Cortisone ointment is often prescribed for skin conditions such as eczema and psoriasis. The ointment often provides good results and the complaints usually diminish. In contrast, cortisone ointment has a bad reputation because of the side effects that can occur with long-term use. Fortunately, side effects with the ointments containing low concentrations of corticosteroids that are used today are no longer common. Side effects can still occur with cortisone ointment of a higher class if used for a long time.
Cortisone ointment, hydrocortisone, corticosteroid ointment or hormone ointment
Cortisone ointment, also called hydrocortisone, corticosteroid ointment or hormone ointment, is an ointment that inhibits inflammation, flaking, itching and swelling on the skin. Corticosteroids are steroid hormones that are produced in the adrenal gland in humans. However, the body’s own adrenal cortex hormones are almost never used for an ointment. The steroid hormones in this ointment are a synthetic variant of the body’s own hormone. Cortisone ointment works quickly, results are often seen after applying it once. The inflammation is inhibited, which reduces flaking, itching and swelling. The complaints can disappear by applying daily lubricants. Once the inflamed or irritated areas are gone, the skin can be maintained with a greasy cream, so that the inflamed areas will stay away for longer. It is generally not recommended to use cortisone ointment for long periods of time due to possible side effects.
History
After first tests with cortisone in 1930, it was only understood around 1940 that there are various steroids that are responsible for the anti-inflammatory effect. Between 1954 and 1958, six synthetic steroids were made for applications in creams and ointments, among other things. Cortisone ointment has been used for various skin conditions since the 1950s. The marketing of cortisone ointment has therefore led to skin diseases that could not be treated being suddenly combated in a simple way. Although the results achieved were good, the side effects of the hormone ointment also quickly became known. Due to the strong drugs used at the time, side effects were often reported. Since the 1960s, developments have been initiated to reduce the dosage. This has resulted in ointments and creams that use a relatively low dosage.
For which skin diseases do you use cortisone ointment?
Cortisone ointment can be used for inflamed, itchy or scaly patches on the skin. These spots may not be caused by bacteria, parasites, fungi, yeasts, ulcers, mites or warts. The hormone ointment is, for example, prescribed for eczema, psoriasis, allergies and extremely dry skin. The active corticosteroids counteract inflammation and itching and inhibit cell division in the case of psoriasis.
Species
There are 4 classes of cortisone ointment. We often start with the lightest class. If this does not give the desired result, a doctor can prescribe an ointment of a higher class. There are the following classes of cortisone ointment:
- class 1, mild corticosteroids, such as hydrocortisone acetate 1%
- class 2, strong corticosteroids, such as triamcinolone acetonide 0.1%
- class 3, strong corticosteroids in higher concentration, such as betahametasone valerate 0.1%
- class 4, very strong corticosteroids in very high concentrations, such as clobetasol
The lighter first class ointment is best suited for use on the face and on areas where the skin is thinner, such as genitals. Class two is most commonly used for eczema complaints. Class 3 is for worse skin complaints in places where the skin is somewhat thicker, such as arms, legs and torso. This ointment is often prescribed for psoriasis, for example. Class 4 ointment is used for persistent complaints. This ointment should never be used for a long time.
Operation
Cortisone ointment works because the steroid hormones penetrate the skin cells. To make this process run better, horn softeners are added to the ointment. These are, for example, urea or salicylic acid. Sufficient ointment must be applied to be effective. A layer that is too thin cannot penetrate the skin properly. Ointments with too low a concentration of active substance may also work less well. An ointment with a higher concentration must then be used.
Usage
Cortisone ointment must be used in the correct dosage for a certain period of time to give good results. Applying too little does not give the desired effect, while applying too much increases the risk of side effects. The same applies to the frequency of lubrication, too little lubrication gives a less good result, while long-term lubrication increases the risk of side effects. In addition, long-term use can reduce the effectiveness of the ointment. Preferably use class 1 ointment on the face. Class 3 or 4 can be used for serious skin conditions. Once the complaints have reduced, you can return to the lower class to keep the skin condition under control. If the skin condition does not return, the treatment can be reduced. Always follow the doctor’s advice. In addition to the cortisone ointment, always use a good oily maintenance ointment without cortisone to keep the skin supple and reduce complaints.
Quantity
Cortisone ointment can be spread thinly. A fingertip is often sufficient, depending on the amount of skin that is inflamed. In any case, make sure that you no longer see any ointment, but that the skin is well greased.
Frequency
Applying once a day is often sufficient. In the beginning, this can be done twice a day. Apply for several days in a row until the symptoms have disappeared. You can then usually switch to applying the cream two to three times a week. You can also choose to apply four days in a row and not for the other 3 days. By not using the hormone ointment frequently, the risk of side effects will be reduced.
Side effects
Although cortisone ointment has a bad name because of the many side effects seen in the early days, the side effects are now almost non-existent if used correctly. Class 1 ointments in particular often have no side effects.Side effects with long-term use include:
- Thinning skin
- Cracks of the skin, caused by thinning skin
- The appearance of bruises
- The appearance of stretch marks on the skin
- The appearance of small blood vessels in the face
- Clown eczema
- Skin infections
Long-term use of high-quality cortisone ointment can cause side effects due to the absorption of steroid hormones in the blood. These side effects include:
- Inhibition of the production of the body’s own adrenal hormones
- Cushing’s syndrome, which can cause fluid retention in the face. Diabetes and rising blood pressure can also develop.
- Bone decalcification
- Growth inhibition in children
- Increased intraocular pressure and cataracts
Alternatives
Although cortisone ointment is often prescribed for eczema or psoriasis, there are also alternatives. Tar ointment can work well against the complaints and does not contain the side effects that can occur with cortisone ointment. In addition, positive results are achieved with light therapy. However, light therapy can accelerate the symptoms of skin aging. It can also increase the risk of skin cancer.