There is some evidence that sun exposure can accelerate steroid-induced skin atrophy, the development of which can be limited by protecting the skin, particularly the face and arms, from the sun. Daily use of a broad-spectrum sunscreen (UVB and UVA block) and appropriate protective clothing is recommended. 10 , 12 - 14 Patients on corticosteroids should also be encouraged to regularly use moisturisers on their arms and legs, as these may reduce bruising and tearing of the skin from minor trauma. 11 Evidence suggests that topical tretinoin can increase the epidermal thickness of sun-damaged atrophic skin, but long-term use may be necessary. 14 In dermatological practice, topical retinoids are used to help reverse skin atrophy caused by sun exposure or corticosteroid use.
In the end, many factors go into choosing among the inhaled steroids, some based on known differences between the medications, some based on personal preferences. The same is true when choosing among the anti-hypertensive medications used to treat high blood pressure. Often it is necessary to try one of the medications: if it is works well, causes few or no side effects, is convenient and not excessively expensive, you are likely to continue with it. If it fails to meet one or more of these criteria, you and your doctor now have the "luxury" of other preparations to try until you find the one best for you.
The common side effects of inhaled corticosteroids are hoarse voice, sore throat, and a mild throat infection called thrush (yeast infection). Sore throat and thrush are commonly caused by poor puffer technique. Show your healthcare provider how you use your puffer. Rinsing out your mouth with water after every dose of inhaled corticosteroids will also help reduce these side effects. If you are using a pressurized MDI (pMDI) inhaled steroid, then doctors recommend the use of a spacer device , especially for children. A spacer slows down the delivery of the aerosol droplets that carry the medicine, making delivery even better targeted to get into the airways. Remember, spacers should not be used with dry-powered devices such as the DISKUS® or Turbuhaler®.