Corticosteroid Safety: Potential Side Effects
As helpful as they are, corticosteroids for psoriasis do come with a lot of baggage in the form of side effects.
Your health care provider can help you weigh the risks versus benefits for your individual needs.
Side effects are dependent on the potency of steroid being used low potency, medium potency, high potency, highest potency as well as the site of application, explained Robert J. Michocki, PharmD, a professor in the department of pharmacy practice and science at the University of Maryland.
Possible side effects include:
Resistance to treatment. Steroid treatments that work initially may lose their effectiveness over time as your body develops a resistance to them.
Skin damage. Topical corticosteroids can wreak havoc on your skin. An ultrasonographically detectable decrease in skin thickness can occur after a single application of a very potent topical steroid.
Thinning of skin, loss of elasticity resulting in stretch marks, easy bruising, and dilated surface blood vessels are potential risks associated with steroid use.
These side effects can occur even when low-potency topical steroids are used. Skin changes that are mild typically reverse when you stop using steroids, but more visible changes in skin texture can be permanent.
Adverse Effects Of Biologic Drugs
More common side effects include:
Long-term methotrexate treatment can lead to:
- liver damage
- changes to red and white blood cell production
A doctor should inform a person who is receiving psoriasis injections about the possible side effects and their symptoms. Anyone who experiences new or worsening symptoms after taking a drug should contact their doctor.
There are several different types of psoriasis, and they may need different approaches.
When prescribing a treatment a doctor will consider:
- the psoriasis type
- how severe the symptoms are
Whats Psoriasis Again Lets Recap
Psoriasis is a chronic condition that causes red, stinging patches or bumps on your arms, legs, and even your scalp. When you have this disease, your skin cells turn over faster than they should, leading to a buildup of cells on your body’s surface that turn into those inflamed, scaly spots.
At first glance, it looks like a skin issue. And while thats true, experts say it starts on a deeper levelin your immune system. An overactive immune system, along with a genetic predisposition for psoriasis, and at least one other factor such as infection, obesity, or smoking are thought to be the driving forces behind the condition.
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Psoriasis: Oral Medications And Injections
Topical treatment alone doesnt always help enough in people with moderate to severe psoriasis. Then medications that have an effect throughout the entire body are considered. They can be taken as tablets or injected. Because of the possible side effects, it is a good idea to be well informed about their pros and cons.
Mild plaque psoriasis can usually be effectively treated with topical medications. Additional treatment may be needed for moderate to severe psoriasis. UV light therapy is often tried first. If that doesn’t help either, oral medications and injections are considered. This is called “systemic treatment” because the medicines enter the bloodstream and have an effect throughout the entire body . The treatment typically begins with one of these drugs:
- Methotrexate
- Fumaric acid esters
- Ciclosporin
- Less common: Acitretin
If these medications don’t provide enough relief for psoriasis or are unsuitable for some other reason, treatment with biological treatments is possible. This group of drugs manufactured using biotechnology includes:
- Adalimumab
- Infliximab
- Ixekizumab
Another option is apremilast . It belongs to a separate class of drugs.
Dealing With These Conditions Can Be Difficult Enough Without The Added Stress Of Losing Your Hair Luckily Any Loss Is Usually Temporary Heres How To Safeguard Your Strands
If youre one of the roughly 2 percent of Americans who have psoriasis, a chronic condition that typically causes raised, red patches of skin topped with silvery scales, theres a good chance that it has impacted your scalp. This also holds true for the more than 40 percent of people with psoriasis who also have psoriatic arthritis , a form of arthritis that can appear in combination with psoriasis.
Psoriasis causes skin cells to divide about 10 times faster than normal. The excess cells pile up on the surface of the skin, causing scaly patches of itchy, dry skin. Known as plaques, these lesions often itch, burn, and sting.
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How Psoriasis And Psoriatic Arthritis Affect The Scalp
For many patients, the scalp is the only part of the body where psoriasis occurs or its the first location where the autoimmune disease develops.
Research shows that at least a quarter of people with plaque psoriasis, the most common type of psoriasis, initially present with lesions on the scalp.
Its very common for psoriasis to affect the scalp statistics show a range of 40 percent to 80 percent of people with psoriasis have scalp involvement, says Mount Kisco, New York, dermatologist David Bank, MD, who is also an assistant clinical professor of dermatology at Columbia Presbyterian Medical Center in New York City. It may occur in isolation or with psoriasis in other areas.
Scalp psoriasis can run the gamut from mild to severe .
Sometimes, in addition to the scalp, plaques also cover nearby areas such as the forehead, back of the neck, and the skin around the ears.
Tips For Good Reviews
- Only rate drugs or treatments you’ve tried.
- In your description, mention the brand, dose, and period of time that you used the drug or treatment.
- Please share your positive and negative experiences with the drug, and compare it with other treatments you have used.
