Cortisone is a powerful anti-inflammatory corticosteroid drug that is available in different forms. It is a synthetic form of the hormone by the same name which is naturally produced in the human body. Do not confuse it with cortisol (earlier we wrote about methods to reduce cortisol naturally). Cortisone began to be used in clinical practice in the 1950’s. 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? Let’s figure it out.
Cortisone cream – the remedy for external application
At this point, there is no such thing as cortisone cream. This is due to the fact that cortisone is an inactive substance if it is used topically (unlike testosterone, for example; testosterone cream or generic testosterone gel 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 reduced to “cortisone” by removing the prefix “hydro”.
One of external steroids’ benefits is their ability to temporarily eliminate inflammation, which is suitable for children (and adults) with a severe degree of eczema. Short-term use of steroids is unlikely to have side effects. Use them only in extreme cases, when temporary relief is simply necessary, apply a thin layer of the cream and follow the doctor’s instructions. However, their long-term application can damage collagen, thereby reducing elasticity of the skin and making it more delicate. Steroids can also raise the sensitivity of the skin and increase the risk of blood vessels’ damaging.
Cortisone ear drops – the way to reduce inflammation in the ear
Otic corticosteroids (cortisone-like medicines) should be used inside the ear to reduce redness, itching, and swelling caused by some ear diseases. These drugs are often referred to as cortisone ear drops. Here are two examples of such medicines:
1. Sofradex. It is an antimicrobial and anti-inflammatory drug used in ophthalmology and otorhinolaryngology. Bacteriostatic action of the drug is directed to the majority of pathogenic bacteria that can cause inflammation of ears and eyes. Glucocorticosteroid (dexamethasone) reduces the signs of inflammation – swelling, flushing, pain, and also has a desensitizing effect by inhibiting inflammatory mediators. The use of the drug for a long time can lead to the formation of a stable microflora of the ear and the development of superinfections. Sofradex is used not only for the treatment of external otitis, but also in ophthalmic practice. With its help doctors perform therapy of the following diseases:
- hordeolum (stye);
- bacterial conjunctivitis;
- keratitis, iridocyclitis, scleritis;
- superinfections with eczema skin of the eyelid.
Read more on conditions treated with antibiotic steroid eye drops.
2. Cetraxal Plus. It is a combined preparation for external use. The pharmacological action of Cetraxal Plus is explained by the properties of fluocinolone, a corticosteroid with anti-inflammatory and analgesic characteristics, and ciprofloxacin, an antibiotic of the fluoroquinolone group. The bactericidal effect of the drug is associated with the inhibition of bacterial DNA gyrase, which is involved in the synthesis of bacterial cell DNA.
Cortisone pills – systemic corticosteroid treatment
Cortisone pills may be used for a wide variety of diseases as means of systemic treatment. The main component of the drug has the properties to reduce the level of protein in the blood plasma, and to strengthen its decay in muscle fibers. This contributes to the fact that in some systems protein formation slows down considerably, while in others, it accelerates. Also, cortisone can control the breakdown of amino acid molecules in the liver.
During the administration of this drug, hexokinase is inactivated. Cortisone increases the intake of glucose into the bloodstream and provokes gluconeogenesis synthesis processes, which increases the rate of formation of carbohydrates from amino acids. There is a decrease in tolerance to glucose molecules and an increase in the amount of glycogen in the liver and in the muscle fiber.
Carbohydrates are very actively absorbed in the loops of the intestines, while their use by muscles is reduced. The drug contributes to the split of the lymphoid tissue and the decrease of synthesis rate of connective tissue. Cortisone blocks the development of allergic reactions and stops the process of formation of hyaluronidase. Also, the drug retains sodium, while potassium is actively excreted from the body.
Cortisone is prescribed for chronic adrenal impairment (Addison’s disease, hypokorticism after bilateral total adrenalectomy, hypopituitarism with secondary hypocorticism, congenital dysfunction of the adrenal cortex) – concurrently with mineralocorticoids. Other indications include:
- Rheumatic disorders.
- Collagen diseases.
- Dermatologic diseases.
- Respiratory diseases.
- Hematologic disorders.
- Neoplastic diseases.
- Edematous states, and some other disorders.
The main contraindication for the short-term use of cortisone according to vital indications is hypersensitivity to the components of the drug. Other contraindications to the use of medication in the form of oral steroid pills include systemic fungal infections. Children who are still actively growing can be prescribed cortisone only in the presence of absolute indications and under the special supervision of the attending physician. This medication is replaced by other, more effective drugs based on corticosteroids, which have a more targeted effect and are safer for the body.
Side effects of cortisone tablets may occur in different systems and organs. Thus, the nervous system may respond by dizziness, hallucinations, and convulsions. Patients may experience insomnia, headache, and euphoria. Paranoia, depression, manic-depressive psychosis, nervousness, and anxiety can occur.
Cortisone nasal spray for treatment of rhinitis & polyps
Cortisone nasal spray is the wrong name for some nasal sprays with corticosteroids, as these sprays contain another corticosteroid component, for example triamcinolone, ciclesonide, budesonide, beclomethasone, etc. The spray works well for treating allergic rhinitis symptoms and nasal polyps. Common examples of steroid nasal sprays include:
- Rhinocort. The main active component of this spray is budesonide. The drug has anti-inflammatory and anti-allergic effect. In the case of inhalation administration, a pronounced clinical effect usually develops within 5-7 days of course use. Indications for the use of the spray include bronchial asthma, asthmatic bronchitis; vasomotor rhinitis (inflammation of the mucous membrane of the nasal cavity); allergic rhinitis, as well as the prevention of nasal polyps after polypectomy (surgical removal of polyps in the nose). Side effects of the medication may be irritation of the throat, hoarseness, candidiasis (fungal disease) of the mouth and throat.
- Zetonna. This is a relatively new drug containing an innovative corticosteroid called ciclesonide. In 2012, the FDA approved Zetonna nasal aerosol for the treatment of symptoms caused by seasonal and all-year-round allergic rhinitis in adults and children aged 12. Aerosol Zetonna is to be used once a day. Contraindications for the use of ciclesonide are: recent surgery on the nose, nose injuries, erosions, ulcer, perforation of the nasal septum. The most common adverse reactions include nasal discomfort, headache and nasal bleeding. The maximum effect of the drug is usually observed in the first or second week after the start of treatment. The manufacturer of the drug is a large American company, Sunovion Pharmaceuticals.
Cortisone lotion – light topical remedy
Just like in the case of cream, ear drops, and nasal sprays you are unlikely to find a lotion containing pure cortisone (cortisone lotion) in the pharmaceutical market. Most likely, you will find hydrocortisone lotion. This remedy is used to treat skin irritation and rashes.
Before each use, the lotion should be shaken. Then you need to apply a small amount of medication to the affected area of the skin. Gently rub this lotion until it is evenly distributed over the skin. Wash your hands well after applying the lotion (if your hands are not the target area for applying the lotion).
Cortisone ointment – another topical medication
Again, cortisone ointment is not exactly the correct name for ointments containing corticosteroids as the main component of these ointments is hydrocortisone. Indications for its use include inflammatory and allergic skin diseases of non-microbial etiology (including those accompanied by itching) such as eczema, allergic and contact dermatitis, neurodermatitis, psoriasis, erythroderma, pruritus, insect bites, and seborrhea.
Here are some useful tips for proper use of corticosteroid ointments:
- It is necessary to apply the ointment containing medication only to affected areas of the skin.
- The ointment should be applied in a thin layer, in one direction, gently massaging the skin.
- It is necessary to regularly clean the lid of the ointment and the opening of the tube.