Cortisone in Children

Cortisone is a medication that can help reduce the inflammatory response in our body and is a lifesaver in many situations. However, its administration can sometimes be not only ineffective but also harmful, especially in children.

Cortisone in Children: When is it useful and when not?

Cortisone and corticosteroid medications are anti-inflammatory and immunosuppressive (they inhibit the immune response) drugs that have a structure similar to the hormones naturally produced by our body (the so-called "endogenous" corticosteroids). These are very powerful drugs used in many conditions such as asthma, arthritis, certain dermatitis, and autoimmune diseases. However, there is a downside: administering cortisone to children can cause some side effects.

So let's see how cortisone works and when it is useful to use it

When is cortisone used? Little Emanuele has had a fever for six days and his parents are very concerned. Since paracetamol and ibuprofen only manage to control the symptoms for a few hours, they ask the pediatrician if they can give the child a little cortisone, just to help "reduce inflammation". However, after examining Emanuele, the doctor explains to them that the child simply has a common flu and that administering cortisone in this case can be not only ineffective but also harmful.

So when should cortisone be used in children? And in which cases is it better to avoid it instead?

Corticosteroid medications help reduce the inflammatory response in our body and are very useful and potentially life-saving in many situations. The pediatrician may prescribe them in cases of severe asthma attacks or allergic reactions. There are also some autoimmune diseases that require the use of these drugs, even for an extended period. The important thing is that cortisone is only given following a prescription and is never taken without proper medical evaluation.

It is better to avoid using cortisone to treat a fever, even though this medication has a powerful antipyretic action. The child's fever episodes, often linked to infections of the upper respiratory tract, should not be treated with corticosteroids at all, as these drugs exert a potent immunosuppressive action and can worsen viral infections or promote "opportunistic" infections (bacterial infections that occur during viral infections or other situations of weakened immune system).

The side effects of cortisone use in children can be significant and difficult to manage. Moreover, if the medication is given for two weeks or more, it is necessary to be very careful when discontinuing it. In these cases, it is important to gradually reduce the dosage until it is completely discontinued to allow the body to readjust to the absence of the drug.

There are also conditions where cortisone should be absolutely avoided, such as in cases of severe infections (due to its immunosuppressive power) or extensive wounds (as it can delay wound healing). Finally, cortisone should be used with extreme caution in patients with diabetes and high blood pressure as it can worsen these conditions.

From what age and how to use cortisone

There is no exact answer. Corticosteroids can be administered even to very young children when there is a genuine need and under medical prescription.

In this regard, the administration methods should also be considered:

- Systemic, if taken orally or through injections;

- Local or topical, if administered in a specific body area (intranasal, aerosol, or on the skin).

- Oral administration can be offered in various formulations, including soluble tablets or drops, depending on the child's preference and the specific medication to be taken.

- Injections, on the other hand, are usually not used unless oral administration is not possible (e.g., in case of vomiting).

Among local administrations, one of the most commonly used is through aerosol, which is used to treat or prevent asthma attacks. Bronchial inflammation is indeed the cause of asthma, and inhaled cortisone acts by reducing this inflammation. In such cases, side effects are much less common and serious compared to systemic administration. However, it is important to note that, especially with prolonged administration for several days, an annoying "thrush" infection (candida infection in the oral cavity) may occur. Usually, rinsing the mouth thoroughly after each administration is enough to prevent it.

Another route of administration is intranasal, which is very useful in cases of allergic symptoms such as runny nose and nasal congestion due to allergic rhinitis. The most common side effect, in addition to the discomfort of a liquid dripping down the throat, is nosebleeds (blood from the nose). To reduce the risk of nosebleeds, it is necessary to avoid prolonged administration,