Corticosteroids (steroids) are medicines that are used to treat many chronic diseases. Corticosteroids are very good at reducing inflammation (swelling) and mucus production in the airways of the lungs. They also help quick-relief medicines work better. The steroids (corticosteroids) used to treat chronic lung diseases are not the same as anabolic steroids, used illegally by some athletes for bodybuilding. Corticosteroids do not affect the liver or cause sterility.

The most common way steroids are prescribed for children is by inhalation. An inhaled steroid is typically prescribed as a long-term-control medicine. This means that it is used every day to maintain control of your child's asthma and prevent symptoms. An inhaled steroid prevents and reduces swelling inside the airways, making them less sensitive. It may also decrease mucus production. An inhaled steroid will not provide quick relief for asthma symptoms.

Your healthcare provider usually will recommend a starting dose to control symptoms but may adjust the dosage of the inhaled steroid based on your child's symptoms, how often the child uses quick-relief medicine to control symptoms, and peak flow measurements. Children with asthma may still need a short burst of oral steroids when they have more severe symptoms.

The most common side effects of inhaled steroids are thrush (a yeast infection of the mouth or throat that causes a white discoloration of the tongue), cough, and hoarseness. Your child should rinse his mouth (and spit out the water) after inhaling the medicine and use a metered-dose inhaler with a spacer to reduce the risk of thrush. When a dose is prescribed that is higher than the normal dose listed in the package insert, or even the normal dose, some systemic side effects may occur. These can include reddening of the cheeks, irritability, and sleep problems. Prolonged use of a higher dose can affect a child's growth. This is the most important side effect in children, and children on inhaled steroids should be followed closely by a physician to check for this side effect. Keep in mind, however, that an inhaled steroid has much less potential for side effects than steroid pills or syrups.

Steroid pills and syrups are very effective at reducing swelling and mucus production in the airways. They also help other quick-relief medication work better. They are often necessary for treating more severe episodes of lung disease.

Many children with asthma periodically require a short-term burst of steroid pills or syrups to decrease the severity of acute attacks and prevent an emergency room visit or hospitalization. A burst may last two to seven days and does not necessarily require a gradually decreasing dosage (this is normally required after people take steroids for more than seven days). Your child may experience a few mild side effects, such as increased appetite, fluid retention, moodiness, sleep disturbances, and stomach upset. These side effects are temporary and typically disappear after the medicine is stopped. Frequent bursts of oral steroids can dramatically slow growth in children. Taking frequent bursts of steroids usually means a child's asthma is out of control and requires significantly more attention to determine the cause and address it.

Some children need extra calcium and vitamin D because of long-term steroid therapy.