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Smoking similarly impairs tissue healing and should be minimized or eliminated during treatment
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Conversely, regular intake of these medications is unsafe as they may have severe side effects such as gastric ulcers, Cushing's habitus, hyperglycemia, muscle weakness, fragile skin, purple striae, flaring up of latent infections, delayed wound healing, cataract, osteoporosis, glaucoma and hypothalamic pituitary axis suppression with corticosteroids, and an increased risk of opportunistic infections and development of lymphomas.[1] In addition, some refractory condition can lead to severe morbidity and decrease in the quality of life.[1] Recently, biologics such as anti–TNF-α, anti–alpha-4 integrin, as well as Peroxisome proliferator-activated receptor gamma (PPARγ) ligand and probiotic therapy are being used, but their long-term benefits are unknown.[1] Importantly, reports suggest that the long-term use of biologics, especially infliximab, adalimumab, and certolizumab, may increase the risk of infections and malignancies, especially non-Hodgkin's lymphoma.[13] Drugs that block leukocyte adhesion such as natalizumab, those that target cytokines, like IL- 12/23, and antibodies inhibiting T-cell signaling, such as IL-6 receptor antibodies, are also being studied
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