How do steroids work?

Steroids are hormones that are made by the body and they play an important role in our development. There are 5 types of steroids; glucocorticoids, mineralocorticoids, androgens, estrogens and progestogens. These hormones are important in the proper functioning of metabolism, immune system, salt and water balance, sexual organ development and the ability to recover from injury and withstand illness.

Natural steroids are produced by the adrenal glands. The steroids found in topical creams, ointments, injections and oral products are synthesized by the pharmaceutical companies and are called corticosteroids. They mimic the effects of the natural steroids. It is very important to bear in mind, that these externally introduced hormones will work against the naturally produced hormones and there is a conflict between the effects of two sources of the hormone.

Steroids work by affecting the body at the molecular level and they have a profound influence on the production of various proteins, i.e. they either increase production of certain proteins and reduce or stop production of other proteins and at some level, increase or stop cell replication. This is essentially how steroidal products work when used either as topical creams, ointments, cortisone injection or oral pills and capsules.

In the case of inflammatory conditions, steroidal products reduce or stop proliferation of immune cells. The immune system responds to invading pathogens and other threats, by rapidly multiplying various immune cells to deal with the risk to the body. Therefore, the inhibiting ability of the steroids is responsible for the reduction in immune response and this is why steroidal creams and ointments have been very popular with doctors who prescribe them for anything from an eczema rash to minor scrapes and skin inflammation, due to just about anything.

When steroidal products are used over a long period of time, in order for the body to resume to a normal immune response and protect the patients’ body from external threats, it will begin developing other means of promoting immune response and this is why after some time, the patient develops resistance to the steroids effect. Unfortunately, steroidal inhibition of protein production and cellular proliferation is not specific to the immune system and over time the body will use other means to overcome this steroidal inhibition and a new balance develops between the body’s natural steroidal hormonal levels and the externally introduced steroidal levels.

As the effectiveness of the steroidal products begins to decline, the temptation is to increase dosage and for a time, this will provide a remedy to the localised inflammation, but in many instances, those using the product have a more systemic condition and the continual use of steroidal products will ultimately lead to lack of effectiveness. At this point, if the patient stops using the steroidal product, the balance that the body has reached with the externally provided steroid product comes to an abrupt end and the patient will experience a “steroid withdrawal” and this in itself can be very stressful to the patient.

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Today the number of babies and children with eczema and similar dermatological condition is on the rise and current estimates are as high as 25% of babies and children. This is a staggering increase in the diagnosis of new patients. As I mentioned earlier, using steroidal products inhibits the production of various proteins and cell proliferation. So babies and children with developing and evolving immune systems, that are put on steroid products for the treatment of their dermatological conditions, will ultimately have a deleterious effect on their immune system and their development and might influence their health and well being as adults.

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