What side effects can corticosteroids cause?

Corticosteroids carry a risk of side effects, some of which can cause serious health problems. When you know what side effects are possible, you can take steps to control their impact.

Side effects of oral corticosteroids

Because oral corticosteroids affect your entire body instead of just a particular area, this route of administration is the most likely to cause significant side effects. Side effects depend on the dose of medication you receive and may include:

• Fluid retention, causing swelling in your lower legs
• High blood pressure
• Problems with mood swings, memory, behavior, and other psychological effects, such as confusion or delirium
• Upset stomach
• Weight gain, with fat deposits in your abdomen, your face and the back of your neck

When taking oral corticosteroids longer term, you may experience:

• Elevated pressure in the eyes (glaucoma)
• Clouding of the lens in one or both eyes (cataracts)
• A round face (moon face)
• High blood sugar, which can trigger or worsen diabetes
• Increased risk of infections, especially with common bacterial, viral and fungal microorganisms
• Thinning bones (osteoporosis) and fractures
• Suppressed adrenal gland hormone production that may result in a variety of signs and symptoms, including severe fatigue, loss of appetite, nausea and muscle weakness
• Thin skin, bruising and slower wound healing

Side effects of inhaled corticosteroids

When using an inhaled corticosteroid, some of the drug may deposit in your mouth and throat instead of making it to your lungs. This can cause:

• Fungal infection in the mouth (oral thrush)
• Hoarseness

If you gargle and rinse your mouth with water — don't swallow — after each puff on your corticosteroid inhaler, you may be able to avoid mouth and throat irritation. Some researchers have speculated that inhaled corticosteroid drugs may slow growth rates in children who use them for asthma.

Side effects of topical corticosteroids

Topical corticosteroids can lead to thin skin, red skin lesions and acne.

Side effects of injected corticosteroids

Injected corticosteroids can cause temporary side effects near the site of the injection, including skin thinning, loss of color in the skin, and intense pain — also known as post-injection flare. Other signs and symptoms may include facial flushing, insomnia and high blood sugar. Doctors usually limit corticosteroid injections to three or four a year, depending on each patient's situation.