Steroids

Steroids, also called corticosteroids, are anti-inflammatory medicines used to treat a range of conditions. They are a man-made version of hormones normally produced by the adrenal glands found above the kidneys. When taken in doses higher than the amount your body normally produces, steroids reduce redness and swelling (inflammation).

As well as acne, steroids can be used to treat a wide range of conditions, including asthma, hay fever, eczema, arthritis and sciatica.

Steroids, including systemic, oral or topical, can be used successfully in the treatment of acneSteroids are only prescribed for patients who are suffering from severe inflammatory acne, where clogged pores have become infected with bacteria and have turned into pimples (papules, pustules) or cysts. A short course of steroids will reduce the amount of inflamed lesions and has the ability to take control of severe inflammatory acne very quickly.

For large inflammatory lesions an injection steroid called cortisone may be given. This treatment is best administered in the early stages of the inflammation process to reduce inflammation and clear lesions.

Oral steroids are usually given alongside oral antibiotics or isotretinoin (used for the treatment of moderate to severe acne – see notes below).

These types of steroids are also known as corticosteroids, glucocorticoids or cortisones and work in the same way as natural cortisol, a hormone your body releases when you’re under stress. Corticosteroid medicines control inflammatory responses and suppress inflammation in the skin.

Systemic steroids are synthetic derivatives of cortisol, and include tablets, syrups ad liquids (prednisone), injections (methylprednisolone), inhalers and nasal sprays (beclomethasone) and creams, lotions and gels (hydrocortisone).

Natural cortisol regulates various aspects of the body, including:

  • your body’s response to stress or danger
  • increase your body’s metabolism of glucose
  • control your blood pressure
  • reduce inflammation

Natural cortisol regulates various aspects of the body, including:

  • your body’s response to stress or danger
  • increase your body’s metabolism of glucose
  • control your blood pressure
  • reduce inflammation

Your doctor/dermatologist will advise you on the best course of treatment for your acne symptoms.

If your doctor/dermatologist has prescribed steroid treatment then regular monitoring of your body weight, blood pressure and blood sugar levels will be required.

Topical corticosteroids should not be applied to areas of the skin not affected by acne including acne rosacea. They should not be used during pregnancy/breast feeding unless your doctor feels it appropriate.

When the time is right your doctor/dermatologist will prepare a programme to gradually wean you off steroid treatments – do not stop taking them suddenly. Any side effects will usually pass once you finish the treatment.

Side effects of steroids

Taking steroid tablets for less than three weeks is unlikely to cause any significant side effects. However, you may get some side effects if you need to take them for longer or at a high dose.

Steroids don't tend to cause significant side effects if they're taken for a short time or at a low dose. Sometimes they can cause unpleasant side effects, such as an increased appetite, mood changes and difficulty sleeping. This is most common with steroid tablets.

Taking steroid tablets can cause:

  • indigestion or heartburn
  • increased appetite, which could lead to weight gain
  • difficulty sleeping and changes in mood and behaviour, such as feeling irritable or anxious
  • an increased risk of infections – especially chickenpox, shingles and measles
  • high blood sugar or diabetes and high blood pressure
  • weakening of the bones (osteoporosis)
  • Cushing's syndrome – symptoms such as thin skin that bruises easily, stretch marks on the thighs and fat deposits in the face
  • eye conditions, such as glaucoma and cataracts
  • mental health problems, such as depression or suicidal thoughts

Caution when taking Isotretinoin

Isotretinoin gel can make your skin sensitive to sunlight. For safety, stay out of bright sun and use a high factor sun cream even on cloudy days

If you're a woman, it's really important not to become pregnant while using isotretinoin gel and for at least 1 month after stopping. Isotretinoin can harm an unborn baby.

If you become pregnant during treatment with isotretinoin gel, stop using it and talk to your doctor straight away.

Don't breastfeed while you're using isotretinoin gel. This medicine can get into breast milk and harm your baby.

Sources used in writing this article are available on request

Information contained in this Articles page has been written by talkhealth based on available medical evidence. Our evidence-based articles are certified by the Information Standard and our sources are available on request. The content is not, though, written by medical professionals and should never be considered a substitute for medical advice. You should always seek medical advice before changing your treatment routine. talkhealth does not endorse any specific products, brands, or treatments.

Information written by the talkhealth team

Last revised: 18 March 2018

Next review: 18 March 2021