Short-Term and Long-Term Side Effects of Systemic Steroids

Most are minor but others can be severe—and even permanent

Steroids, like prednisone, can have side effects, such as a flushed, red face. As topical creams or ointments, these medications can relieve redness, itching, and irritation of eczema and other skin disorders.

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Steroids that are taken by mouth or injected are used for treating a wide range of diseases by working systemically, affecting the entire body. The conditions systemic steroids are typically prescribed for are those associated with inflammation, including autoimmune diseases such as systemic lupus erythematosus and rheumatoid arthritis. Systemic steroids also are taken for treatment of asthma attacks and, on occasion, for managing symptoms of severe hay fever.

Prednisone, which is available as a generic and under the brand names Prednisone Intensol, Deltasone, and Rayos, is a commonly prescribed systemic steroid. And Medrol dose pack (methylprednisolone) is a similar systemic steroid that works differently.

Although these drugs are often necessary and sometimes even life-saving, it's important to keep their potential drawbacks in mind. 

Short-Term Side Effects of Steroids

Most people are prescribed systemic steroids for just a few days at a time, so side effects are usually temporary; most resolve after a few days once the steroids have been stopped. If you are otherwise healthy, the most common side effects you can expect include insomnia, changes in mood or behavior, flushing of your face, an increase in appetite, and short-term weight gain due to increased water retention. 

Certain underlying medical conditions can worsen when you take steroids. For example, your blood sugar levels can increase if you have diabetes mellitus. Similarly, your blood pressure can become elevated if you already have high blood pressure. And if you have glaucoma, taking steroids might increase your eye pressure. You can also retain water if you have congestive heart failure.

Long-Term Side Effects of Steriods

When a systemic steroid is used for a long period of time, or when steroids are taken on multiple occasions, more serious side effects are possible. For this reason, doctors tend to keep both the dose and the duration to a minimum when prescribing steroids.

The risk of certain side effects might be reduced when a steroid is taken every other day rather than daily, even if the total dose winds up being the same. Long-term side effects often go away once you stop taking a steroid, but sometimes they're permanent. 

Side effects of long-term steroid use include:

Regardless of your overall health, it's important that you are closely monitored if you are taking a systemic steroid.

It's also often recommended that anyone who is using a steroid for a long period of time guard against bone loss by taking supplemental calcium and vitamin D. Sometimes a bisphosphonate drug such as Fosamax (alendronate) or Boniva (ibandronate) is prescribed, and bone-mineral density should be measured regularly.

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  1. Excema. Johns Hopkins Medicine website. https://www.hopkinsmedicine.org/health/conditions-and-diseases/eczema. Published date unknown.

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