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Prednisone for Eczema: Dosage and Side Effects

Medically reviewed by Kelsey Stalvey, PharmD
Posted on September 11, 2023

Prednisone is a medication used to treat eczema by quickly reducing inflammation all over your body. If you’re having an eczema flare-up, quick relief sounds appealing. However, when it comes to prednisone, there’s a risk of side effects.

As one MyEczemaTeam member shared, “Prednisone helps with the itching, but it’s a double-edged sword.”

Continue reading to learn more about prednisone, how it can help your eczema symptoms, and what side effects it has.

What Is Prednisone?

Prednisone is in a class of medications called corticosteroids that reduce inflammation. Medications in this class may also be called glucocorticoids or simply, steroids. Prednisone is a synthetic (laboratory-made) version of cortisol, an anti-inflammatory hormone your adrenal glands make naturally.

Prednisone works by reducing the activity of your immune system and decreasing the amount of inflammatory chemicals your body makes. It can lessen the symptoms of different medical conditions that involve inflammation. It’s commonly used to treat conditions such as rheumatoid arthritis and asthma and to prevent organ transplant rejection.

Prednisone is a commonly prescribed steroid you can take by mouth (orally). Other oral steroids include:

  • Prednisolone (Orapred)
  • Methylprednisolone (Medrol)
  • Dexamethasone (Decadron)

You might have used a steroid medication that you apply directly to the skin (topically) to treat eczema and atopic dermatitis. Topical steroids work similarly to prednisone, but they work only on the area where they’re applied. In contrast, oral prednisone is absorbed into your bloodstream and has effects all over your body, not just in the area affected by eczema.

When Is Prednisone Used To Treat Eczema?

Prednisone can help improve eczema symptoms quickly. A MyEczemaTeam member shared, “Prednisone really works.” However, with any medical treatment, the benefit should outweigh the potential risk of adverse effects (side effects).

The International Eczema Council released a guideline in 2018 to discourage the use of oral corticosteroids like prednisone to treat eczema. This council recommends only using prednisone for severe, acute flare-ups of eczema and only for a short time. Prednisone may be used to treat eczema in case of:

  • Severe eczema symptoms
  • A lack of other treatment options
  • A waiting period while other treatments begin to work
  • An upcoming major life event, such as a wedding

The American Academy of Family Physicians also released a statement about avoiding oral and injected corticosteroids for most people with atopic dermatitis. They recommend systemic steroids only be offered to people with severe eczema flares who cannot use any other treatment options — and only for a short time.

How Do You Take Prednisone?

You should take prednisone exactly as your doctor prescribes. The most common way to take prednisone is by swallowing a tablet, but it may also be available as a liquid. It’s usually taken with food to decrease stomach upset.

The best dose is the lowest possible dose that will improve your eczema symptoms. Your doctor will determine your prednisone dose based on the severity of your symptoms and your body weight.

Usually, you will only take a short course of prednisone (one to four weeks) because of the risk of long-term side effects. If you take prednisone for an extended period, you may need to taper off slowly by decreasing the dose over time. Talk to your doctor about the best way to take prednisone safely to avoid problems.

What Are the Risks of Prednisone?

You’ve heard that prednisone use should be limited to reduce the risk of side effects, but what are the possible side effects? A MyEczemaTeam member shared, “Prednisone helps with one thing but wrecks another.”

In general, you’re less likely to have side effects if you take prednisone for a short while compared to taking it for a longer time. More than 90 percent of people will experience some side effects if they take a steroid such as prednisone for more than two months.

