Cortisone is available in a wide variety of forms and has always been considered one of the most effective remedies for atopic dermatitis.
It is used particularly in the form of creams and ointments for neurodermatitis, but should only be used with caution and under medical supervision due to the many side effects.
The word cortisone is derived from the Latin cortex = cortex and is a steroid hormone which was discovered in the adrenal cortex of humans in 1935 and can now be produced synthetically.
Cortisone has several important functions in the human body itself. The mobilization of energy reserves, which causes the breakdown of protein, is also responsible for cardiovascular function and electrolyte balance.
However, one of the best-known functions of cortisone is the suppression of immunological and allergic processes. It is therefore also used in the form of ointments for atopic dermatitis.
Nowadays, more advanced cortisones such as hydrocortisone, prednisolone, dexamethasone and methylprednisolone are used, as they are more suitable than the original substance. These include cortisol, prednisolone and dexamethasone.
These types have anti-inflammatory, anti-allergic, immunosuppressive and antipruritic properties and are used to treat eczema and other skin diseases.
It is applied to the affected areas of skin a maximum of twice a day and can lead to skin damage if used incorrectly.
This type of cortisone is taken in tablet form or injected directly. The concentration and effect is therefore many times higher than with external application through skin creams and ointments.
It can be used as a short-term treatment for severe flare-ups of neurodermatitis but not as a long-term treatment. However, not only is the effect greater when used internally than externally, but so are the side effects.
As the cortisone enters the entire body through the blood, it is distributed and affects all parts of the body and therefore not just the affected areas. Here too, a rebound effect must be expected if the tablets are discontinued too quickly and treatment should always be discussed with a doctor beforehand.
The side effects of cortisone are numerous and can have a serious effect on the skin of the person receiving treatment and lead to permanent damage.
Depending on the area of application, the cortisone even penetrates into the lower layers of the skin.
If cortisone is used for too long or incorrectly, the skin structure and collagen fibers, which are responsible for the elasticity of the skin, can change permanently. The skin appears brittle. In neurodermatitis sufferers, prolonged use of cortisone causes the skin to become thinner and thinner (=atrophy) and makes the bluish veins stand out clearly.
In addition, the skin may become increasingly vulnerable or wound healing may be impaired. When applied to the face, it can lead to permanent facial redness due to burst veins or to a worsening of rosacea.
You also become more susceptible to infections such as herpes viruses. Another very serious side effect of cortisone is Cushing’s disease, a disorder of the carbohydrate and fat metabolism, which causes a build-up of fat on the trunk of the body. This makes the face look puffy and reddened. This can also lead to increased hair growth in the treated areas.
The rebound effect can occur if cortisone is used incorrectly, leading to a worsening of symptoms.
As the body quickly becomes accustomed to the cortisone, the inflammation reoccurs if the cortisone is stopped immediately. It is therefore advisable to use cortisone less and less each day until the symptoms subside completely.
If the ointment is initially used twice a day, it should later be applied only daily, then every two days and finally twice a week to prevent the rebound effect.
When using cortisone, it is extremely advisable to follow the instructions of the doctor who is treating you. The aim is to minimize side effects and the rebound effect as much as possible. Cortisone is primarily applied externally to the skin with so-called cortisone ointments.
It is particularly important to use a sufficiently strong ointment, as diluted ointments do not allow the inflammation to heal completely. Too little ointment could lead to a rebound effect. Long-term, daily use over several years should also be avoided at all costs in order to rule out the risk of side effects such as thinning of the skin. It is therefore advisable to only apply cortisone to the affected areas of skin. Other therapies should be used, especially for longer applications on the face, as the skin is particularly susceptible to side effects.
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Author: Christian Unterlechner, Dipl.-Ing. (FH), MBA
“From our own experience with neurodermatitis – and the long path of suffering associated with skin conditions like this – we started to look for alternative solutions to drug treatments. We are very happy to share the knowledge and experience that has gone into the years of developing our SkinCare products with you.”
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