- Do not include any personal information or links in your review.
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Are There Any Major Differences In Side Effects With Systemic Treatments Compared With Topical Treatments
Systemic treatments have potential side effects for the entire body, including a risk of infections or cancer. Certain medications may cause nausea or skin reactions at the site of injection.
Topical treatments are associated with side effects in the specific treated areas. These side effects include thinning of the skin, stretch marks, dilated blood vessels, and pimples.
What Is Systemic Treatment For Psoriasis
You may have heard your provider talk about systemic psoriasis treatment, as opposed to treating with topicals or light therapy. Systemic therapy means that the treatment gets where it needs to go through systemic circulation throughout the body, as opposed to putting a cream or a light directly on the affected area. In the case of psoriasis treatment, systemic therapies include oral treatments, injectables, and IV infusions, according to the National Psoriasis Foundation.4
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Treatment Of Psoriasis: An Algorithm
ASHA G. PARDASANI, M.D., STEVEN R. FELDMAN, M.D., PH.D., and ADELE R. CLARK, P.A.-C., Wake Forest University School of Medicine, Winston-Salem, North Carolina
Am Fam Physician. 2000 Feb 1 61:725-733.
See related patient information handout on psoriasis, written by the authors of this article.
Psoriasis is characterized by red, thickened plaques with a silvery scale. The lesions vary in size and degree of inflammation. Psoriasis is categorized as localized or generalized, based on the severity of the disease and its overall impact on the patient’s quality of life and well-being. Patient education about the disease and the treatment options is important. Medical treatment for localized psoriasis begins with a combination of topical corticosteroids and coal tar or calcipotriene. For lesions that are difficult to control with initial therapy, anthralin or tazarotene may be tried. The primary goal of therapy is to maintain control of the lesions. Cure is seldom achieved. If control becomes difficult or if psoriasis is generalized, the patient may benefit from phototherapy, systemic therapy and referral to a physician who specializes in the treatment of psoriasis.
How Do You Use Cosentyx
Cosentyx comes in three forms, all of which are given as an injection under your skin:
- liquid solution in a single-use Sensoready pen
- liquid solution in a single-use prefilled syringe
- powder in a single-use vial thats mixed into a liquid solution
Your doctor can help determine which form of the drug is the best fit for you.
For the pen or syringe form, you may receive your first dose at your doctors office so they can show you how to inject the drug. After that, youll likely give yourself injections at home.
If you use the powder form, you wont use Cosentyx at home. This form of Cosentyx is only given by a healthcare professional at your doctors office, in a clinic, or in your home.
If youre using Cosentyx at home, you should take your dose out of the refrigerator about 15 to 30 minutes before your injection. You can inject your medication into:
- the front of your upper legs
- your upper outer arms
- your lower abdomen , but not within 2 inches of your belly button
Do not inject Cosentyx into tender or bruised skin, or skin that is red or discolored, scaly, or hard from psoriasis plaques . You should rotate the sites you use for each injection.
For helpful videos with step-by-step instructions and tips on how to use the prefilled syringe and the Sensoready pen, visit the manufacturer website. If you still have questions about how to inject Cosentyx, talk with your doctor or pharmacist.
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Are There Lifestyle Changes Or Complementary Therapies That May Help
Psoriasis is associated with metabolic syndrome, including heart disease and diabetes. Eating a well-balanced diet that is rich in fresh fish, colorful fruit, and green leafy vegetables provides the body with the vitamins and nutrients it needs to function at its best.
A low fat diet is important for people who have high cholesterol. A diet low in sugary food benefits people who have diabetes or prediabetes. Doctors may recommend weight loss for people who have overweight or obesity.
Finally, smoking is a known factor that can worsen psoriasis. It is especially important for people with psoriasis to quit smoking.
Before And During Treatment
Because systemic treatment affects the entire body, there is a higher risk of serious side effects. So it’s a good idea to find out about the advantages and disadvantages of the different medications before deciding on a treatment. That includes talking with your doctor about any possible reasons why you shouldn’t take them like interactions with other medications or treatments.
Most of the medicines used for psoriasis also affect your immune system. So, before and during the treatment, certain blood tests are done on a regular basis to detect possible harmful effects such as serious infections, or problems with your liver or kidneys, as early as possible.
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Side Effects Of Biologics
The most common side effects of getting a biologic are irritation and soreness around the injection site. But, like any medication that alters the way your immune system works, you will be more vulnerable to pathogens while taking a biologic. In practice, for most patients, that amounts to about one more cold per year, Dr. Cheng says.
But its a risk thats worth talking over carefully with your doctor. Theyll likely want to make sure youre up-to-date on all of your vaccinations before starting the biologic, Dr. Lipner says. Not only does being on a biologic increase your risk for new infections, but in some cases it also increases the risk that latent illnesses in your body might reappear, especially tuberculosis. So, if you show any reactivity to tuberculosis in particular, youll need to be treated for that before starting the medication, Dr. Lipner explains.
