Corticosteroids have been used as drug treatment for some time. Lewis Sarett of Merck & Co. was the first to synthesize cortisone, using a complicated 36-step process that started with deoxycholic acid, which was extracted from ox bile .  The low efficiency of converting deoxycholic acid into cortisone led to a cost of US $200 per gram. Russell Marker , at Syntex , discovered a much cheaper and more convenient starting material, diosgenin from wild Mexican yams . His conversion of diosgenin into progesterone by a four-step process now known as Marker degradation was an important step in mass production of all steroidal hormones, including cortisone and chemicals used in hormonal contraception .  In 1952, . Peterson and . Murray of Upjohn developed a process that used Rhizopus mold to oxidize progesterone into a compound that was readily converted to cortisone.  The ability to cheaply synthesize large quantities of cortisone from the diosgenin in yams resulted in a rapid drop in price to US $6 per gram, falling to $ per gram by 1980. Percy Julian's research also aided progress in the field.  The exact nature of cortisone's anti-inflammatory action remained a mystery for years after, however, until the leukocyte adhesion cascade and the role of phospholipase A2 in the production of prostaglandins and leukotrienes was fully understood in the early 1980s.
In some cases, it’s not a matter of whether you should choose nasal or oral corticosteroids. You may need to decide whether corticosteroids are a good option for you overall. Some people don’t respond well to any form of steroids, making these types of medications useless for allergy symptoms. Your doctor might order a blood test to see whether or not this is the case for you. Discuss any past reactions to steroid medications with your doctor. Tell them about any family history of issues from taking this medication. This can help avoid the potential for dangerous side effects.
Studies on corticosteroids tend to lean toward the extreme use, rather than the average use. For example, some studies look at corticosteroids for extreme and rarer cases of eczema. This makes it harder to research what long-term studies are out there on steroid use. To complicate things further, corticosteroids can be oral, topical, injected, or inhaled, and this dramatically changes the benefits and risks, and in turn the short-term and long-term effects. Speak with your doctor and pharmacist on what, if any, long-term studies out there are relevant to your own medical treatment.