Steroids and Vocal Health

Steroids are an anti-inflammatory medication, they can be used to reduce vocal fold inflammation. When can a singer use them to get back on stage, and what problems might occur? Firstly – all medications that have an effect will also have side-effects. The side-effects from a short-term dose of steroids can be negligible or they can be unpleasant. Secondly – a prescription for steroids to reduce vocal fold inflammation should only be given following a nasendoscopic evaluation by a laryngologist. This is essential to make sure that the symptoms are from inflammation and not anything else. A GP will not be able to assess this.

Our colleague Declan Costello MA, MBBS, FRCS (ORL-HNS) has said this:
Steroids are potent medications that can rapidly and effectively reduce inflammation. They can be given systemically (by tablet or injection), or locally (by injecting into an affected area). For singers, systemic steroids can sometimes be helpful as a short-term remedy to reduce swelling of the vocal folds. However, they can generally only be given in single doses (or very short courses) often to help a singer through a specific performance. If a singer is struggling with their voice and feels that they might benefit from steroids, it is important to have a laryngeal examination to ensure that there is not an injury before prescribing the steroids. In my own practice, I would never prescribe steroids unless the patient has had a very recent examination of their vocal folds. Even then, I would only prescribe one or maybe two doses of steroids to help with the performance.

If you are thinking of getting a prescription for steroids, bear in mind that this will be by necessity coming up at short notice, so you will need a private ENT appointment which you will have to pay for. The performance needs to be worth this investment!