Mention “steroids” and most people think of muscle-bound body builders. Anabolic steroids taken to increase strength and muscle growth are derived from testosterone, a male hormone. More about this type of steroid in a future column.

Corticosteroids are another type of steroid altogether. These are used for a wide range of medical problems, including many types of allergies, asthma, all types of arthritis, some types of cancer, ulcerative colitis, Crohn’s disease, autoimmune diseases such as systemic lupus, eczema and psoriasis.

The body naturally makes corticosteroids in the adrenal glands (a pair of small organs located next to the kidneys). Scientists have learned how to make synthetic corticosteroids for use in humans and animals with inflammatory conditions.

Corticosteroids come in many different forms: injectable liquids, tablets, eye drops, eardrops, rectal suppositories, inhaled solutions, ointments, creams and lotions. Some are available over the counter (such as hydrocortisone creams), but most are sold by prescription only.

These types of steroids are designed to reduce inflammation, so they are known as anti-inflammatory drugs. They work by suppressing the immune system to some degree.

Topical corticosteroids come in a vast array of creams, ointments and lotions. These are used to soothe skin irritations by reducing redness, swelling, flaking and itching. They can be used for eczema, psoriasis, diaper rash, poison oak and many other types of itchy skin problems. The brands sold over the counter are generally safe. The higher-potency prescription formulas should be used exactly as prescribed, since they can cause long-term skin damage if used too frequently, too long, or on the delicate skin of the face or genital areas.

Inhaled corticosteroids are given to people with nasal allergies and asthma, in order to reduce inflammation in the nose, sinuses, trachea and lungs. For nasal allergies such as hay fever, corticosteroids are inhaled into the nose. For asthma, they are inhaled through the mouth in order to get the medicine deep into the lungs. Inhaled corticosteroids are not fast acting; they do not offer instant relief of symptoms. Instead, they need to be used every day in order to reduce inflammation and keep allergy or asthma symptoms under control. At high doses, inhaled steroids can be absorbed into the bloodstream and cause side effects, but this risk is usually outweighed by the benefits of avoiding severe asthma attacks which can be life threatening.

Different formulations of corticosteroids can be used in the eyes, ears, mouth and rectum to treat specific problems in those areas. They can also be injected into painful joints. In all cases, some of the medication can be absorbed into the bloodstream, but rarely is the amount enough to suppress the immune system or cause side effects, especially if used correctly for short periods of time.

Oral corticosteroids (taken by mouth) are used to reduce inflammation in serious medical conditions, such as arthritis, autoimmune diseases and some cancers, such as lymphoma and leukemia. In some cases, inhaled medication for asthma is not sufficient to control symptoms, so an oral corticosteroid must be used. Also, severe poison oak reactions will resolve more quickly with oral rather than topical medications. Organ transplant recipients must take oral corticosteroids to suppress the immune system and prevent the body from rejecting the new organ.

These oral corticosteroids (prednisone, methylprednisolone and dexamethasone are some common generic names) work wonderfully to decrease inflammation and pain, but have side effects, especially when used at higher doses for long periods. These side effects include increased susceptibility to infections, weight gain, rounding of the face, diabetes, muscle weakness, trouble sleeping, mood swings, personality changes and osteoporosis.

The “NSAIDs” are non-steroidal anti-inflammatory drugs. Their anti-inflammatory action is similar to steroids, but without the more serious side effects and immune suppression. These can be safer, and are quite useful for pain and swelling due to certain medical problems such as arthritis or acute injuries.

Kathryn B. Brown is a family nurse practitioner with a master’s degree in nursing from OHSU. Is there a health topic you would like to read about? Send ideas to kbbrown@eastoregonian.com.