There is little question that corticosteroids like prednisone have been prescribed promiscuously. They are a quick fix for everything from arthritis and asthma to allergies and rashes. But there is no doubt that prednisone can also be a life saver in critical situations. The question this reader poses is: are poison ivy and prednisone a match made in heaven or a bad romance?
Poison Ivy and Prednisone: A Bad Mix?
Q. I used to take prednisone any time I got poison ivy. Then my endocrinologist told me NEVER to take it for something minor like poison ivy. My rashes were quite severe, but he said the prednisone could cause diabetes. That would be much worse and last much longer.
My husband had a total knee replacement. After several months, he was still having some pain.
Against my wishes, he and the doctor thought a steroid shot would do the trick. The resulting severe case of shingles was no joke. It was much more painful for him than the surgery.
Steroids are dispensed too frequently. They are miraculous but also very dangerous. Everyone should be aware that diabetes and shingles are possible side effects.
Poison Ivy and Prednisone: Sometimes an Essential Response!
A. We agree with your endocrinologist that corticosteroids like prednisone can increase the risk for diabetes when taken for long periods of time. Short exposures, for a week or two, are much less likely to trigger type 2 diabetes.
Such drugs also dampen the immune system. This can lead to a resurgence of the virus (herpes zoster) that causes shingles (Open Forum Infectious Diseases, Sept. 28, 2016).
A bad case of poison ivy is not always a minor problem, though. We have seen people who are severely allergic to poison ivy. This can be an emergency situation. We believe that there are times when a short course of prednisone is absolutely justified.
The Problem with Silos in Medicine:
This story is an example of how silos exist in medicine. Endocrinologists live in a silo that involves a lot of diabetes. They see patients who develop this serious metabolic condition after taking corticosteroids for long periods of time. They perceive prednisone as a risky drug when used too readily.
Dermatologists live in a different silo. They see patients with terrible skin conditions. They know that prednisone can clear up a horrific rash quickly. They may not see the negative consequences of long-term steroid use.
The Slow Taper:
Most doctors prescribe a short course of corticosteroids for serious allergic reactions as a taper. That means a big dose is given for the first day or two and gradually reduced over the next several days or weeks. This gives the body a chance to restart cortisol production on its own.
If you would like to learn more about poison ivy and prednisone and why tapering slowly is so important, here is a link. You will also find out about prednisone side effects at this link:
Prednisone for Poison Ivy | Please Taper Slowly!
Have you ever had poison ivy? The skin reaction can be awful! Doctors prescribe prednisone for poison ivy rashes. It calms contact dermatitis. Side effects?
Share your own poison ivy and prednisone story in the comment section below.
