Many of us will be prescribed steroid medications in our lifetime to help manage a range of conditions from asthma to eczema. These medications are often very effective in relieving symptoms, and can even be lifesaving.
However, like all drugs, steroid medications can have a number of negative side effects that you should be aware of when considering your treatment plan.
Kiri Yanchenko, founder of AMPERNA® became acutely aware of the negative side effects steroid medications can have when she was incorrectly diagnosed and prescribed them to treat her skin conditions.
She had recently developed a severe case of pustular acne that was so painful she could not sleep at night. She then developed perioral dermatitis, a common facial irritation that manifests as spots and flaky skin around the mouth and chin.
Kiri searched for treatment options and in her search, she was prescribed a topical steroid. Instead of helping her condition, which she later discovered was triggered by a fluoride and latex allergy, it made her skin a lot worse.
The side effect was her perioral dermatitis spread and resulted in sore, pimply, flaky and inflamed skin covering the bottom of her face.
What are Steroid Medications?
Your body naturally produces steroid hormones to help it fight stress, injury and disease.
Steroid medications (corticosteroids) are anti-inflammatory drugs and have a similar effect to the hormones produced by the body.
These medications are often prescribed to help manage asthma, arthritis and skin conditions such as dermatitis, eczema and acne.
Steroid medications on the market include methylprednisolone, cortisone, hydrocortisone, prednisolone, prednisone and dexamethasone. They can be administered in a range of ways: orally, with an inhaler, by injection, as drops for eyes or ears or as a cream applied topically to the skin.
Topical Steroids for Skin Conditions & Their Potential Side Effects
For over 50 years, dermatologists have been effectively treating eczema and atopic dermatitis with topical steroids. These medications are often recommended when traditional skin care regimens fail i.e.
- Regular use of moisturisers
- Using anti-bacterial controls
- Eliminating possible food allergies/intolerances
- Eradicating environmental allergens such as dust mites, plant pollens or animal fur
- Addressing irritation from soaps, fabrics, detergents or other chemicals
Whilst the use of topical steroids can certainly help skin conditions, for some people like Kiri, there can also be serious side effects.
Topical steroid addiction/withdrawal, sometimes referred to as ‘red skin syndrome’, can occur when frequently using or misusing moderate to high potency corticosteroids then stopping.
The condition can manifest in two ways:
- Within days to weeks after stopping the use of topical steroids
- A worsening rash that requires stronger and more frequent application of topical steroids to control.
There are two types of rashes that may develop:
- Red, swollen, scaly and peeling
- Red, pus-filled bumps without scaling or peeling.
The skin may be burning, stinging or itchy, and you may experience facial hot flashes.
The treatments available for this side effect are:
- Discontinuing the steroid
- Using other medications (such as antihistamines or antibiotics)
- Using methods to soothe the symptoms i.e. cool compresses
- Changing your skin care routine
There has not been a lot of media attention on this subject and no large-scale quantifiable study, but research does suggest that adult women who blush easily are most at risk, whilst very few cases have been reported in children.
Based on the available research, the recommendation given is to “continue vigilance and adhere to a safe, long-term treatment plan developed in conjunction with your dermatology provider”.
Please be aware that Elidel and Tacrolimus are classed as immunosuppressants. Immunosuppressants suppress your immune response to an issue, so it is still possible to rebound from these creams. Please read about the FDA's Black-box warning for these medications HERE.
Topical Steroid Withdrawal (TSW) Period
Withdrawal symptoms include swelling, redness, burning, and skin sensitivity and these start usually within 1-2 weeks of stopping the steroid. TSW can last for as long as you have been using the steroid for or, in the case of years of steroid misuse, even longer.
Holistic Skin Regimes to Consider
If faced with the prospect of topical steroids for your skin condition, you may also want to consider a variety of traditional/holistic approaches.
Kiri discovered it took a combination of health & wellness measures to help her acne and perioral dermatitis. She changed her diet, took supplements, exercised, used de-stress techniques and developed a tailored skincare range.
When it comes to eczema, Eczema Association Australasia suggests a number of options to consider as part of a holistic approach:
- Keep fingernails short to prevent scratching from breaking the skin and wear cotton mitts or gloves at night
- Wearing 100 per cent cotton or soft fabrics – avoiding rough, scratchy fibres and tight clothing
- Using rubber gloves with cotton liners
- Having lukewarm baths and showers
- Using hypoallergenic products and avoiding anything artificially perfumed
- Gently patting, not rubbing, the skin dry with a soft towel
- Applying a moisturizer within three minutes after bathing to “lock in” the moisture
- Avoiding rapid changes of temperature and activities that raise a sweat
- Reducing dust mites
- Using sensitive skin washing powders and detergents
- Reducing daily stress
- Learning your eczema triggers and how to avoid them
- Developing and maintaining a daily skin routine
For perioral dermatitis, The American Academy of Dermatology recommends ceasing topical steroids but cautions the rash can worsen before it gets better (this is steroid withdrawal). In addition, they advocate for a change in your skin care routine: “Skin care can play an important role in treating this rash. You may need to switch to a mild, artificial fragrance-free cleanser and be very gentle when you wash your face. You may need to use artificial fragrance-free skin care products.”
As part of your skin care routine, Kiri developed AMPERNA® to help people with their holistic approach.
The AMPERNA® range is suitable for all skin types and has been tested on eczema, perioral dermatitis, rosacea, acne prone skin and more. AMPERNA® is an Australian owned, ethical skincare brand, dedicated to creating revolutionary and unique formulas to help rebalance and transform the appearance of skin.
Go to https://amperna.com/ for more information.
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. If symptoms persist, we recommend that you see your GP or dermatologist.