Cortisone is a powerful anti-inflammatory corticosteroid drug available in different forms. It is also a naturally produced substance in the human body. Don’t confuse it with cortisol (earlier we wrote about methods to reduce cortisol naturally). Cortisone first appeared in clinical practice in the 1950s. The main forms of the drug are steroid injections and tablets. Are there any creams, ear drops, ointments and lotions based on this active ingredient? Here you can get a glimpse into the power of these meds.
Cortisone Cream — Remedy for External Application
Right now, there is no such thing as cortisone cream. This is because cortisone is an inactive substance if it’s administered topically unlike testosterone, eg testosterone cream or generic testosterone gel which may be used during testosterone replacement therapy. Nevertheless, many people use “cortisone cream” as a substitute for “hydrocortisone cream”. This can be explained by the fact that the word “hydrocortisone” is conveniently shortened to “cortisone” by removing the prefix “hydro”.
One of the key benefits of external steroids is their ability to eliminate inflammation, not just transiently but in perpetuity. This is especially beneficial for both children and adults, suffering from severe eczema. Short-term application is unlikely to trigger any complications so usage is recommended in extreme cases, for achieving interim relief. Apply a thin layer and strictly adhere to the physician’s instructions. Long-term application can lead to damage to collagen, thus reducing the elasticity of the skin making it too fragile. Steroids can also induce increased skin sensitivity and heighten the possibility of destruction of the blood vessels.
Cortisone Ear Drops — Solution to Reduce Ear Inflammation
Otic corticosteroids (cortisone-like medicines) are used inside the ear to diminish redness, itching, and swelling caused by some ear conditions. These preparations are often referred to as cortisone ear drops. Here are two examples of such medicines:
Sofradex. It features antimicrobial and anti-inflammatory properties. The remedy is widespread in ophthalmology and otorhinolaryngology. Its bacteriostatic action is directed towards most pathogenic bacteria, which provoke inflammation of the ears and eyes. Glucocorticosteroid (dexamethasone) abates various inflammatory signs, namely swelling, flushing, pain, and also has a desensitizing effect. Prolonged therapy can lead to the formation of a stable microflora of the ear and the creation of superinfections. Sofradex is effectual to treat external otitis and is also popular in ophthalmic practice. With its help, doctors can treat the following diseases:
- hordeolum (stye);
- bacterial conjunctivitis;
- keratitis, iridocyclitis, scleritis;
- superinfections with eczema on the skin of the eyelid.
Read more on conditions treated with antibiotic steroid eye drops.
Cetraxal Plus by Salvat. This preparation is combined and designed for external use. The pharmacological action of Cetraxal Plus is determined by the advantages of fluocinolone (C24H30F2O6), a corticosteroid, featuring anti-inflammatory and analgesic characteristics, and ciprofloxacin (C17H18FN3O3), the antibiotic, belonging to a fluoroquinolone group. Its bactericidal effect refers to the inhibition of bacterial DNA gyrase, which takes part in the synthesis of cell DNA for cells of a bacterial nature.
Cortisone Pills — Systemic Corticosteroid Treatment
Cortisone tablets are used for a wide variety of diseases as a means of a systemic therapeutic program. The medicine’s key component decreases protein rates in the plasma and accelerates its decay in the muscles. This results in a significant diminution of protein creation in some systems, while in others, this process intensifies. Cortisone is also involved in controlling the aminos’ breakdown in the hepatic cells.
During the administration, hexokinase, which catalyzes the phosphorylation of glucose, is inactivated. The substance increases glucose content in the blood and activates gluconeogenesis.
Gluconeogenesis (abbr. GNG) is a metabolic pathway, the generation of glucose from some non-carbohydrate carbon substrates like glycerol and glucogenic aminos.
Carbohydrates are absorbed in the intestines rapidly but their use by the musculature decreases. The drug influences the split of the lymphoid tissue and contributes to the decline of synthesis of connective tissue.
Cortisone impedes allergies and prevents the formation of hyaluronidase and catalyses the degradation of hyaluronic acid (HA or hyaluronan). The drug retains sodium, while potassium is actively excreted from the human body.
It is prescribed for chronic adrenal impairment (Addison’s disease, hypocorticism after bilateral total adrenalectomy, hypopituitarism with secondary hypocorticism, congenital disorder of the adrenal cortex) – concurrently with mineralocorticoids. Other indications include:
- Rheumatic conditions.
- Collagen diseases.
- Dermatologic problems.
