Triamcinolone (Kenalog) injections are often used to control symptoms of seasonal allergic rhinitis (SAR). Many patients report good control of symptoms with treatment annually or biannually. Is there any danger in using steroids in this manner? How often can this be done?
—Cathy Wayand, MSN, ANP, Statesville, N.C.

While this appears to be a fairly common practice, I found no studies that evaluated the effectiveness or the risks/benefits of this therapy compared with other recommended therapies. There are only a handful of studies evaluating systemic corticosteroid therapy (oral) for SAR. Most experts agree that very long-acting corticosteroid injections should be used only when all other measures have failed, not for convenience. This form of therapy carries all the risks of chronic corticosteroid therapy, including immunosuppression, and should not be prescribed lightly. For further discussion, see Allergy. 2000;55:11-15.
—Julee B. Waldrop, MS, PNP (101-1)