Steroid Side Effects: What Do You Need to Know Before Taking Steroids

With proven effectiveness and wide-ranged applications, steroids, or corticosteroid, have become one of the commonly used drugs by many medical professionals. However, rumours said that steroids tend to cause serious side effects, such as obesity, ‘moon face (swelling face)’, acne and sleep problems. In this article, Cigna Smart Health will introduce the principles, applications and side effects of steroids in depth.

What Are Steroids?

The adrenal glands of the human body secrete a certain amount of steroid hormones every day. When the body is under extreme conditions (such as shock, severe infections and injuries), the glands produce steroids to make stress and immune response and control inflammation to maintain one’s health.

Steroids are an artificial version of chemicals, known as hormones, made naturally in the human body. Corticosteroids are designed to act like these hormones to reduce inflammation by regulating the immune system (many diseases are developed from inflammation).

Types of Steroids

There are three types of steroids.

Types of Steroid Agents	Applications	What Conditions Is It Used For?
Oral	tablets, dissolvable tablets and liquids	Rheumatoid arthritis, lupus, gout, other types of inflammatory arthritis or autoimmune conditions.
Topical	Eye drops, ointments, nasal spray and cream	Improve respiratory system conditions, relieve allergy and control asthma
Injection	Inject into a joint, muscle, blood or spinal area Intravenous injection	Muscle or joint conditions,reduce pain and inflammation Immune system related diseases such as lupus erythematosus

What Is A Pulse Steroid Therapy?

Pulse Steroid Therapy is a concept with a high daily dose of intravenous steroids over a short span of time (usually 3 continuous days). It is designed to treat long-term severe autoimmune disease such as:

• Lupus erythematosus that oral medications cannot control
• Rheumatoid arthritis
• Polymyositis and dermatomyositis
• Ankylosing spondylitis

During the therapy, patients’ blood pressure and heartbeat need to be monitored. Possible side effects include increased blood pressure, weight gain, increased striae formation, and hypokalemia.

If you are doubtful about pulse steroid therapy or need to receive this treatment, Cigna’s Care Managers, staffed by passionate registered nurses possessing proven clinical experience of handling complex situations, are standing by to provide you with suitable assistance and monitor your conditions during the course of treatments.

Uses of Steroids

As mentioned above, steroids are used to reduce pain and inflammation. Common clinical applications of steroids are listed as followed:

1. Endocrine dyscrasia: E.g. adrenal glands dysfunction
2. Rheumatism: E.g. rheumatic arthritis, ankylosing spondylitis and spondylitis
3. Allergic disease: E.g. allergic rhinitis, Dermatitis or asthma
4. Gastrointestinal disorder: E.g. gastroenteritis and ulcerative colitis
5. Haematological disease: E.g. Hemolytic Anaemia, Idiopathic Thrombocytopenic Purpura
6. Dermatomycosis: E.g. psoriasis and seborrheic dermatitis
7. Autoimmune Diseases: E.g. nephrotic syndrome, transplant rejection and lupus erythematosus

Side Effects of Steroids

Although steroids are effective in improving the conditions above, they could cause serious side effects. In Hong Kong, steroids are categorised as prescription-only medicine. Your doctors would evaluate the risk and effectiveness before any prescription. It is not recommended to purchase the drugs without a prescription.

The side effects of corticosteroid vary among people. Some even do not experience any effects after application. Side effects become more prominent with higher doses and prolonged treatments. Generally, the side effects of oral steroids are more significant than the other types.

Here are some possible side effects brought by steroids:

• Acne
• Blurred Vision
• Cataract or glaucoma
• Easy bruising
• Difficulty sleeping
• High blood pressure
• Increased appetite, weight gain
• Increased growth of body hair
• Insomnia
• Lower resistance to infection
• Muscle weakness
• Nervousness, restlessness
• Osteoporosis
• Stomach irritation or bleeding
• Sudden mood swings
• Swollen, puffy face
• Water retention, swelling
• Worsening of diabetes

In rare cases (especially by injection), the following side effects may be observed:

• Infection
• anaphylaxis
• Hemarthrosis
• disinsertion
• Color change of skin
• Bone, ligament and tendon weakness (due to a repeated injection over one area)

How Long Do Steroid Side Effects Go Away?

The side effects of steroids are temporary and mild, diminishing along with the reduction in dosage. In general, only prolonged use of steroids yields serious side effects. The steroid metabolites do not accumulate in the human body and go away by excretion.

How to Minimize the Steroid Side Effects?

Please consult your doctor and understand the side effects when taking any types of steroids. Below are some precautions that you may need to take note of.

• Do not stop taking or change the dosage as required
• Inform other medical staff that you are using steroid when necessary
• Consult your doctor before vaccination as serious complications may develop
• Visit your doctor if you experience side effects
• Take oral steroids with or after a meal (as per your doctor’s instructions)

You could also reduce the side effects by changing your lifestyle.

• Avoid interacting with varicella, herpes zoster or measles patients.
• Lower your calorie intake and exercise more to prevent weight gain.
• Strengthen your muscles and mitigate the risk of osteoporosis by exercising.
• Quit smoking and drinking.
• Wash your hands more often and wear a surgical mask in public areas to prevent infection.
• Under certain circumstances, you may need to take calcium, vitamin D or other supplements to prevent bone loss.

Where Can You Purchase Steroids?

Steroids are prescription-only drugs. Please consult your doctors regarding the details and costs of treatments.