What complication is most associated with intranasal steroid use?

Intranasal steroid use is primarily associated with mucosal atrophy, which can occur as a side effect of prolonged local steroid use. Intranasal steroids are effective in reducing inflammation in the nasal passages, but steroid-induced atrophy can lead to thinning of the nasal mucosa over time. This can result in symptoms like nasal dryness, irritation, and potentially increased susceptibility to infections.

The development of atrophy is due to the action of corticosteroids, which can inhibit cellular turnover and protein synthesis in the mucosal tissue, leading to a decrease in the mass of the mucosa. It’s important to monitor patients using these medications for prolonged periods to ensure that they are not experiencing adverse effects related to mucosal health.

The other options represent complications that are less commonly associated with intranasal steriod use. For instance, while fungal infections can occur with steroid use, they are more frequently seen with systemic steroid therapies or in immunocompromised individuals, rather than local intranasal use. Systemic hypertension and weight gain are more associated with systemic corticosteroid use rather than localized therapy via the intranasal route, as the systemic absorption is minimal when used correctly.