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Wednesday, April 29, 2020

Do inhaled Steroids Damage Airways

Your question.  "I have a question about how steroids effect the lining of the lungs long term (by using steroidal inhalers. When steroid creams are used on the skin, over time the skin becomes thinner, is there any similar effect on the lining of the lungs?"

My answer.  Great question.  Corticosteroids have been around since the 1950s. They have been used for a variety of reasons due to the fact they decrease inflammation and therefore benefit many of our modern diseases. Corticosteroid creams can be used to reduce inflammation and itching and redness of the skin. When this is done it is directly applied to the skin with salves and lotions. In a similar way, systemic corticosteroids (like prednisone) reduce inflammation inside your body. This helps reduce airway inflammation so you can obtain good asthma control. Both corticosteroid creams and systemic steroids must be used short-term only due to risk of long-term side effects, such as thinning skin as you mention.

Inhaled corticosteroids are a different story. Because they are applied directly to the airways, a very, very, very low dose is needed. This low dose is sprinkled on airways. Using them every day has shown to reduce airway inflammation to control asthma. They have now been used for the treatment of asthma since the 1960s. So, they have been extensively studied for nearly 70 years. it has been determined there is a sight risk for side effects, although these are are considered negligible and treatable when they do occur. You can see this by the articles in this link: (https://asthma.net/?s=corticosteroid%2C+side+effect). The impact of this very low dose of ICS on your airways has also been extensively studied. It has been determined that ICS do not cause thinning of airway tissue. 

Sorry for the long answer, but I thought it would be beneficial to show it in perspective. As always, the side effects of any medicine are aways weighted against the risk of potential side effects. Poor asthma control can have a definite negative impact on the quality of your life. So, researchers, for over 50 years now, have recommended ICS as a safe and effective treatment for asthma. 

Does that answer your question

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