Disclaimer [ENGLISH]
If your child has asthma or allergic rhinitis (sometimes called hay fever), your pediatrician may prescribe a corticosteroid, also commonly referred to as a steroid. These medicines are the best available to decrease the swelling and irritation that occurs with asthma and allergies. They are not the same as the anabolic steroids that are used illegally by some athletes to build muscles.
In general, corticosteroids are safe and have few side effects if used as prescribed by your pediatrician. Millions of children have safely taken steroids to help their noses and lungs, some for many years in a row. However, you may still have concerns about steroids.
What are corticosteroids?
They are medicines used to reduce inflammation in the body.
Systemic corticosteroids must go through the body to treat the inflammation.
Inhaled or intranasal corticosteroids go directly to where the inflammation is.
What will be prescribed?
Your pediatrician will decide which is best for your child.
Systemic corticosteroids
May be given for a short period if your child has a bad asthma attack. In some cases, these medicines can save lives.
Your child may take a pill, tablet, or liquid. If your child cannot take the medicine by mouth, it might be given by injection. In the Emergency Department or hospital, these medicines can also be given through a vein.
Inhaled corticosteroids
May be given to prevent or control asthma symptoms.
These medicines are breathed in through an inhaler or nebulizer.
Intranasal corticosteroids
May be given to prevent or control a runny nose and congestion from allergies.
Intranasal corticosteroids work very well in treating allergy symptoms, and your child might not need to take as many other allergy medicines.
These medicines are sprayed into the nose.
Are corticosteroids safe?
In general, corticosteroids are safe and work well if the medicine is taken as recommended by your pediatrician.
There are far fewer side effects with inhaled or intranasal corticosteroids than systemic corticosteroids because much less medicine is given.
Systemic corticosteroids
Side effects can be seen when a child is on this type of steroid for a short period.
Side effects can include:
- behavior change
- increased appetite
- acne
- thrush (a yeast infection in the mouth)
- stomach upset
- trouble sleeping
These all go away when the medicine is stopped.
More serious side effects can happen if this medicine is used often or for longer periods of time.
These side effects might include:
- cataracts (clouding of the lens of the eye)
- weight gain
- worsening of diabetes
- bone thinning
- slowing of growth
- reduced ability to fight off infections
- stomach ulcers
- high blood pressure
Your child’s doctor will try to use as little of this type of medication as possible to decrease the chances of side effects.
Inhaled corticosteroids
Side effects are fewer, less common, and less serious than with systemic corticosteroids.
Side effects may include:
- thrush (a yeast infection in the mouth)
- hoarse voice
You can decrease the chance of side effects by making sure your child uses their steroid inhaler with a spacer (when instructed), and rinses their mouth after each use. Click here to learn more about how to use your child’s inhaler.
Some parents worry these medications will impact their child’s growth. Recent studies have shown some children might have slower growth during the first year of treatment. This is only temporary and these children ultimately grew to reach their expected adult height.
Intranasal corticosteroids
Side effects are not common, but might include:
- irritation of the nose
- feeling that something is “running down the throat”
- Nosebleeds. If this occurs, stop the nose spray for 3 to 5 days and the restart.
To decrease the chance of side effects make sure to use the spray the correct way. Angle the spray towards the outer side of the nose (towards the ear) - it helps to use of the opposite hand.
Remember
Corticosteroids are some of the most powerful medicines available to reduce your child's asthma and allergy symptoms.
Experts agree that the benefits of corticosteroids, when used correctly, are greater than the possible risks.
Your child’s pediatrician will make sure that they are given as safely as possible. If you have any questions or concerns about these medicines, talk with your pediatrician.
This publication was adapted from information from American Academy of Pediatrics Patient Education Materials.
Reviewed by: AR D.O., TT D.O. | 08/2023