Cortisone is a drug that is often spoken of, at times for better or for worse. Generally, this name generates concern – especially in regards to the possible side effects that can arise from its use. However, since the 50’s of the last century, it is considered one of the most effective drugs used to treat diseases including the most severe forms of rheumatic diseases. We try to learn more about cortisone by answering seven questions with the help of Prof. Bianca Marasini, Head of the Outpatient Rheumatology department at Humanitas Gavazzeni.

Doctor writing

Does cortisone make you fat?

Weight gain can occur because cortisone tends to increase appetite and can hold liquids. To reduce these effects, a calorie controlled diet is recommended; rarely, and only for some patients with heart disease, a diuretic may be needed. Cortisone also tends to redistribute body fat that accumulates in the abdomen, neck and face, giving the face a somewhat “full moon” shape. Also, the limbs tend to dwindle because cortisone tends to decrease muscle mass.

Does cortisone weaken the immune system?

Cortisone, like all other immunosuppressants, can alter the immune response, resulting in risk of infectious diseases, viral or microbial. This risk is usually small, and controllable with antibiotics and/or antiviral drugs, depending on the dosage and timely use of the cortisone, as well as the presence of other risk factors and comorbidities. However, it should kept in mind that cortisone is also used in some infectious diseases to reduce the inflammatory response.


Is excitement from cortisone intake possible?

It’s possible; your doctor may lower your dose of cortisone and, if necessary, will resort to mild sedatives and drugs for inducing sleep.


Should cortisone be discontinued in cases regarding surgery?

Absolutely not. Instead, it will be necessary to increase cortisone dosages during the hospitalization period.


Should cortisone be discontinued in cases regarding vaccination?

Absolutely not, but rather only for some immunizations, such as the anti-flu vaccinations. Some vaccinations are contraindicated.


Is cortisone bad for your skin?

In younger individuals, sometimes the use of cortisone can worsen acne. In elderly individuals,  it makes the skin fragile. Rarely, you may notice increased hair growth. It is best to reduce exposure to the sun. Remember that prolonged exposure to the sun is to be avoided in any cases regarding various forms of rheumatic diseases ( precisly those who use cortisone for their condition).


Is there an alternative to cortisone?

In cases where very high doses are required, or if you experience severe side effects, cortisone dosages can be reduced or even suspended and instead, immunosuppressive drugs can be used. However, why not use these to start with? This is due to the fact that the effect of cortisone is faster and with side effects often substantially lower than those of other immunosuppressants.