When we hear the word steroids online, our minds usually jump to images of fake-tanned body builders standing in uncomfortable looking poses. The word steroid, when used in that context refers to anabolic steroids. Male sex hormones that help lay down muscle mass.
Our bodies evolved in an environment of dealing with basic predatory threats in the animal kingdom. The stress response is often referred to as the fight or flight mechanism, because we produce a cocktail of hormones that make us stronger to fight a predator or flee the scene. Studying animals in Africa help us understand our own physiology better. Fights are sudden and violent, during which a lot of the dust from the dry plains is disturbed. As we use more air during combat, we would cause an allergic reaction if our stress hormones did not suppress the normal inflammatory response.
The body therefore makes a short term survival decision that overrides longer term health consideration. For example blood is diverted away from digestion and directed to muscles as there is no point in wasting energy digesting your lunch at the point you are likely to become someone else’s lunch! Corticosteroids drugs were developed from the action of our adrenal hormone cortisol due to its inflammatory and immune suppressing abilities.
It is thought that alopecia areata is caused by a proliferation of immune cells attacking the hair follicles in the area of the hair loss. So technically it is a malfunction of the immune system not a problem with the hair. Many people still hold a very negative view of steroids, because of their well documented side effects. However what is not appreciated is that the early development of steroids involved systemic use and today topical versions are available in differing strengths.
The smaller the areas being treated topically and the shorter the period of treatment, the less likely one is to develop side effects. However the following are the most common side effects with topically applied steroids: