Corticosteroids are medications used to lower inflammation in the body or reduce immune system activity. They are synthetic steroids that work similarly to cortisol, a hormone naturally produced by the adrenal glands.

These medications have strong anti-inflammatory and immunosuppressive effects. For this reason, corticosteroids may be recommended for health conditions such as rheumatoid arthritis, asthma, chronic obstructive pulmonary disease, irritable bowel syndrome, dermatitis, hives, severe allergic reactions, or anaphylactic reactions.

Corticosteroids should only be used when prescribed by a doctor, with regular appointments to monitor treatment and check for side effects. These medications should not be stopped suddenly without medical guidance, especially when used in high doses or for a long time, as the dose usually needs to be reduced gradually.

What are corticosteroids

Corticosteroids are medications that mimic the effects of hormones naturally produced by the adrenal glands, which are located above the kidneys.

They help reduce inflammation, regulate immune system activity, and control certain functions in the body.

Corticosteroids are divided into two main groups: glucocorticoids, which primarily reduce inflammation and regulate immune responses, and mineralocorticoids, which help control blood pressure and the balance of water and minerals in the body.

What they are used for

Corticosteroids are recommended for the treatment of inflammatory, allergic, or autoimmune diseases, such as:

Asthma, allergic rhinitis, nasal polyps, or sinusitis;
Dermatitis, hives, psoriasis, lichen planus, or vitiligo;
Eczema, impetigo, pemphigus;
Systemic and discoid lupus erythematosus or multiple sclerosis;
Rheumatoid arthritis, osteoarthritis, or ankylosing spondylitis;
Bursitis, tenosynovitis, or myositis;
Conjunctivitis or keratitis;
Ulcerative colitis or Crohn’s disease;
Organ transplant.

In addition, corticosteroids may be used for autoimmune hemolytic anemia, thrombocytopenia, idiopathic thrombocytopenic purpura, brain swelling, sarcoidosis, thyroiditis, severe COVID-19, Stevens-Johnson syndrome, or shingles.

Corticosteroids may also be used in cancer treatment, such as multiple myeloma, mycosis fungoides, leukemias, or lymphomas.

Other uses include treating allergic or anaphylactic reactions to medications, foods, or insect stings, for example, or serum sickness.

Types of corticosteroids and examples

There are several types of corticosteroids. The type used depends on the condition being treated and may include:

1. Inhaled corticosteroids

Inhaled corticosteroids, also known as inhalers, reduce inflammation in the lungs. They are usually recommended for the treatment of asthma, chronic obstructive pulmonary disease, and other respiratory allergies.

Inhaled corticosteroids should be used every day, as directed by a doctor. It is important to rinse the mouth or brush the teeth right after inhaling the medication. In addition, the inhaler should be cleaned with a soft brush to remove medication residue.

Examples of inhaled corticosteroids: fluticasone, budesonide, and beclomethasone.

2. Topical corticosteroids (cream)

Topical corticosteroids are dermatologic creams, ointments, gels, or lotions. They are usually recommended by a doctor to treat allergic reactions or skin conditions, such as seborrheic dermatitis, atopic dermatitis, hives, or eczema, for example.

Examples of topical corticosteroids: hydrocortisone, betamethasone, mometasone, flurandrenolide, and dexamethasone.

3. Oral corticosteroids

Oral corticosteroids may be found as tablets, syrups, or oral solutions. They are commonly recommended to treat several endocrine, bone, muscle, rheumatic, collagen, skin, allergic, eye, respiratory, blood, or cancer-related diseases, for example.

Examples of oral corticosteroids: prednisone and prednisolone.

4. Corticosteroid nasal sprays

Corticosteroid nasal sprays are used to treat rhinitis and severe nasal congestion. They help relieve an itchy nose, a stuffy nose, constant sneezing, and symptoms such as excessive tearing and eye redness.

These nasal sprays should be applied directly inside the nostrils. The type of corticosteroid, dose, and length of treatment should be recommended by a doctor.

Examples of corticosteroid nasal sprays: fluticasone or mometasone.