Once you’re on the biologic, you’ll have to be careful to avoid live vaccines, like the MMR vaccine, Dr. Cheng says. Attenuated , like the flu shot, are safe and recommended, though. The one exception is the nasal flu vaccine, which is a live vaccine, Dr. Cheng explains.
While there are possible side effects of psoriasis medication, having a detailed discussion with your provider about your symptoms, your health history, and your quality of life can help you find the right fit for you.
Rated For Psoriasis Report
UTIs were frequent, other side effects.Took humira 14 months for ” very mild psoriasis ” which I never had found out later it was triggered by propranolol. I quit humira because of UTI after 14 months and shouldn’t have been on it anyway. Poor Dermatologist prescribed as first line treatment. Crazy
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When Will I Start Seeing Results
Patients taking HUMIRA see clearer skin in as little as 4 months.
In clinical trials, most adults taking HUMIRA were clear or almost clear, and many saw 75% and even 90% skin clearance in just 4 months. Your results may vary.
HUMIRA is not right for everyone. Only your doctor can decide if HUMIRA is right for you.
What Is Plaque Psoriasis
Plaque psoriasis is an autoimmune condition that causes thick plaques on your skin that are red or discolored. These patches may be painful or itchy and may have white buildup in them.
Plaque psoriasis can affect any part of your body, but it commonly occurs on your knees, elbows, and scalp. Its believed that psoriasis may be caused by an overactive immune system, which causes inflammation in your body. This may lead to the symptoms of plaque psoriasis.
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Steroid Creams Or Ointments
Steroid creams or ointments are commonly used to treat mild to moderate psoriasis in most areas of the body. The treatment works by reducing inflammation. This slows the production of skin cells and reduces itching.
Topical corticosteroids range in strength from mild to very strong. Only use them when recommended by your doctor.
Stronger topical corticosteroids can be prescribed by your doctor and should only be used on small areas of skin or on particularly thick patches. Overusing topical corticosteroids can lead to skin thinning.
Ask Your Doctor About Tremfya And Download The Patient Brochure To Learn More
TREMFYA® safety
Ask your doctor about the benefits and risks of TREMFYA®. Prescription medications, including TREMFYA®, have possible risks involved with treatment, so its important to discuss them with your doctor.
What is the most important information I should know about TREMFYA®?
TREMFYA may cause serious side effects, including:
- Serious allergic reactions. Stop using TREMFYA and get emergency medical help right away if you develop any of the following symptoms of a serious allergic reaction:
- fainting, dizziness, feeling lightheaded
- swelling of your face, eyelids, lips, mouth, tongue or throat
- trouble breathing or throat tightness
- chest tightness
- skin rash, hives
- itching
Tell your healthcare provider right away if you have an infection or have symptoms of an infection, including:
- fever, sweats, or chills
- blood in your phlegm
- muscle aches
- warm, red, or painful skin or sores on your body different from your psoriasis
- weight loss
- burning when you urinate or urinating more often than normal
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Before Using This Medicine
You should not use Cosentyx if you are allergic to secukinumab.
Tell your doctor if you’ve had or been exposed to tuberculosis, or if you recently traveled. Some infections are more common in certain parts of the world, and you may have been exposed during travel.
To make sure you can safely use Cosentyx, tell your doctor if you have ever had:
-
an active or chronic infection
-
an allergy to latex or
-
if you currently have signs of infection such as fever, sweats, chills, muscle pain, cough, shortness of breath, cough with bloody mucus, weight loss, skin sores, stomach pain, diarrhea, or painful urination.
Make sure you are current on all vaccines before you start using Cosentyx.
Tell your doctor if you are pregnant or breastfeeding.
Who Can Take Biosimilars
All biologics, including biosmilars, are typically prescribed for people with more advanced disease, including individuals with moderate-to-severe psoriasis and active PsA. But each of the three approved biosimilars are indicated for different groups within this population.
You should not take biosimilars if:
- Your immune system is significantly compromised
- You have an active infection
Screening for tuberculosis or other infectious diseases is required before starting treatment with all biologics, including biosimilars.
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Tablets Capsules And Injections
If your psoriasis is severe or other treatments have not worked, you may be prescribed systemic treatments by a specialist. Systemic treatments work throughout the entire body.
These medications can be very effective in treating psoriasis, but they all have potentially serious side effects. All the systemic treatments for psoriasis have benefits and risks. Before starting treatment, talk to your doctor about your treatment options and any risks associated with them.
If you’re planning for a baby, become pregnant or are thinking of breastfeeding, you should also speak to your doctor first before taking any new medicine to check it’s suitable for use during pregnancy or breastfeeding.
There are 2 main types of systemic treatment, called non-biological and biological .