Corticosteroids over the counter topical

I thank Dr. Scott Garrison for his thoughtful comments. Statistics are not my thing so am not able to provide a sense of absolute risk.
I do think that the large cohort study by Dr. Feng-Chen Kao provides compelling evidence for the association of systemic corticosteroid use with both fracture-related arthroplasty and fracture-unrelated surgery. In a group of 21,995 users matched 1:1 with non-users followed over 12 years, the hazard ratio (HR) was double for steroid users over non-users.
The HR increased with increased steroid dosage, particularly in those with fracture-unrelated arthropathy. The adjusted HR increased from (95% CI, –) in the low-dose subgroup, (95% CI, –) in intermediate-dose users, to (95% CI, –) in the high-dose counterpart (Ptrend<).
I think the most important point is that systemic corticosteroids are not a substitute for topical corticosteroids. They are a potent, broad-spectrum immunosuppressive agent and need to be prescribed with the same cautions you would use with any other immunosuppressive agent.
Topical corticosteroids are potent immunosuppressants but with normal use, rarely cause systemic symptoms. Our skin is an excellent barrier.
I remember seeing a sixteen-year-old girl who had been prescribed clobetasol cream to treat her atopic dermatitis. It cleared her disease. However, she continued to apply it to her skin every morning after her shower to prevent the eczema from coming back.
She continued the daily treatment for a year. By that time, she had developed severe striae over her arms and legs. She was assessed by an endocrinologist and had no evidence of adrenal suppression.

Oral and injectable systemic corticosterois are steroid hormones prescribed to decrease inflammation in diseases and conditions such as arthritis (rheumatoid arthritis, for example), ulcerative colitis, Crohn's disease, asthma, bronchitis, some skin rashes, and allergic or inflammatory conditions that involve the nose and eyes. Examples of systemic corticosteroids include hydrocortisone (Cortef), cortisone, prednisone (Prednisone Intensol), prednisolone (Orapred, Prelone), and methylprednisolone (Medrol, Depo-Medrol, Solu-Medrol). Some of the side effects of systemic corticosteroids are swelling of the legs, hypertension, headache, easy bruising, facial hair growth, diabetes, cataracts, and puffiness of the face.

Corticosteroids, including prednisone, are a class of powerful drugs that reduce inflammation and suppress the immune system. They are prescribed for a wide variety of conditions, including rheumatoid arthritis (RA) and lupus, as well as multiple sclerosis, some types of cancer, asthma and skin rashes – including those caused by poison ivy. They can be prescribed short-term – until a rash clears up or until another drug can take effect, for example – or they may be used long-term. Corticosteroids come in skin creams, injections and inhaled forms; however, this study examined only people who took them orally.

I received a steroid injection in my left wrist area for severe pain in September of 2013. It is now December 2014, and I have severe subcutaneous atrophy. The skin in that area is pink/red and is VERY SENSITIVE. I can’t wear long sleeve shirts or jewelry on my wrist. I visited several hand specialists who inform me that the atrophy is permanent and that this is the most severe atrophy they have seen due to a steroid injection. My life is forever changed…. Every day I experience a new sensation in my wrist and hand: burning, zings, and aches. In addition to having to look at an atrophied wrist/forearm that continuously needs babied as any grazing results in severe pain and bruising similar to an elderly person on coumarin. You state in your article that “cutaneous atrophy normalizes.” Is this true? Do I have ANY chance of gaining some SQ tissue to protect my normally petite wrist?? I am desperate to find someone who can help with my SQ atrophy as it’s making my life miserable. Thank you

Corticosteroids over the counter topical

corticosteroids over the counter topical

I received a steroid injection in my left wrist area for severe pain in September of 2013. It is now December 2014, and I have severe subcutaneous atrophy. The skin in that area is pink/red and is VERY SENSITIVE. I can’t wear long sleeve shirts or jewelry on my wrist. I visited several hand specialists who inform me that the atrophy is permanent and that this is the most severe atrophy they have seen due to a steroid injection. My life is forever changed…. Every day I experience a new sensation in my wrist and hand: burning, zings, and aches. In addition to having to look at an atrophied wrist/forearm that continuously needs babied as any grazing results in severe pain and bruising similar to an elderly person on coumarin. You state in your article that “cutaneous atrophy normalizes.” Is this true? Do I have ANY chance of gaining some SQ tissue to protect my normally petite wrist?? I am desperate to find someone who can help with my SQ atrophy as it’s making my life miserable. Thank you

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