What My Doctor Never Told Me About Corticosteroids

One day I should write a book about having psoriasis. This condition has been a part of my life for 56 years. Though within that time, there has always been something new to try - including corticosteroids. I have been taking corticosteroids on and off for over 40 years. The mention of side effects never came up.

Choosing corticosteroids for psoriasis treatment

Those of us with psoriasis should be familiar with the term corticosteroids. It’s the main active ingredient in our topical creams and oral medication. The natural hormone cortisol a steroid that is produced by our body's adrenal glands. They sit above our kidneys in response to stress.

Corticosteroids reduce inflammation in our bodies by suppressing our immune system. This mistakenly attacks healthy tissues. They can be administered using different methods such as creams, oral tablets or injected.

What my corticosteroids treatment journey has looked like

I’ve mainly been prescribed four types of topical treatments over the years. There was always a chart in my doctor’s office illustrating the potency across all the available options for plaque psoriasis.

Betamethasone

This was mostly used on my scalp and came as a cream. Betnovate is a stronger version and was used when my skin wouldn’t respond to weaker corticosteroids. I can remember years ago feeling my own skin for the first time after using Betnovate. My scalp was covered in plaque psoriasis and this was a very personal moment for me.

Vizomet and dermasone

These creams were prescribed to me to help with redness, itching, inflammation, and any swelling on my skin. My dermatologist prescribed Dermasone to be used for thicker lesions. He would switch to Vizomet once the lesions had thinned out.

Daivobet

This ointment had betamethasone dipropionate in it along with vitamin D. It suppresses overactive skin cells and is very potent. As far as ranking, it was very high on my doctor’s chart. I was told to use this when the plaques started spreading quickly and not to used it on my face.

What I've learned about corticosteroids and psoriasis

I came across a video by chance on YouTube about steroid withdrawal syndrome. It was talking about the side effects of prolonged steroid usage and consumption. My ears perked up because it said to pay attention if you have been using these creams or ointments daily for more than a year.

The video stated long-term use could be harmful to the body. You should never abruptly stop your prescribed medication. Your adrenal glands need time to adjust back to secreting normal amounts of cortisol for your body’s needs.

What the side effects of corticosteroids look like

Some symptoms may vary across individuals. It typically takes between 4 to 6 weeks for your system to completely flush out all the steroids. This depends on how frequent and long you were on the medication. Pacing yourself is very important. I had never heard this before.

Potential side effects of corticosteroids include:

• High blood pressure
• Thinning bones and skin
• Severe fatigue
• Nausea and vomiting
• Muscle weakness and abdominal pain
• Weight gain and weight loss
• Loss of appetite and diabetes
• Confusion and mood swings

If you are concerned about any of these, you can consult your doctor to get a better understanding of what you’re putting in your body. It is your right to know.

Do you use corticosteroids as a part of your psoriasis treatment plan?

I do believe that corticosteroids can benefit us. Discuss with your doctor about long term side effects. Doctors should monitor us and try to avoid risks to our health. Be your own best advocate!