Topical steroids

My dermatologist prescribed me a topical steroid for some skin issues I am having. I plan on calling my surgeons office tomorrow to see if they think it's okay to take.

I was just curious what other's have been told on using these. Is it safe, would I also need to take a PPI?

Thanks!

Is it a steroid, or an NSAID? NSAIDS are not safe, no matter how you take them. They are systemic, and can affect your stomach and intestines just as much as an oral NSAID. Its not worth the risk.

Steroids have their own issues, but are safer.

I use topical steroids as needed. They are safer than NSAIDS, but still csn cause systematic isdues, not necessary related to pouch, but hormonal balance. Use as little as possible and works.

Thank you!

I use a topical steroid cream and have had no problems. Now my initial skin problem has cleared up, I'm down to once or twice a week for maintenance.

There are no NSAIDS in the cream I use.

I confirmed it is a steroid with no NSAIDS.

I was also able to speak with my Surgeon's office this morning and they said that it was fine to use.

That said, they do very few RNY's so I like to make sure the info they give is aligned with what others have been told.

Thanks for weighing in!

The British Medical Journal* published a systematic review and meta-analysis of the literature in 2013 to determine whether oral steroids increased the risk of gastrointestinal bleeding or perforation. The study found that oral steroids increase the risk by 40%, but the results were significant only for hospitalized patients.

I wasn't able to locate any articles evaluating the risks of gastrointestinal bleeding or perforation from topical steroids. However, some assumptions can be made based on the pharmacokinetics and the pharmacodynamics of oral and topical steroids:

1. A greater amount of a steroid will be absorbed systemically when it's administered orally rather than topically.
2. Some of a topically-applied steroid will be absorbed systemically and can produce effects and side effects throughout the body.
3. The more potent the topical steroid is, the more effects and side effects it will produce systemically.
4. Broken skin or applying an occlusive dressing over skin where a topical steroid was applied will increase the amount of topical steroid that is absorbed systemically.

Overall, the amount of topical steroid applied to the skin that is absorbed systemically is lower than the amount of oral steroid that is absorbed systemically. Since in ambulatory patients, orally-administered steroids do not significantly increase the risk of gastrointestinal bleeding or perforation, it is highly unlikely that in outpatients, topical steroids will increase the risk of gastrointestinal bleeding or perforation.

---Joyce

http://dx.doi.org/10.1136/bmjopen-2013-004587

*Narum S, Westergren T, Klemp M: Corticosteroids and risk of gastrointestinal bleeding: A systematic review and meta-analysis; BMJ Open; 2014; 4:e004587