If your child has asthma, severe allergies, or even eczema, your pediatrician has probably prescribed a corticosteroid at some point. But what exactly is it, and is long-term use safe for your child?
Corticosteroids are potent anti-inflammatory drugs that resemble cortisol, a hormone naturally produced by the body. Corticosteroids are also often referred to as “steroids,” but they are different from the performance-enhancing drugs that athletes sometimes abuse.
Corticosteroids come in different forms, including inhalers, nasal sprays, injections, tablets, liquid, and topical creams or ointments. Their main use is to reduce inflammation, especially when the body mistakenly triggers inflammation where it shouldn’t exist, such as the kind caused by asthma, allergies, or autoimmune diseases. During an allergic reaction, for example, the body may regard a certain substance as harmful and trigger an inflammatory reaction. Corticosteroids block the chemicals the body uses to start the inflammation process. For allergic skin conditions like eczema, creams or ointments applied directly to the skin can calm an inflamed area. For allergies like hay fever, steroid nose sprays can offer your child much-needed relief.
When treating asthma, a corticosteroid can work in two ways. A systemic corticosteroid, which is an oral medication, travels through your child’s entire system to counteract inflammation. An inhaled corticosteroid targets the inflammation in the lungs directly.
A systemic corticosteroid, usually in the form of an oral pill, liquid, or an intramuscular injection, can be given for a specific period of time, such as a bad asthma attack or allergy. Side effects can be mild (increased appetite or upset stomach) or more severe over time (stomach ulcers or high blood pressure).
An inhaled corticosteroid works by lessening inflammation of the lungs and helps to control and prevent asthma attacks. Because less medicine is given than with a systemic corticosteroid, side effects are less serious but can include yeast infections in the mouth.
Can pregnant women safely use corticosteroids? Generally, yes. In cases where the benefits of treatment are greater than any potential side effects or risks to the fetus—for example, in the case of severe asthma—an oral corticosteroid may be prescribed. Most inhalers, sprays, and injections are also considered safe for breastfeeding mothers. However, these corticosteroids should be used only when the benefits to the mother outweigh the risks to the infant.
Some studies suggest that asthma inhalers could potentially slow a child’s growth during the first year of treatment, but not in the long term. These children eventually reached normal adult heights. Your pediatrician should prescribe the lowest necessary dose to start treatment. By following the correct dosage and by maintaining regular check-ups and monitoring, your child can minimize any potentially negative side effects of a corticosteroid while benefitting from its treatment.
Reviewed by Dr. Sara Connolly, February 2019
- Corticosteroids are strong, anti-inflammatory drugs.
- Corticosteroids can be inhalers, injections, tablets or liquids, and topical creams or ointments.
- Their main purpose is to reduce inflammation.
- Corticosteroids can be safe for treating children, when used properly in the appropriate doses.