Cortisone is a chemical (hormone) made by the human body, and is essential for life. The compounds are widely used in medicine. They control allergies, inflammation, and many disease processes. Cortisone compounds can be applied to the skin in the form of creams, or taken internally. Here we are describing the use of cortisones taken internally, either by mouth or by injection.
When is cortisone taken internally?
The most common internal cortisone treatment is Prednisone, taken by mouth. This medicine acts rapidly and is inexpensive. Most patients are told to take the entire day’s dose of Prednisone in the morning, since this coincides with the body’s own rhythm of cortisone production. If you are being treated for a severe allergic reaction, you may be told to divide the day’s Prednisone into two or more doses.
The amount of Prednisone prescribed for you depends on the severity of your skin problem. The starting dose is an estimate; it may have to be increased or decreased, depending on your response to it. Prompt improvement is important not just to clear your skin, but also to hold down the severity of side effects.
As your skin improves, the dose of prednisone will gradually be decreased. When your skin has cleared, or nearly so, the Prednisone tablets will be stopped. If you’ve been taking the medication for only one or two weeks, it’s safe to stop taking it all at once.
If your skin doesn’t improve promptly, or if you are having trouble with the side effects, make sure you call your dermatologist right away.
Safety concerns of Prednisone
Cortisone has effects on the entire body; those that are not desired are called side effects. When Prednisone is used to treat a skin condition, the purpose is almost always to alleviate pain and suffering and not as a life-saving intervention. If you do not think the side effects are worth the risk, then you should not take internal steroids.
Cortisones are remarkably safe for most people when used for brief periods of several weeks or less. Some people taking them for short periods have no unpleasant side effects; however, disturbances of sleep patterns and increased appetite are common. Others will notice weight gain resulting from fluid retention or changes in mood–usually nervousness, trouble sleeping, and restlessness. Sometimes, there is indigestion. These side effects are usually minor, and disappear after your physician stops the cortisone. If you’re having troublesome side effects, call your doctor.
CAUTION: Internal cortisones increase blood sugar and blood pressure. They may worsen diabetes and hypertension. If you are being treated for diabetes or hypertension, please inform your doctor. Internal cortisones may also worsen or activate peptic ulcers; please tell your doctor if you have ever had a stomach or duodenal ulcer. In order to help prevent an ulcer from forming while on cortisone, one should take Tums three times a day.
Unfortunately, when cortisone is used for many months or years, serious side effects are common. Consequently, doctors use long-term cortisone treatment only when a disease threatens or seriously disturbs a patient’s life.
When cortisones are take daily for long periods of time, the skin can thin and bruise very easily. Daily application of alpha hydroxyacids can help to lessen this side effect.
There have been rare cases of people becoming psychotic (agitated and having hallucinations) or depressed while on short treatments of Prednisone. There also are cases of people developing osteonecrosis of the hip while on short-term Prednisone. This complication can only be treated by total hip replacement (a major operation).
People with glaucoma should not take Prednisone without asking their eye doctor as it can cause glaucoma to occur in people who have never had it before.