Question: Is it all right for someone who has had Cushing's or is recovering from Cushing's to use topical steroid cremes, Medrol™ dose packs, steroid inhalers for asthma, or prescription nasal sprays?

Answer: Someone who has had or is recovering from Cushing's syndrome is no more or less likely to develop Cushing's from the use of topical or inhaled steroids than someone who has not. Steroids are absorbed into the bloodstream from the skin and mucous membranes, and excessive dosages can cause Cushing's syndrome. The amount of topical steroid that is absorbed also depends on the location where it is applied (greatest in the armpits and the groin, much less on the forehead, face, and scalp, least on the outer forearm and legs, where the skin is thickest), whether the preparation contains a vehicle to increase absorption (such as dimethylsulfoxide, urea, or salicylic acid), and whether it is covered with a dressing (which can increase absorption ten-fold). They are absorbed more by inflamed skin and the thin skin of infants. One should use steroids only when necessary and as directed by one's physician.