Adverse effects of Cortisone
Cortisone (corticosteroids) or steroids have been in use for the treatment of various diseases, administered either locally (on skin) or oral tablets or through injections.
Judicial use of cortisone is life saving, however, its routine use may not be
indicated as often as it has been prescribed.
Some of the major conditions where cortisone is routinely used in conventional medicines, whereby the patients may end up with adverse effects, are:
a. Skin diseases: Psoriasis,
Lichen planus, etc.
b. Autoimmune diseases:
Rheumatoid arthritis, etc.
d. Ulcerative colitis,
adverse effects could be listed in brief as under:
Decreased resistance to infections such as coughs and colds
Increase in appetite which may lead to a rapid increase in weight
Flushed, swollen cheeks and stretch marks on the skin, acne (pimples)
Rise in blood pressure
Behavioral problems e.g. temper tantrums or mood changes and/or depression
Steroids in very high doses can cause an increase in blood sugar and fat
Atherosclerosis i.e. "hardening of the arteries"
Slowing of growth rate producing shunted growth
Osteoporosis (bones becoming hollow due to lessening of calcium)
Moon face is a common side effect of cortisone:
Typical swollen face with excessive hair growth on forehead due to cortisone
use. The second photo shows normal face on stopping cortisone, while on
here for more photo of moon-face.)
|A 4 years old child suffering from
Nephrotic Syndrome who developed "moon face" i.e. swelling on the face, due
||1 year 4 months old child suffering from
Nephrotic Syndrome who developed "moon face", due to cortisone.
Some of the adverse effects of cortisone may be
described in detail as under:
Long term effects:
Some adverse effects of cortisone develop over a period of time in people receiving long-term treatment. Cortisone or cortisone acetate taken on a long-term basis can cause many health problems. Some of them are:
Critical adverse effects:
Adverse reactions to cortisone can call for emergency care. Seek immediate medical advice if you experience any of the following when on cortisone therapy.
- Dependency: One of the most important problems with the use of cortisone is that it produces drug dependency. Once cortisone used, it is likely that you may have to use it again, as the disease is likely to relapse on stopping it.
- Rebound effect: Another hurdle with the use of
cortisone in any form is the rebound effect after stopping its use. In most of
the diseases such as psoriasis (local and oral cortisone), vitiligo (local and
oral cortisone), urticaria (oral cortisone), ulcerative colitis (oral
cortisone), nephrotic syndrome (local cortisone), lichen planus (local,
injectible and oral cortisone), etc. it has been observed that patients
receiving cortisone respond well initially. However, either on stopping it or on
long term use, there is either a severe relapse or flare up in the form of a
rebound effect. Such a flare up is often difficult to handle with mild
medicines; as it might require probably higher dose of cortisone. This leads to
a vicious cycle.
- Suppresses immunity: Cortisone is an immunosuppressive medicine. It suppresses and alters the immunity, making one prone to have relapse of the same disease with more intensity.
- Changes in appetite: An increase in appetite and weight gain is seen in many long-term receivers of corticosteroid therapy.
- Generalized swelling in the body: Corticosteroids can cause excess water retention within the body, thus making it swell. Salt and water retention can also lead to high blood pressures and reduced levels of potassium in the blood.
- Faulty fat deposition: There ma be excess fat deposition in the back, face, chest and abdomen.
- Skin changes: The skin becomes very delicate and bruises easily. It may appear very thin in certain areas with patchy discoloration. Wound healing may also take a longer time than usual. Acne and dry skin are other skin conditions commonly seen.
- Repeated infections: Corticosteroids can depress your immune system, thus lowering our body's natural defenses against illnesses. Hence, repeated infections are very common in long-term Corticosteroid therapy.
- Sleep problems: Difficulty in falling asleep (insomnia) is a common side effect.
- Mood changes: Person can either become very irritable, very euphoric or depressed for no understandable reason.
- Eye disorders: Cataract, glaucoma and exophthalmos are known to occur in long-term Corticosteroid treatment.
- Muscle weakness
- Giddiness, Headaches, vertigo
- Gastrointestinal upsets: Stomach ulcers and inflammation of the pancreas (pancreatitis) are common conditions arising from long-term treatment.
- Adrenal suppression: Long-term treatment with Corticosteroids can suppress the natural production of these hormones from the adrenal glands. This particularly occurs when these medications are suddenly stopped or not tapered off properly.
- Diabetes: Long-term use of Corticosteroids can result in increased blood sugar levels.
- Sudden onset of visual disturbances.
- Severe headache, giddiness, imbalance, weakness and rapid heart beat, with or without excessive sweating.
- Any sudden skin eruptions like hives or urticaria. Sudden swelling of the face, lips or hands and feet.
- Difficulty in breathing.
- Black or bloody stools.
More about cortisone:
It is very easy for any physician to get you started treatment with cortisone.
However, it is not easy to stop cortisone! Abuse of cortisone is often a bigger
medical issue than the basic disease itself. Ask your doctor following questions
before you start with the prescription of cortisone:
a. Is this cortisone therapy really
essential at this time?
b. Is it going to cure my disease?
c. How long will I have to take it?
d. What will happen when I will stop
e. What are the likely adverse
f. On discontinuing the use of
cortisone, will my disease relapse? If yes, will I require to use cortisone once
again or I will be able to manage with milder medicine at that time?
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