Steroid medications are taken for many different medical conditions. Many people think of steroids and immediately think of negative side effects such as weight gain, moon-face (facial swelling), and mood swings. Most people do not have many side effects when on short courses of steroids of 10-14 days or more. However, when taken for longer periods of time, there can be some very serious side effects. When we ingest steroids or any medication, especially by mouth, the drug is absorbed into our vascular system and travels to all parts of our bodies, including our eyes. As a result, doctors are very cautious when prescribing steroids. It is well documented that oral steroids taken for an extended period of time can increase your risk for developing cataracts.
Discuss whether a change in controller medication or decrease in the dose or strength of the inhalant would be an option. Some health experts have reported a reduction in hoarseness after backing down the dose, but this is not always effective. There is a particular inhaled steroid which is inactive until it reaches the surface of the lung (after inhalation). It seems to be an ideal inhalant for people who have adverse effects which are localized to the throat or tongue. The brand name of this unique inhaled steroid is Alvesco. It is only available by prescription. Unfortunately no currently available steroid based inhaler, (including Alvesco) eliminates the risk of dysphonia. One study referenced below suggested reduced risk with some dry powder inhalers.