Common Side Effects

When you take prednisone by mouth, it affects your entire body, not just the area affected by eczema. Prednisone can affect your digestive system in several ways, including:

  • Stomach upset
  • Nausea and vomiting
  • Increased appetite
  • Heartburn

You may also experience changes to your appearance when you take prednisone. It can cause the following physical changes:

  • Weight gain
  • Acne
  • Changes in fat distribution, leading to a rounder “moon face” appearance

Other common side effects of prednisone include:

  • High blood pressure
  • Increased blood sugar levels
  • Headache
  • Dizziness
  • Changes in mood, like irritability, depression, and hyperactivity
  • Slow healing
  • Muscle weakness
  • Increased sweating
  • Trouble falling asleep or staying asleep

Serious Side Effects

Long-term use of prednisone or taking a high dose of prednisone can increase your risk of serious side effects, such as:

  • Severe infections — Prednisone can make you more susceptible to infections because it suppresses your immune system.
  • Heart problems — Prednisone can increase your blood pressure, blood sugar, and cholesterol, which can increase your risk of heart disease.
  • Diabetes — Prednisone can increase your blood sugar and cause symptoms similar to diabetes.
  • Bone problems — Prednisone can weaken your bones and increase your risk of fractures and osteoporosis, a disease that causes a decrease in bone density.
  • Hormone problems — Prednisone can affect how your body responds to your hormones, such as cortisol.
  • Growth suppression — Prednisone may suppress growth in children.
  • Eye problems — Prednisone may cause eye issues, such as cataracts (cloudy areas in the lens of your eye) or glaucoma (fluid buildup in your eye).

Managing Prednisone Side Effects

Talk to your dermatologist if you experience any severe side effects or side effects that don’t get better with time. If you’re taking prednisone, you can take steps to keep yourself healthy while you’re on it.

Eat a Healthy Diet

The way you eat while taking prednisone can affect your side effects. Take prednisone with a meal to help with stomach problems. Check with your dermatologist and dietitian to see if you need any changes to your eczema-friendly diet while taking prednisone.

You can help to prevent weight gain if you eat a balanced diet with plenty of fruits, vegetables, whole grains, and lean protein. Eating a healthy diet may also help prevent possible complications like increased blood sugar. It can also help to make a meal plan for the time you’re taking prednisone to avoid overeating if you experience an increased appetite.

Talk to your doctor about how much calcium and vitamin D you should eat every day. You can help to prevent complications from weak bones by eating calcium-rich foods, like dairy products and green leafy vegetables.

Stay Active

If you get regular physical activity while taking prednisone, you may be able to help prevent weight gain and keep your bones and muscles strong.

Avoid Infections

You are more susceptible to infections while taking prednisone. It’s important to take steps to avoid infections, such as:

  • Washing your hands frequently
  • Avoiding people who are sick
  • Staying up to date with your vaccines
  • Keeping any cuts and scrapes clean
  • Wearing a face mask in crowded places

Be sure to tell all of your health care providers — including doctors, nurses, dentists, or physical therapists — that you’re taking prednisone.

Risks of Stopping Prednisone Suddenly

Depending on the dose of prednisone and how long you’ve been taking it, you may need to decrease your dose slowly over a few days to weeks. When you take prednisone, your body adjusts to it and stops making as much natural cortisone. Stopping prednisone slowly will make sure your body can adjust to living without it.

Some people experience a rebound eczema flare when they stop taking prednisone. Check with your doctor about how best to manage this and other risks.

Talk With Others Who Understand

MyEczemaTeam is the social network for people with eczema and their loved ones. On MyEczemaTeam, more than 49,000 members come together to ask questions, give advice, and share their stories with others who understand life with eczema.

Have you taken prednisone or other oral steroids? Did you have side effects, and how did you manage them? Share your experience in the comments below, or start a conversation by posting on your Activities page.

Posted on September 11, 2023
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Kelsey Stalvey, PharmD received her Doctor of Pharmacy from Pacific University School of Pharmacy in Portland, Oregon, and went on to complete a one-year postgraduate residency at Sarasota Memorial Hospital in Sarasota, Florida. Learn more about her here.
Amanda Jacot, PharmD earned a Bachelor of Science in biology from the University of Texas at Austin in 2009 and a Doctor of Pharmacy from the University of Texas College of Pharmacy in 2014. Learn more about her here.

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