(BPT) - Asthma, allergies and eczema are more common than you may think. More than 28.2 million people in the U.S. have asthma. About one in three adults and one in four children live with allergies. And almost 6% of adults and more than 10% of children have eczema. These conditions can significantly impact daily activities and quality of life.
When symptoms get worse, doctors may prescribe oral corticosteroids (OCS). If you're prescribed OCS to treat severe flare-ups of these or related conditions, make sure to have an open conversation with your doctor about these medications. Learn how OCS can get symptoms under control. Ask about the risk of potential side effects.
1. What are OCS?
Oral corticosteroids are human-made steroid medications modeled after cortisol, a natural hormone produced by the adrenal glands. These pills or liquid medications are used to quickly reduce inflammation. Examples of OCS include:
prednisone
prednisolone
methylprednisolone
dexamethasone
OCS are inexpensive, fast-acting drugs. They are typically prescribed in a short course, or burst, of three to five days. That is often all it takes for OCS to provide relief from symptoms.
OCS differ from inhaled corticosteroids (ICS) and topical corticosteroids. ICS, delivered through an inhaler or nebulizer, act directly on the lungs and airways as a daily controller medication for asthma. Topical corticosteroids, on the other hand, are applied to the skin to treat localized inflammation from eczema.
OCS are also different from anabolic steroids, which are related to the male hormone testosterone and sometimes used for muscle building.
2. What are OCS prescribed for?
OCS are powerful anti-inflammatory medications used to treat a wide range of medical conditions. They are mostly prescribed to manage flare-ups of respiratory and allergic conditions, such as asthma, chronic obstructive pulmonary disease (COPD), allergic rhinitis, nasal polyps and sinusitis. They are sometimes used to treat severe flare-ups of skin conditions such as eczema, chronic hives or psoriasis.
In addition, OCS are used to treat autoimmune diseases like arthritis, lupus and inflammatory bowel disease.
3. What are the benefits of OCS?
OCS can quickly reduce inflammation and swelling in various body systems, including the airways and skin. They can provide relief and effectively stop symptoms from worsening.
This is why OCS are prescribed for severe asthma symptoms, nasal inflammation, and eczema flares, among other conditions. They are not usually prescribed for long-term daily management or control of symptoms.
4. What are the potential side effects of short-term OCS use?
OCS can quickly treat flare-ups, but they can cause serious side effects. That's why doctors prescribe them in short courses of three to five days – to minimize the risk and impact of side effects.
Weight gain, particularly in the abdomen, face or neck
Eye problems
Muscle weakness
Insomnia and sleep problems
High blood pressure
Elevated blood sugar levels
Swelling in lower legs
Gastrointestinal issues (heartburn, nausea)
Mood changes and irritability
Depression and anxiety
5. What are the potential side effects of long-term OCS use?
In rare cases, doctors prescribe OCS for long-term use when inflammation is severe, and the benefits outweigh the risks and side effects.
Long-term use can lead to the following side effects:
Skin thinning and easy bruising
Osteoporosis and bone loss or weakness
High blood pressure and cardiovascular risks
Diabetes onset
Slow growth in children
Immune system suppression and increased infection risk
Adrenal gland suppression and hormonal imbalance
Glaucoma and cataracts
6. What is OCS overuse?
Oral corticosteroids have a high rate of success in treating flare-ups. As a result, some people may develop a reliance on them for treatment. They may want to continue taking OCS to keep their condition under control.
OCS overuse is defined as when you take the medication at a dose or duration that increases the risk of adverse effects without a clear benefit.
The overuse may occur when you:
take more than 2 courses or bursts of OCS per year, especially for asthma symptoms;
take OCS daily or regularly for more than 3 months, particularly at high doses.
How much is too much? This is a conversation you should have with your doctor to decide what's best for your medical condition.
7. How to prevent OCS overuse?
If you are prescribed two or more courses of oral corticosteroids per year, this is a sign that your condition is not well-controlled. You may need to adjust your treatment plan instead of continuing to rely on OCS.
Talk with your doctor – preferably a specialist such as an allergist or dermatologist – to discuss treatment options. Ask about advanced treatments such as biologics to help keep your symptoms in check.
