Experts Urge Caution on Pediatric Steroid Use

Growing concerns over long-term effects drive shift in treatment approach

Feb. 2, 2026 at 7:55am

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Pediatric experts are sounding the alarm on the potential long-term consequences of chronic steroid use in children, including growth suppression, metabolic changes, and mood impacts. This is driving a significant shift towards more nuanced, collaborative, and steroid-sparing treatment approaches, with a focus on newer topical agents and advanced systemic therapies.

Why it matters

Corticosteroids have long been a mainstay in treating inflammatory conditions in children, but growing awareness of the potential for serious side effects is prompting a re-evaluation of how these powerful medications are prescribed. This issue is particularly relevant for parents and pediatricians navigating complex skin and respiratory conditions in young patients.

The details

Repeated or long-term use of both topical and systemic corticosteroids can disrupt a child's natural hormonal balance, leading to visible Cushingoid features as well as more subtle impacts on growth, metabolism, and mood. Experts are advocating for 'clear stop rules' and frequent reevaluation when multiple steroid courses become necessary. Newer topical agents like TCIs and PDE4 inhibitors are demonstrating favorable safety profiles, while systemic biologics and JAK inhibitors offer powerful inflammation control with the potential for 'catch-up' growth in affected children.

  • A 2023 study published in the Journal of Pediatric Endocrinology and Metabolism highlighted a correlation between prolonged topical steroid use in infants with atopic dermatitis and a slight, but measurable, reduction in growth velocity.

The players

Autumn Atkinson

An expert at McGovern Medical School at UTHealth Houston who is advocating for a more nuanced and proactive strategy in pediatric steroid use.

Adelaide Hebert

An expert at McGovern Medical School at UTHealth Houston who is emphasizing the importance of careful patient selection and shared decision-making with families when it comes to advanced therapies like biologics and JAK inhibitors.

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What they’re saying

“We must have clear stop rules - pre-defined criteria for discontinuing steroid use - and frequent reevaluation when multiple courses become necessary.”

— Autumn Atkinson, Expert, McGovern Medical School at UTHealth Houston (newsy-today.com)

“Careful patient selection and shared decision-making with families is crucial when considering systemic biologics and JAK inhibitors.”

— Adelaide Hebert, Expert, McGovern Medical School at UTHealth Houston (newsy-today.com)

What’s next

Researchers are actively searching for biomarkers that can predict a child's response to steroids and their risk of developing adverse effects, which would allow for more precise monitoring and early intervention.

The takeaway

The key to navigating this complex terrain lies in collaboration between dermatologists and pediatricians, as well as empowering families with information to make informed decisions about their child's treatment. The future of pediatric steroid use will likely be shaped by personalized medicine and the identification of biomarkers to better assess risks and benefits.