General Medical Information

Steroids

David J. Terris

Numerous studies confirm that steroids administered systemically, locally, or topically may impair wound healing and/or strength. This suppression of wound healing occurs by three mechanisms: reduction in leukocyte and monocyte migration and phagocytosis, which diminishes the inflammatory response; inhibition of keratinocyte and fibroblast mitosis, which slows reepithelialization; and vasoconstriction, resulting in reduced oxygen and nutrient delivery to the healing wound. A steroid dose equivalent to at least 10 mg of prednisone per day is required to induce these changes. These effects may be mitigated by the systemic or topical administration of vitamin A.