- Respiratory illnesses.
- Hematologic, neoplastic disorders.
- Edematous states, and some other disorders.
The main contraindications for the short-term use of cortisone in the form of oral steroid pills according to vital indications are hypersensitivity to the components of the drug and systemic fungal infections. Children in the period of active growth can take cortisone only if absolute indications are available and under the strict supervision of the specialist. This medication is replaced by other, more effective drugs based on corticosteroids, which have a more targeted effect and are safer for the patient.
Side effects of cortisone tablets may occur in different systems and organs. Thus, the nervous system may respond by producing dizziness, hallucinations, and convulsions. Individuals may experience insomnia, headache, and euphoria. Paranoia, depression, manic-depressive psychosis, nervousness, and anxiety can also occur.
Cortisone Nasal Spray for Treatment of Rhinitis & Polyps
Cortisone nasal spray is the wrong name for some sprays with corticosteroids, as they contain another corticosteroid component, for example triamcinolone, ciclesonide, budesonide, beclomethasone, etc. The remedy works well for curing allergic rhinitis symptoms and nasal polyps. Common examples of steroid nasal sprays include:
Rhinocort. The main active component of this spray is budesonide (C25H34O6). It’s characterized by anti-inflammatory and anti-allergic properties. A pronounced clinical effect is provided within 5-7 days. Indications for use include bronchial asthma, asthmatic bronchitis; vasomotor rhinitis; prevention of nasal polyps after polypectomy (surgical removal). Thus, Vendelo Johansen L, Illum P, Kristensen S et al. at the Danish University Hospital of Aarhus have concluded that budesonide is effectual for small- and medium-sized polyp formations. Adverse events can manifest as throat irritation, hoarseness, candidiasis (disease of a fungal nature) of the mouth and throat. Budesonide may also be used for other purposes. Other budesonide brand names include Entocort, Pulmicort, Miflonil, Budenid, Neo-Rinactive, Olfosonide, Proetzonide, Vinecort, Cuteral, and Dedostryl.
Zetonna. This is a relatively new medication containing an innovative corticosteroid – ciclesonide (C32H44O7), which may be your knight in shining armour. Its efficiency is proven in several trials, in particular, in 2009 by Timothy J Schaffner and David P Skoner at Allegheny General Hospital and Drexel College of Medicine, respectively. In 2012, the FDA issued an act, approving Zetonna nasal aerosol’s efficiency in treating the symptoms triggered by seasonal and all-year-round allergic rhinitis in adults and children over 12. The aerosol should be administered once daily. There are the following contraindications: recent surgery in the nasal cavity, ulcer, injuries of this organ, erosions, perforation of the nasal septum. Adverse reactions include headache, nasal discomfort and bleeding, usually during the first or second week of the course. The gigantic American company, Sunovion Pharmaceuticals, manufactures this medicine. According to the Drugs.com International Drug Name Database, ciclesonide is also marketed as Alvesco (Nycomed), Berosynt (BCN Medical), Cinase (German Remedies), Disbronc (Neumobiotics), Finorinex (Lafrancol), and Omnaris (Nycomed, Takeda).
Cortisone Lotion — Light Topical Remedy
Just like using cream, eardrops, and sprays you are unlikely to find a lotion comprising pure cortisone (cortisone lotion) in the pharmaceutical market. Most likely, you will be offered hydrocortisone lotion. This treats skin irritation and rashes.
Before each use, the lotion should be shaken vigorously. Then apply a small amount of the solution to the affected area. Gently rub the lotion until it’s evenly distributed. Wash your hands well afterwards.
Cortisone Ointment — Another Topical Medication
Again, cortisone ointment isn’t exactly the correct name for balms consisting of corticosteroids as the main component of these ointments is hydrocortisone. Keep in mind one remark: “cortisone” is sometimes used as a generic name for hydrocortisone or even collectively for all CORTs [corticosteroids] as they are called by Cheryl D. Conrad in “The Hanbook of Stress”. It treats inflammatory and allergic skin diseases of non-microbial etiology, in particular, those accompanied by itching, such as eczema, psoriasis, dermatitis, pruritus, neurodermatitis, erythroderma, seborrhea (seborrhoeic dermatitis), insect bites from mosquitoes, fleas, ticks, bugs, and spiders.
Here are some useful tips for proper use of corticosteroid ointments:
- Apply only to the affected area.
- Smear thinly in one direction with gentle massaging. Don’t leave a thick layer.
- Keep the lid of the tube clean.