What are CorticoSteroids?

Corticosteroids are synthetic hormones that mimic a naturally occurring hormone called cortisol.

• Cortisol and corticosteroids suppress our immune systems resulting in reduced inflammation.

• Corticosteroids are used to treat inflammatory diseases like asthma and psoriasis, in addition to treating vocal fold swelling.

• Corticosteroids are different from anabolic steroids which are often used and abused in athletics.

1. Prednisone

2. Cortisone

3. Hydrocortisone

The most common treatment is a corticosteroid pill. Injections are another option, albeit much more rare, as the steroid will be injected directly into the vocal fold. You may be more familiar with steroid inhalers, which treat the lungs and esophagus for conditions like asthma. Inhalers are not a common treatment method for the vocal folds.

Positive:

• Lessens vocal fold swelling (edema)

• Improves mucosal wave

Negative:

• Increased risk of vocal fold hemorrhage

• Increased risk of glottic thrush

• Increased risk of steroid dependency

• High blood pressure

• High blood sugar and increased risk of diabetes

• Weight gain

• Psychological effects like mood swings, memory loss, and behavioral changes

• Cataracts and glaucoma

• Osteoporosis

• Increased bruising

• A slower immune system response leading to an increased risk of infection and slower healing

Consult a specialist, be aware of the risks, and weigh the factors.

• Receive imaging (video stroboscopy) before taking corticosteroids

• Use corticosteroids only for emergencies and when diagnosed

• Do NOT use long-term

  • Steroids only treat symptoms and do not treat the underlying cause

• Postpone or cancel performances, if possible

INSTEAD, TRY:

• Combining intermittent voice rest with moderate voice use

  • Full voice rest is often not necessary or as effective as moderate voice use

  • Incorporate semi-occluded vocal tract exercises (bubble phonation, straw phonation, lip trills, etc.)

• Alleviate other symptoms

  • Take guaifenesin (Mucinex) to loosen mucus without dehydrating the vocal folds

*Not medical advice

Mayo Clinic: Prednisone and other corticosteroids

National Library of Medicine: Corticosteroids

Prospective Evaluation of Safety of Singing on Steroids: Testing the Truth of Received Wisdom, Estes et al. (2021)

The Role of Steroid Injection for Vocal Fold Lesions in Professional Voice Users, Al-Ali and Anderson (2020)