Side effects

In acute therapy, no side effects are to be expected even at high, systemic doses of cortisone. In long-term systemic therapy (high doses for at least three months) with cortisone a thinning of the skin (atrophy) is to be expected. Wound healing disorders may occur, which means that wounds take longer to heal.

In addition, the effect on the electrolyte balance of the body can lead to high blood pressure and water retention. Increased excretion of calcium can lead to the storage of calcium in the kidneys, resulting in kidney dysfunction. It can also lead to growth disorders in the bones and to obesity.

Diabetes can also develop. One of the most important side effects is the weakening of the immune system and the associated increase in infectious diseases. Inhaled cortisones, for example in the form of a spray or inhaler, can lead to a local reduction in the immune defence system affecting the mouth and throat area and thus promote local infections.

A typical example is a so-called oral thrush, i.e. an infestation of the oral mucosa by yeast fungi. Hoarseness can also occur in the long term due to its effect on the vocal cord muscles. This can be prevented by rinsing the mouth with water after each spray of cortisone.

It is especially important not to forget to rinse out babies and children. Alternatively, a drink can be taken after administration of the medicine. Cortisone in creams or ointments can rarely cause local thinning of the skin (atrophy) and only with long-term therapy.

This is also known as cigarette-paper or parchment skin. The areas at risk here are the face, skin folds and areas around the genitals and anus. The lowest possible level of cortisone should always be used in these areas.

Why should I – if my paediatrician recommends it – give my child cortisone?

Cortisone is an extremely effective, well researched and important drug. Side effects usually only occur during long-term therapy. For many diseases, however, cortisone is the only effective therapy that can bring about an improvement in symptoms and prevent secondary damage.

The aim of treatment with cortisone is always to enable children to lead as unrestricted a life as possible and also to prevent permanent damage, for example by remodelling lung tissue. Cortisone can also help to contain an initial inflammatory reaction in such a way that the body’s own healing mechanisms can subsequently take over again. To make all this possible, the administration of cortisone is indispensable, if recommended. Alternative drugs are usually accompanied by stronger side effects, especially in children.

What can I do to alleviate the side effects?

The side effects of cortisone therapy are usually very minor. Only long-term therapy leads to relevant side effects. These can be kept to a minimum by following the prescribing doctor’s instructions exactly.

If you are in any doubt, you should always ask precisely. Ask for regular check-up appointments to check whether any side effects occur, whether they need to be treated and, above all, whether further cortisone therapy is necessary. Cortisone should only be used for what it has been expressly prescribed for.

For example, you should not simply use the cortisone cream of an older or younger sibling. Use creams only in the prescribed areas. Especially in the face and in the genital and anal areas, cortisone should be used very carefully and in small doses, as side effects are more common here.

After using a cortisone spray, the mouth must be rinsed out to prevent side effects. Alternatively, something can be drunk after each use. In the case of systemic therapy (tablets or suppositories) the cortisone should be given in the morning if possible. This corresponds most closely to the natural fluctuations of the body’s own cortisone.