Corticosteroids, also called glucocorticoids, steroids or "cortisone" are very useful drugs in treating allergic reactions. Corticosteroids work directly in the nucleus of cells, in the pathways participating in the inflammatory response of allergic, thus reducing the allergic reaction. Corticosteroids are used in the following ways:
Local Treatment
- Corticosteroids creams and ointments. Corticosteroids creams and ointments are very helpful to treat some skin conditions including skin allergies, but should only be used to induce remission of flare-ups and not as a chronic treatment. Prolonged use may cause various side effects such as skin thinning, brittle skin with easy subcutaneous bleeding and premature skin aging. Example of corticosteroids ointments are DERMOVATE, ELOCOM, BETACORTEN.
- Corticosteroids nasal spray (for allergic rhinitis, nose allergy) or inhaler (for asthma). Corticosteroids nasal sprays and inhalers are very safe treatments, which can be used indefinitely, as determined by your doctor. Typical doses have negligible absorption into the blood stream and as a result of this the known side effects from systemic treatment (whole-body, in tablets or injections) do not happen with these sprays or inhalers. Adverse effects that may sometimes appear are mouth fungus infections, which happens rarely and especially in asthma patients treated with high doses. Rinsing the mouth with water after inhalation prevents this side effect. With nasal sprays, especially with high doses nose bleeding may happen, which is not dangerous and can be prevented by applying vaseline to the nostrils, by local treatment with an ENT physician or by reducing the spray dose. Examples of corticosteroids nasal spray are FLIXONASE, NASOCORT, STERONASE, AVAMYS. Examples of corticosteroids inhalers are BUDICORT, QVAR, SERETIDE, SYMBICORT (the last two contain also bronchodilators). It is important to note that the full benefit from the use of corticosteroids nasal sprays and inhalers appears a few weeks after starting treatment and therefore the results of treatment should not be judged immediately.
Systemic "whole-body" Treatment.
- Treatment with oral tablets, injections into the muscle or infusion into a vein. Known side effects of corticosteroids used in a systemic fashion are increase in appetite, weight gain, a change in fat distribution, tendency to diabetes, osteoporosis, the typical symptoms described under the title of treatment with steroids cream and more. Having said that, systemic corticosteroids are one of the most important treatments for allergic diseases and we often treat acute situations with them using short courses, with the aim to induce an abatement of the symptoms so that we can soon stop corticosteroids and switch no another medication. Systemic corticosteroid used in such short flares of asthma or in an itchy rash that does not respond to anti-histamine drugs, is justified in most cases and in the risk against benefit balance, usually deviates toward benefit. Of course it is important to make an effort to reduce the use of systemic corticosteroids. An example of oral corticosteroid tablets is PREDNISONE. An example of a corticosteroid injection into the muscle is DIPROSPAN. An example intravenous infusion with corticosteroids are SOLUCORTEF, SOLUMEDROL.