotions, ointments, and creams to help when psoriasis flares. Topical steroids remain a mainstay of treatment for inflammatory skin conditions, including psoriasis. However, as effective as they may be for some people, there are risks associated with long-term use, especially if the medications are not used properly.
Corticosteroid Safety: Potential Side Effects
As helpful as they are, corticosteroids for psoriasis do come with a lot of baggage in the form of side effects. Your health care provider can help you weigh the risks versus benefits for your individual needs.
Side effects are dependent on the potency of steroid being used — low potency, medium potency, high potency, highest potency — as well as the site of application.
Possible side effects include:
Resistance to treatment. Steroid treatments that work initially may lose their effectiveness over time as your body develops a resistance to them.
Skin damage. Topical corticosteroids can wreak havoc on your skin. An ultrasonographically detectable decrease in skin thickness can occur after a single application of a very potent topical steroid. Thinning of skin, called atrophy; loss of elasticity resulting in stretch marks; easy bruising; and dilated surface blood vessels are potential risks associated with steroid use. These side effects can occur even when low-potency topical steroids are used. Skin changes that are mild typically reverse when you stop using steroids, but more visible changes in skin texture can be permanent.
Systemic side effects. When steroids are absorbed into the skin, you run the risk of them affecting internal organs. This can occur when steroids are applied to large areas of skin, are used for long periods of time, or involve excessive use of occlusion -- covering the affected area with a dressing after applying medication to increase its effectiveness and absorption. According to Michocki, potential systemic side effects include salt and water retention resulting in increased blood pressure, edema, worsening heart failure, hypokalemia (low potassium in the blood), glucose intolerance with worsening diabetes, osteoporosis, aseptic necrosis (localized death of a portion of bone caused by poor blood supply to the bone), increased risk for infection, and ultimately development of Cushing’s disease from too much cortisol and adrenocorticotropic hormone (ACTH). Cushing’s disease has a long list of complications of its own, such as diabetes; high cholesterol; increased risk for heart attack; osteoporosis; and damage to eyes, kidneys, and nerves from high blood sugar.
Corticosteroid Safety: Potential Side Effects
As helpful as they are, corticosteroids for psoriasis do come with a lot of baggage in the form of side effects. Your health care provider can help you weigh the risks versus benefits for your individual needs.
Side effects are dependent on the potency of steroid being used — low potency, medium potency, high potency, highest potency — as well as the site of application.
Possible side effects include:
Resistance to treatment. Steroid treatments that work initially may lose their effectiveness over time as your body develops a resistance to them.
Skin damage. Topical corticosteroids can wreak havoc on your skin. An ultrasonographically detectable decrease in skin thickness can occur after a single application of a very potent topical steroid. Thinning of skin, called atrophy; loss of elasticity resulting in stretch marks; easy bruising; and dilated surface blood vessels are potential risks associated with steroid use. These side effects can occur even when low-potency topical steroids are used. Skin changes that are mild typically reverse when you stop using steroids, but more visible changes in skin texture can be permanent.
Systemic side effects. When steroids are absorbed into the skin, you run the risk of them affecting internal organs. This can occur when steroids are applied to large areas of skin, are used for long periods of time, or involve excessive use of occlusion -- covering the affected area with a dressing after applying medication to increase its effectiveness and absorption. According to Michocki, potential systemic side effects include salt and water retention resulting in increased blood pressure, edema, worsening heart failure, hypokalemia (low potassium in the blood), glucose intolerance with worsening diabetes, osteoporosis, aseptic necrosis (localized death of a portion of bone caused by poor blood supply to the bone), increased risk for infection, and ultimately development of Cushing’s disease from too much cortisol and adrenocorticotropic hormone (ACTH). Cushing’s disease has a long list of complications of its own, such as diabetes; high cholesterol; increased risk for heart attack; osteoporosis; and damage to eyes, kidneys, and nerves from high blood sugar.
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