Table of ContentsView AllTable of ContentsUsesTopical AllergySystemic AllergyDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Uses
Topical Allergy
Systemic Allergy
Diagnosis
Treatment
Corticosteroids(commonly referred to as steroids) are medications used to treat a wide variety of inflammatory conditions includingallergiesandautoimmune disorders.
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Uses of Steroids
Corticosteroids are commonly used to treat, among other things:
Topical and Inhaled Steroid Allergy
Topical corticosteroids include medications that you rub on your skin and inhaled steroids areintranasal medicationsthat you spray into your nostrils. Reactions to these drugs tend to be mild and are estimated to occur in 0.3% to 4.7% of cases.
If a topical steroid allergy is suspected, it is often difficult to discern whether the rash is related to the drug or is simply a worsening of the underlying condition. Similarly, a reaction to an inhaled corticosteroid could as easily be blamed on the underlying allergy.
Systemic Steroid Allergy
Systemic corticosteroids include both oral and injected formulations. They are considered systemic because they are distributed through the entire body as opposed to localized treatment.
While systemic reactions are rare, they can be life-threatening. Those that develop rapidly are considerably more dangerous. Systemic reactions can develop in one of two ways:
Immediate reactionsmost often occur within an hour of a drug being taken.Symptoms may include hives, facial swelling, respiratory distress, rapid heart rate, confusion, and rapid drop in blood pressure that can lead to death.
Non-immediate reactionsare usually mild and can occur up to 48 hours following the use of an oral or injected drug.Symptoms may include a disseminated (widespread) rash.
There may be significantcross-reactivitybetween corticosteroid drugs. Cross-reactivity occurs when the allergen in one drug is similar to the allergen in another drug.
If You Suspect a Steroid AllergyIf a topical or inhaled agent causes a different type of reaction (such as the appearance of a rash following the use of a decongestant spray) or if your condition worsens or fails to improve with treatment, contact your healthcare provider.If you have an immediate reaction, contact your provider right away.
If You Suspect a Steroid Allergy
If a topical or inhaled agent causes a different type of reaction (such as the appearance of a rash following the use of a decongestant spray) or if your condition worsens or fails to improve with treatment, contact your healthcare provider.If you have an immediate reaction, contact your provider right away.
If a topical or inhaled agent causes a different type of reaction (such as the appearance of a rash following the use of a decongestant spray) or if your condition worsens or fails to improve with treatment, contact your healthcare provider.
If you have an immediate reaction, contact your provider right away.
Diagnosing Steroid Allergies
Diagnosing a topical or inhaled steroid allergy involves allergypatch testing.Commercially available assays, such as the TRUE test, can assess a person’s sensitivity to a wide range of corticosteroid drugs. Patch testing can be tricky, however, since the anti-inflammatory effects of the steroids can sometimes dampen the reaction and lead to a false negative result.
Because there is no FDA-approved skin or blood test to diagnose allergy to systemic steroids, a medically supervised drug challenge (in which a person is given a low dose of the drug to see if they react) may be considered. Allergists may choose to create their own skin tests to perform prior to offering a medically supervised drug challenge.
A positive patch test for budesonide and tixocortol is usually a strong indication of a steroid allergy.
If it is determined that you are allergic to a particular steroid, your healthcare provider may recommend trying a different steroid or desensitization.
When your body’s immune system becomes sensitized to a substance in the medication, it perceives it as a foreign invader and releases chemicals to defend against it.
Desensitization only helps if you are taking the drug every day. Once you stop it you will need to go through desensitization a second time if you need the drug again.
Summary
6 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Chen JY, Yiannias JA, Hall MR, et al.Reevaluating corticosteroid classification models in patient patch testing. JAMA Dermatol. 2022;158(11):1279. doi:10.1001/jamadermatol.2022.3774Vatti R, Ali F, Teuber S, Chang C, Gershwin M.Hypersensitivity Reactions to Corticosteroids.Clin Rev Allergy Immunol. 2013;47(1):26-37. doi:10.1007/s12016-013-8365-zAmerican Academy of Allergy, Asthma, & Immunology.Cross-reactivity defined.Svendsen SV, Mortz CG.The benefit of late patch test readings in corticosteroid allergy. Contact Dermatitis. 2022 Nov;87(5):466-468. doi: 10.1111/cod.14197Foti C, Rigano L, Lionetti N, et al.Investigation of new vehicles to patch test corticosteroids: our experience with ethoxydiglycol to detect contact allergy to hydrocortisone butyrate. J Biol Regul Homeost Agents. 2011;25(4):683-8.American College of Allergy, Asthma, & Immunology.Drug allergies.Additional ReadingTorres, M. and Canto, G. “Hypersensitivity Reactions to Corticosteroids.“Curr Opin Allergy Clin Immunol.2010; 10:273-9. DOI: 10.1097/ACI.0b013e32833b1f34.
