Ahh, Prednisone.

Prednisone. 

The word elicits mixed emotions for those of us with Inflammatory Bowel Disease. We never want to take Prednisone, but often times this steroid is the only thing that will get our symptoms under control during a bad flare.

Prednisone is an anti-inflammatory corticosteroid and an immunosuppressant. However, it comes at the cost of a long list of other side effects, and the longer you’re on it the longer that list becomes. Due to this fact, prednisone is used as only a temporary solution and doctors will want you to taper off of it as soon as you can. As annoying as the side effects may be, you can’t just quit taking it because your body adjusts to the presence of the drug. It gives your adrenal glands a break, and they go into a kind of hibernation mode. You need to slowly take smaller doses of Prednisone to allow your glands to become used to producing cortisol on their own again, otherwise you could experience adrenal failure—and you really don’t want that.

For me, prednisone has been very effective in getting my symptoms back under control, but some of its side effects can be quite frustrating. For one, there’s the dreaded prednisone “moon-face.” The drug can cause weight gain and abnormal weight distribution, which can result in puffy, round, chipmunk cheeks. Luckily, my moon face isn’t very severe and not too noticeable, but for some people it can look as though their wisdom teeth were just removed. Although it’s never been that bad, I have noticed a slight puffiness in my face in old photos from when I was on higher doses of prednisone. Even more bothersome than the cheeky face is when the weight that I gain gathers in my stomach area, giving me a puffy, bloated look. How flattering.

I’ve also noticed that I get irritable more easily when on high doses of prednisone (40mg and up). I’ll sometimes feel angry, sad, or moody sometimes, for no real reason. It really does a number on your hormones. I also tend to sweat more frequently and randomly when I’m taking prednisone. I wouldn’t describe them as hot flashes exactly, but the sweatiness will strike at indiscriminate moments. This is rather unhelpful when you’re trying to recover from being sick, but I will choose being moody and sweaty over being in pain any day.  

But the most frustrating side effect by far that I must endure is the prednisone acne rash. I’ll get a bunch of little acne bumps all over my forehead, chin, neck, chest, and even my back when I take high doses of prednisone. It’s not just normal acne either—it actually feels painful when you touch it or accidentally scratch it. The best part is it won’t go away until you are off the medication. Acne-treating face wash will only do so much. I despise prednisone acne. It’s like the cherry on top of my sundae of health problems.  

Some of the other side effects are a little easier to deal with. I’ve experienced increased appetite—which is helpful when you need to gain weight back, mild joint stiffness, mild muscle soreness, and the occasional headache. Oh, the joys of prednisone.

In all honesty, though, this medication has been the one thing that I can count on to get my Ulcerative Colitis flares under control and allow my intestines to heal. As irritating as the side effects can be, I feel a hundred times better when I’m on prednisone; and that’s what I remind myself of when the side effects are bothering me. It’s so much better than being in a flare.