What are steroids?

Steroids are a man-made version of chemicals, known as hormones, that are made naturally in the human body. Steroids are designed to act like these hormones to reduce inflammation.

They’re also known as corticosteroids and are different from anabolic steroids used by bodybuilders and athletes.

Steroids won’t cure your condition, but they’re very good at reducing inflammation and will ease symptoms such as swelling, pain, and stiffness.

Usually, inflammation is the body’s natural reaction to infection or bacteria. Your immune system produces extra fluid to fight infections or bacteria, which causes swelling, redness, and heat in the affected area. You might have noticed this if you have had a cut or wound on your skin.

In some conditions, such as rheumatoid arthritis, the immune system produces inflammation in the joints or other parts of the body by mistake, which can cause permanent damage if left untreated. Steroids can be used to reduce this immune reaction.

Uses

Steroids can be taken in a number of ways for many different types of arthritis and related conditions, as shown in the table below.
How is the steroid taken? What does it do?  What conditions is it used for? What is a common name for this type?
By mouth – tablets, liquids, dissolvable tablets, also known as oral steroids Reduces inflammation throughout the whole body. Rheumatoid arthritis, lupus, gout, other types of inflammatory arthritis or autoimmune conditions. prednisolone, betamethasone, dexamethasone
By injection – into a joint, muscle, the blood or spinal area Reduces inflammation in the area of the body where the injection is given. Rheumatoid arthritis, lupus, gout, other types of inflammatory arthritis or autoimmune conditions. methylprednisolone, triamcinolone,

hydrocortisone

By eye – as drops or ointments Reduces inflammation in the eyes. Uveitis prednisolone
Applied to the skin as a cream or gel, also known as topical steroids Reduces inflammation on the skin. Psoriatic arthritis and psoriasis. hydrocortisone, mometasone, betamethasone,

clobetasol

Steroids are usually only given for a short time to quickly treat flare-ups of your condition. Depending on which condition you have and what dose you’re prescribed, you may notice an improvement in your symptoms within a few days.

This page is about steroids that can be taken as tablets, liquids, creams and eye drops and ointments. Information about steroid injections is covered on a different page.

Are there any reasons why I won’t be prescribed steroids?

You might not be able to start steroids if you have an infection, or if you have any wounds on your body, as steroids might delay these getting better or cover up some of your symptoms.

Steroids might affect some medical conditions, such as diabetes, heart or blood pressure problems, or mental health issues. If you have any of these conditions, the person treating you will need to make sure the steroids aren’t making the condition worse.

If you have systemic sclerosis, prednisolone could cause problems with your kidneys at certain doses, so you might not be able to take this type of steroid.

You won’t be able to have steroid creams or gels if you have an infection that affects your skin. Some other skin problems, such as rosacea, acne and ulcers, can be made worse by steroid creams so you might not be able to take them if you have any of these conditions.

If you normally wear contact lenses, you might need to avoid wearing these while having treatment with steroid eye drops.

How are they taken?

Steroids are taken in different ways, and the dosage may vary depending on the condition you have. The table below gives an idea of how often you might need to take steroids.

You should always take medication as prescribed by the person treating you.

Tablets, liquids and soluble tablets

  • Usually once a day.
  • Preferably in the morning.
  • Either with or after food to prevent stomach problems.

Creams and gels

  • Usually once or twice a day for a few weeks.
  • Your doctor might suggest taking them less often but for a longer period.
  • Should only be used on affected areas of the skin.

Eye drops and ointments

  • May need to be taken regularly throughout the day.
  • Usually one drop in each eye each time you take it.

You will be given the lowest possible dose for the shortest possible time, to reduce the risk of side effects. Your dose will probably be reduced gradually as your symptoms improve, or your doctor might suggest a weaker medication.

It’s important that you don’t stop taking steroids without speaking to the person treating you first.

If you’ve taken steroid tablets for more than a few days, they can cause side effects known as withdrawal symptoms if you stop suddenly. You might be given a small dose, known as a maintenance dose, for a long time to make sure your symptoms don’t return.

Side-effects and risks

As with all medicines, some people will have side effects. These are more likely if you’re on a high dose or if you’re taking steroids for a long time.

The person treating you will make sure you’re on the lowest possible dose to keep your condition under control. You might also be given a drug called a proton pump inhibitor or another medicine to protect your stomach.

Some of the side effects of steroids are shown below:

Tablets, liquids and soluble tablets 

  • weight gain and increased appetite
  • stomach pains, indigestion or heartburn
  • sleep problems
  • changes in mood
  • bruising easily
  • thinning of the skin
  • stretch marks.

Creams and gels

  • stinging or burning where the cream has been applied
  • changes in skin colour
  • thinning of the skin
  • stretch marks
  • increased hair growth where the cream has been applied.

Eye drops and ointments

  • stinging or burning in eyes after putting drops in
  • a funny taste in the mouth after putting drops in.

Treatment with steroids may cause changes in mood – you may feel very high or very low. This may be more common in people with a previous history of mood disturbance. If you’re worried about this, talk to the person who is prescribing your steroids about it.

Taking steroid tablets for a long time can make you more likely to get infections. If you feel feverish or unwell, or develop any new symptoms after starting steroids, it’s important to tell your doctor or rheumatology nurse.

See your doctor or the person treating you straight away if you develop chickenpox, shingles or measles, or if you come into contact with someone who has any of these illnesses. Sometimes these diseases can be severe in people who are taking steroids, and you might need to have other treatment before you start to get better.

Steroids taken for a long time can also cause your muscles to become weaker, and they might occasionally affect periods in women.

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