The revelation that the Irish Medicines Board has issued a warning about the unauthorised marketing of powerful steroid creams is a source of serious medical concern and a worry for those who may have used these products.
Steroids are among the most powerful drugs available. They are used orally and intravenously to treat seriously ill people with conditions such as asthma, severe allergic reactions and inflamatory conditions of the body including inflamatory bowel disease and rheumatoid arthritis.
With such powerful benefits, it is no surprise that steroids also have potentially serious side effects.
They cause the skin and bones to thin out, changes that are irreversible. Weight gain occurs quite rapidly, with the face and abdomen showing most change. High blood pressure and water retention may occur.
Prolonged use of steroids can also bring on diabetes. They also have a mood-altering effect and cause an increase in acid secretion in the stomach. Cataracts are another side effect following prolonged use.
All these side effects occur with prolonged usage of medium to high doses of oral steroids.
No doctor will prescribe such doses over a prolonged period without careful monitoring and the prescription of medication to help prevent side effects.
What about the side effects of steroids used on the skin? Generally speaking, the side effects are not as severe. However, skin-thinning is common with prolonged use, leading to stretch marks. Blood vessels will show under the skin's surface, and these will burst, leading to bruising in older people.
Children are specially at risk. Their developing bodies can be affected by growth retardation, as potent steroid is absorbed through the skin and into the blood stream. The artificially circulating steroid sends a conflicting message to the pituitary gland in the brain, which then switches off some hormones which promote growth and development.
The risk of side effects from topical steroid use runs parallel with the strength of the steroid, the duration of therapy and, to a lesser extent, depends on whether the cream is left exposed or occluded under a bandage. The face and genitalia will absorb more steroid than other areas.
Fluocinonide and Betamethasone are potent steroids found by the Irish Medicines Board in the products marketed by the Cherryfield Herbal Company. Clobetesol is a moderately potent steroid present in some of the company's products.
Potent steroid use should be limited to a few weeks and is usually followed by the prescription of a milder steroid so as to wean the patient off the drug. Only mild and occasionally moderately potent steroids should be used in children, for treatments generally limited to five days.
What should you do if you or your child has been using these products?
Do not abruptly cease treatment, especially if you have been using the product for a prolonged period of time.
Go and see your GP within the next 48 hours for a medical assessment.
Bring any remaining cream with you to the doctor.
Think carefully about using unprescribed creams or medication without full knowledge of the active ingredients.