Can corticosteroids (cortisone) cause easy bruising, also known as ecchymosis?

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From the Guidelines

Yes, cortisone can cause easy bruising. According to a study published in the Annals of Internal Medicine 1, inhaled corticosteroids were associated with a moderate to severe degree of easy bruising. This occurs because corticosteroids, such as cortisone, can thin the skin and weaken blood vessel walls, making them more fragile and prone to breaking with minor trauma.

Key Points to Consider

  • The study found that inhaled corticosteroids were associated with an increased frequency of easy bruising, among other side effects such as oropharyngeal candidiasis and throat irritation 1.
  • The risk of easy bruising may increase with higher doses and longer duration of treatment, although the study did not provide specific details on the dosage and duration of cortisone treatment 1.
  • It is essential to continue medication as prescribed and inform your healthcare provider if you experience excessive bruising, as they may want to monitor this side effect or adjust your treatment plan if necessary.

Important Considerations for Patients

  • Patients, especially older adults, women, and those on long-term therapy, should be aware of the potential for easy bruising as a side effect of cortisone treatment.
  • If you are experiencing excessive bruising while taking cortisone, do not stop your medication without consulting your healthcare provider, as this can lead to other complications.
  • Regular monitoring and open communication with your healthcare provider can help minimize the risks associated with cortisone treatment and ensure the best possible outcome.

From the FDA Drug Label

wound healing Thin fragile skin Petechiae and ecchymoses

  • Easy bruising can be related to Petechiae and ecchymoses, which are listed as potential effects of cortisone.
  • Thin fragile skin may also contribute to an increased risk of bruising.
  • The FDA drug label for cortisone 2 suggests that it can cause easy bruising due to these effects on the skin.

From the Research

Cortisone and Easy Bruising

  • Cortisone, a type of corticosteroid, has been linked to easy bruising in several studies 3, 4, 5.
  • A study published in The European Respiratory Journal found that patients taking inhaled corticosteroids (ICS) reported easy bruising more frequently than those not taking ICS, with a relative risk of 2.18 3.
  • Another study published in Chest found that patients with COPD taking ICS reported easy bruising more frequently than those taking a placebo, with a significant association between ICS use and easy bruising 4.
  • A study published in The European Respiratory Journal also found that high doses of ICS were associated with an increased occurrence of skin bruising, particularly in older subjects and females 5.

Risk Factors for Easy Bruising

  • Age: Older patients are more likely to experience easy bruising when taking cortisone 3, 4, 5.
  • Sex: Females are more likely to experience easy bruising when taking cortisone 3, 5.
  • Dosage: Higher doses of cortisone are associated with an increased risk of easy bruising 3, 5.
  • Duration of use: Longer duration of cortisone use is associated with an increased risk of easy bruising 3, 4.

Mechanism of Easy Bruising

  • The exact mechanism of easy bruising associated with cortisone use is not fully understood, but it is thought to be related to the systemic effects of corticosteroids on the skin and blood vessels 4, 5.
  • Cortisone may cause skin thinning and fragility, making it more susceptible to bruising 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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