Lower arm of a 47-year-old female showing skin damage caused by topical<unk>  use Use of<unk> s has numerous side-effects, some of which may be severe: * Severe amebic colitis: Fulminant amebic colitis is associated with high case fatality and can occur in patients infected with the parasite Entamoeba histolytica after exposure to<unk>  medications. * Neuropsychiatric: steroid psychosis, and anxiety, depression. Therapeutic doses may cause a feeling of artificial well-being ("steroid euphoria"). The neuropsychiatric effects are partly mediated by sensitization of the body to the actions of adrenaline. Therapeutically, the bulk of<unk>  dose is given in the morning to mimic the body's diurnal rhythm; if given at night, the feeling of being energized will interfere with sleep. An extensive review is provided by Flores and Gumina. * Cardiovascular:<unk> s can cause sodium retention through a direct action on the kidney, in a manner analogous to the mineralocorticoid aldosterone. This can result in fluid retention and hypertension. * Metabolic:<unk> s cause a movement of body fat to the face and torso, resulting in "moon face", "buffalo hump", and "pot belly" or "beer belly", and cause movement of body fat away from the limbs. This has been termed<unk> -induced lipodystrophy. Due to the diversion of amino-acids to glucose, they are considered anti-anabolic, and long term therapy can cause muscle wasting. * Endocrine: By increasing the production of glucose from amino-acid breakdown and opposing the action of insulin,<unk> s can cause hyperglycemia, insulin resistance and diabetes mellitus. * Skeletal: Steroid-induced osteoporosis may be a side-effect of long-term<unk>  use. Use of inhaled<unk> s among children with asthma may result in decreased height. * Gastro-intestinal: While cases of colitis have been reported,<unk> s are often prescribed when the colitis, although due to suppression of the immune response to pathogens, should be considered only after ruling out infection or microbe/fungal overgrowth in the gastrointestinal tract. While the evidence for<unk> s causing peptic ulceration is relatively poor except for high doses taken for over a month, the majority of doctors still believe this is the case, and would consider protective prophylactic measures. * Eyes: chronic use may predispose to cataract and glaucoma. * Vulnerability to infection: By suppressing immune reactions (which is one of the main reasons for their use in allergies), steroids may cause infections to flare up, notably candidiasis. * Pregnancy:<unk> s have a low but significant teratogenic effect, causing a few birth defects per 1,000 pregnant women treated.<unk> s are therefore contraindicated in pregnancy. * Habituation: Topical steroid addiction (TSA) or red burning skin has been reported in long-term users of topical steroids (users who applied topical steroids to their skin over a period of weeks, months, or years). TSA is characterised by uncontrollable, spreading dermatitis and worsening skin inflammation which requires a stronger topical steroid to get the same result as the first prescription. When topical steroid medication is lost, the skin experiences redness, burning, itching, hot skin, swelling, and/or oozing for a length of time. This is also called 'red skin syndrome' or 'topical steroid withdrawal' (TSW). After the withdrawal period is over the atopic dermatitis can cease or is less severe than it was before. * In children the short term use of steroids by mouth increases the risk of vomiting, behavioral changes, and sleeping problems.
Corticosteroid
Glucocorticoid
Anticorticosteroid
Antiglucocorticoid
Anabolic steroid
Adrenal steroid
Steroid
Nonsteroidal anti-inflammatory drug