Steroids save lives

Don’t be afraid of these medicines. Used correctly they are the right treatment for all sorts of medical problems, and they can transform and save lives

• steroid cream for skin eczema
• inhalers for asthma
• steroid tablets for certain rheumatological conditions

With Dr Morton’s - the medical helpline^© you can email or phone a real doctor at any time for more information, reassurance or advice

Steroids do not deserve such bad press

Unfortunately the misuse of anabolic steroids by unscrupulous athletes and body builders has given steroids a bad name and causes endless anxiety to individuals who are prescribed steroid medicines.

Steroids are naturally occurring polycyclic hydrocarbons which come in many guises. Cholesterol is a type of steroid which is found in numerous foods. Two types of steroid hormone are made by the adrenal glands. These are mineralocorticoids which control levels of sodium in the body and glucocorticoids which regulate our ability to respond to physically challenging situations, such as severe infection and danger. We cannot survive without these hormones. The male and female hormones testosterone and oestrogen are types of steroid.

The development of steroids for medical use only began in the 1950s and was a massive advance. They are now used to treat lots of different problems:

• creams and ointments can be applied for eczema and other skin problems such as lichen sclerosis
• steroid drops can be put into eyes, ears and noses for iritis, otitis externa and allergic rhinitis
• long-acting steroids can be injected directly into swollen joints such as rheumatoid or osteoarthritic joints and around tendons such as shoulder tendons (the rotator cuff)
• can be inhaled as a ‘preventer’ for asthma
• steroid tablets are taken (usually as prednisolone) for acute or worsening medical problems such as asthma and rheumatoid arthritis, and given as the primary treatment for things like polymyalgia rheumatica and sarcoidosis
• intravenous steroids are given to a critically ill person to bolster their ability to survive

Generally they are used to reduce harmful immune responses, such as with hay fever, asthma and ulcerative colitis. They reduce swelling and inflammation such as with rheumatoid arthritis (RA) or acute tendonitis. There are some very specific uses, such as intravenous dexamethasone to quickly reduce pressure inside the skull when a brain tumour, or a head injury, threatens to push the brain stem into a narrow space at the top of the neck (coning). Giving steroids by injection to women who are about to have their baby prematurely, before the baby’s lungs are mature, helps the baby to breathe air more easily.

Important things to remember

• all medicines should be treated with respect and taken exactly as prescribed
• steroid creams vary in strength, from hydrocortisone through betnovate to clobetasone propionate. Your doctor will choose the right one for your problem and for the part of the body affected. Cream or ointment should always be applied sparingly as opposed to lathered on. More is not better
• tablets should be taken in the dose prescribed. Often a short high dose course is required, reducing down in a specific way to a maintenance dose or stopping altogether. You should not stop without advice, as your body may rely on the tablets until your adrenal glands have started to make enough of their own glucocorticoid steroid to take over again
• all medicines have possible side effects. Everyone talks about ‘skin thinning’ but of course if your skin illness needs treatment then it must be treated. If avoiding something that is causing the problem is possible, for example not using rubber gloves when you are sensitive to latex, then that is the better solution

Symptoms

• contact one of our doctors if you don’t understand why you have been prescribed a certain medication
• if you are concerned that you may be having a side-effect from a medicine you are taking

Related topics

• pityriasis rosea
• Nobby's piles
• soothe piles and relieve constipation
• piles in pregnancy
• premature birth
• slipped disc