6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Chen JY, Yiannias JA, Hall MR, et al.Reevaluating corticosteroid classification models in patient patch testing. JAMA Dermatol. 2022;158(11):1279. doi:10.1001/jamadermatol.2022.3774Vatti R, Ali F, Teuber S, Chang C, Gershwin M.Hypersensitivity Reactions to Corticosteroids.Clin Rev Allergy Immunol. 2013;47(1):26-37. doi:10.1007/s12016-013-8365-zAmerican Academy of Allergy, Asthma, & Immunology.Cross-reactivity defined.Svendsen SV, Mortz CG.The benefit of late patch test readings in corticosteroid allergy. Contact Dermatitis. 2022 Nov;87(5):466-468. doi: 10.1111/cod.14197Foti C, Rigano L, Lionetti N, et al.Investigation of new vehicles to patch test corticosteroids: our experience with ethoxydiglycol to detect contact allergy to hydrocortisone butyrate. J Biol Regul Homeost Agents. 2011;25(4):683-8.American College of Allergy, Asthma, & Immunology.Drug allergies.Additional ReadingTorres, M. and Canto, G. “Hypersensitivity Reactions to Corticosteroids.“Curr Opin Allergy Clin Immunol.2010; 10:273-9. DOI: 10.1097/ACI.0b013e32833b1f34.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Chen JY, Yiannias JA, Hall MR, et al.Reevaluating corticosteroid classification models in patient patch testing. JAMA Dermatol. 2022;158(11):1279. doi:10.1001/jamadermatol.2022.3774Vatti R, Ali F, Teuber S, Chang C, Gershwin M.Hypersensitivity Reactions to Corticosteroids.Clin Rev Allergy Immunol. 2013;47(1):26-37. doi:10.1007/s12016-013-8365-zAmerican Academy of Allergy, Asthma, & Immunology.Cross-reactivity defined.Svendsen SV, Mortz CG.The benefit of late patch test readings in corticosteroid allergy. Contact Dermatitis. 2022 Nov;87(5):466-468. doi: 10.1111/cod.14197Foti C, Rigano L, Lionetti N, et al.Investigation of new vehicles to patch test corticosteroids: our experience with ethoxydiglycol to detect contact allergy to hydrocortisone butyrate. J Biol Regul Homeost Agents. 2011;25(4):683-8.American College of Allergy, Asthma, & Immunology.Drug allergies.
Chen JY, Yiannias JA, Hall MR, et al.Reevaluating corticosteroid classification models in patient patch testing. JAMA Dermatol. 2022;158(11):1279. doi:10.1001/jamadermatol.2022.3774
Vatti R, Ali F, Teuber S, Chang C, Gershwin M.Hypersensitivity Reactions to Corticosteroids.Clin Rev Allergy Immunol. 2013;47(1):26-37. doi:10.1007/s12016-013-8365-z
American Academy of Allergy, Asthma, & Immunology.Cross-reactivity defined.
Svendsen SV, Mortz CG.The benefit of late patch test readings in corticosteroid allergy. Contact Dermatitis. 2022 Nov;87(5):466-468. doi: 10.1111/cod.14197
Foti C, Rigano L, Lionetti N, et al.Investigation of new vehicles to patch test corticosteroids: our experience with ethoxydiglycol to detect contact allergy to hydrocortisone butyrate. J Biol Regul Homeost Agents. 2011;25(4):683-8.
American College of Allergy, Asthma, & Immunology.Drug allergies.
Torres, M. and Canto, G. “Hypersensitivity Reactions to Corticosteroids.“Curr Opin Allergy Clin Immunol.2010; 10:273-9. DOI: 10.1097/ACI.0b013e32833b1f34.
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