When no options are left, some dermatologists prescribe systematic steroids although it is not recommended to do so. I know this article is about systematic steroids, but it is just to show dermatologists do not always do what they should.
"There are long-term side effects from chronic use of systemic steroids, but we can say that about nearly all the treatments we use." Yeah, there are are side effects t almost all drugs. Since a case like EC usually requires long-term use of drugs to control it, side effects are more likely with long-term use.