5. Injectable corticosteroids

Injectable corticosteroids are recommended to treat musculoskeletal disorders, allergic and skin conditions, collagen diseases, palliative treatment of malignant tumors, and allergic or anaphylactic reactions to medications, foods, or insect stings, for example.

Examples of injectable corticosteroids: dexamethasone and hydrocortisone.

6. Corticosteroid eye drops

Corticosteroid eye drops may be recommended to treat eye problems, such as conjunctivitis or uveitis. They help reduce inflammation, irritation, and redness in the eye.

The type of corticosteroid eye drops used depends on the condition being treated. These medications should only be used as recommended by an ophthalmologist.

Examples of corticosteroid eye drops: prednisolone or dexamethasone.

What do corticosteroids do

Corticosteroids primarily help reduce inflammation and control the immune system's response. They work by decreasing the production of substances that cause inflammation, helping relieve symptoms such as swelling, redness, pain, and irritation.

These medications also reduce excessive immune system activity, making them useful for treating conditions such as asthma, severe allergies, rheumatoid arthritis, and lupus.

In addition, corticosteroids can affect metabolism, blood sugar levels, and the body's balance of water and minerals. These effects depend on the type of corticosteroid, dosage, and duration of treatment.

Although corticosteroids are effective for managing inflammation and certain immune-related conditions, prolonged use or high doses can increase the risk of side effects, such as high blood sugar, weight gain, and infections.

Possible side effects

Side effects from corticosteroids are more common when a person uses them for a long time and may include:

Tiredness and insomnia;
Increased blood sugar levels;
Changes in the immune system, which may lower the body’s ability to fight infections;
Agitation and nervousness;
Increased appetite, stomach ulcer, or indigestion;
Inflammation of the pancreas and esophagus;
Local allergic reactions;
Cataracts, increased pressure inside the eye, and bulging eyes.

In addition, corticosteroids may cause acne, stretch marks, high blood pressure, or bone fragility.

Do corticosteroids cause weight gain?

Yes, corticosteroids can cause weight gain, especially when taken orally, such as prednisone or dexamethasone, at high doses or for long periods. However, not everyone experiences this side effect.

Weight gain can occur because corticosteroids increase appetite, promote fluid retention, and change how the body stores fat. This may lead to increased fat accumulation around the abdomen, face, and upper back.

The risk of weight gain depends on the type of corticosteroid, dosage, and duration of treatment. Inhaled and topical corticosteroids are generally less likely to cause weight gain when used as prescribed.

To help manage weight gain during treatment, it is important to maintain a balanced diet, limit excess salt intake, and exercise regularly, as recommended by a doctor.

Glucocorticoids vs. corticosteroids

The main difference between glucocorticoids and corticosteroids is that glucocorticoids are one type of corticosteroid. Corticosteroids are a group of steroid hormones that include glucocorticoids and mineralocorticoids, which have different functions in the body.

Glucocorticoids, such as prednisone and dexamethasone, help reduce inflammation and control immune system activity. They are commonly used to treat conditions such as asthma, allergies, and autoimmune diseases.

Mineralocorticoids, such as aldosterone, help regulate blood pressure and the balance of water and minerals, including sodium and potassium, in the body.

Therefore, all glucocorticoids are corticosteroids, but not all corticosteroids are glucocorticoids. The type prescribed depends on the condition being treated and the effects needed.

Who should not use them

Corticosteroids are contraindicated in people with hypersensitivity to the medication or to any other ingredient in the formula.

They are also contraindicated in people with systemic fungal infections or uncontrolled infections.

In addition, corticosteroids should be used with caution in people with high blood pressure, heart failure, kidney failure, osteoporosis, epilepsy, gastroduodenal ulcer, diabetes, glaucoma, obesity, or psychosis. In these cases, they should only be used under medical guidance.

Safety during pregnancy

The use of corticosteroids during pregnancy is not recommended, as it may put the baby or mother at risk. Therefore, corticosteroids should only be used to treat diseases during pregnancy under the guidance of an obstetrician and when the benefits for the woman outweigh the potential risks to the baby.

Corticosteroids: What are, Uses, Types & Side Effects