Cortisone in atopic dermatitis

introduction

Neurodermatitis is a chronic, inflammatory skin disease. On the one hand, it leads to dry and itchy skin; on the other hand, rashes can occur. It can be divided into different stages and the treatment depends on the appropriate stage.

The cortisone is used in acute attacks and can be dosed differently as required.

When do I need cortion for neurodermatitis?

Neurodermatitis is a chronic, recurring disease. However, the disease can worsen in phases and eczema can appear in different parts of the body. This phase is known as an acute episode. During this episode, those affected complain of excruciating itching. Glucocorticoids (cortisone) can be used therapeutically on the affected areas.
Cortisone inhibits the production of inflammatory messengers and suppresses the body's own immune system. A down-regulated immune system means that the superficial skin cells are less attacked and damaged. The inflammatory reaction is also milder.

The dosage and type of the respective cortisone preparation depends on the severity and location of the symptoms. Neurodermatitis can be divided into 4 degrees of severity. Level 1 is a mild form that is associated with dry skin. In this case, general measures, such as avoiding cold air, profuse sweating and individual triggering factors, should be observed. In addition, the skin should be cared for with moisturizing creams. Cortisone therapy is not yet necessary here. Stage 2 describes neurodermatitis with mild eczema. In this case, low-dose cortisone preparations (hydrocortisone) can be administered. From level 3, highly potent cortisone preparations (betamethasone, mometasone) should be used, as the eczema is more pronounced here. And from level 4, very powerful preparations (Clobetasol) should be prescribed.

Find out all about the topic here: The atopic dermatitis attack.

When do i need oral cortisone?

In addition to local therapy with cortisone preparations, oral administration may be necessary. This is the case with severe neurodermatitis with eczema on different parts of the body. To shorten the duration of the episode, the dose must be increased on the one hand and taken orally on the other. In this way, cortisone can act systemically, i.e. throughout the body. It can act on cells of the immune system, where it leads to a down-regulation of their activity. Furthermore, the inflammatory reaction is alleviated, since inflammatory messenger substances are less produced.

Also read the article: The effects of cortisone.

These creams are there

There are numerous different creams available on the market. A suitable cream is prescribed depending on the severity of the neurodermatitis.

For mild atopic dermatitis, creams containing hydrocortisone are first prescribed. These are available from pharmacies without a prescription and are explained in more detail in the next paragraph. If the symptoms are severe, you need highly potent cortisone preparations - creams with betamethasone can be used for this. There are numerous products on the market, such as the Betamethason Hexal® Comp ointment (with 0.64 mg Bethamethasone), the Beta Cream from Lichtenstein (with 1.21 mg Bethethasone) and the BetaGalen® Cream (1.21 mg Bethamethasone). The attending physician should prescribe the appropriate cream with the correct dosage.
If the neurodermatitis is very pronounced, the very powerful Clobetasol is used.In this case, too, different products can be bought, such as the Clobetasol acis cream (with 0.50 mg Clobetasol).

In addition to these creams, eczema sufferers should continue to value basic care. Creams with a high percentage of fat should be used for this, as the skin's barrier function must be stabilized.

Find out more about the topic here:

• Skin care for neurodermatitis
• Cortisone ointment
• These creams can help with eczema

Are there any over-the-counter cortisone creams?

Mild cortisone preparations, such as hydrocortisone, can be purchased without a prescription from a pharmacy. They are usually available in a dosage of 0.25% or 0.5%. Possible commercial products are the FeniHydrocort®, Hydrocortisone-ratiopharm®, Soventol® HydroCort or the Systral® Hydrocort.
However, these creams only help with mildly developed neurodermatitis. If you have severe symptoms or acute relapses, you should consult a dermatologist who will prescribe the right cream for you.

Cortisone helps that quickly

The exact speed of the effect cannot be answered across the board, as it depends on the type and dosage of the cortisone preparation. However, it can be said that cortisone has an acute and a long-term effect.

The acute effect occurs within a few minutes. It is believed that cortisone stabilizes the cell membrane and thus has a positive effect. The long-term effect sets in after several hours. The production of inflammatory messenger substances is inhibited.

Find out more about the here Effects of cortisone.

This is how long cortisone helps

It is not possible to give an exact indication of the duration of the effect of cortisone. Here, too, the type and dosage of the cortisone preparation play an important role. The acute effects of cortisone only last a few hours. The long-term effect, however, can persist for up to several days. Usually the patients perceive this as particularly positive.

When can you do without cortisone?

Cortisone should never be used in the chronic phase, as long-term therapy has side effects. In addition, the inflammatory reaction in this phase is very weak, so that the application does not bring any noticeable benefit. So you should only use cortisone during an acute attack.

Furthermore, cortisone can be omitted in the case of mildly pronounced neurodermatitis, which is only associated with dry skin. Rather, one should pay attention to basic care. Creams that also contain urea, glycerine or paraffin are suitable for this. In addition, general measures such as extreme sweating, mechanical skin irritation or individual trigger factors should also be avoided.

Cortisone can also be avoided in the case of neurodermatitis with mild eczema. However, this depends on the localization and the accompanying symptoms. For eczema on the face or neck area, people are reluctant to prescribe cortisone anyway and would wait for a mild form first. If symptoms such as redness, swelling and itching are minor and do not pose a burden for the patient, the use of cortisone would also be avoided. If the symptoms worsen, however, a dermatologist should be consulted, who should initiate appropriate therapy.

At which parts of the body do you have to be careful with cortisone?

Cortisone is an effective drug in the use of acute attacks. However, it also has some disadvantages. It can cause skin atrophy. This means that the skin becomes thinner at this point (so-called parchment skin). The skin can tear more easily and injuries are more likely. Particularly sensitive areas are the face, neck and genital region. You should also be careful when using it in the crook of the elbow or the hollow of the knee, as the skin is very thin here.

In the case of infants, care should also be taken when applying it to the scalp, as the absorption capacity of various substances is increased

Atopic dermatitis in babies? Get information here.

What are the side effects of cortisone treatment for neurodermatitis?

There is a lot of skepticism when using cortisone preparations, as numerous side effects are known. In itself, however, cortisone is an endogenous hormone that is produced in the adrenal cortex. It controls many metabolic processes and increases the body's willingness to perform in stressful situations.

In order for side effects to occur with topical application, long-term use must take place. These side effects include skin atrophy and telangieectasias. Skin atrophy describes a thinning of the skin. The skin can tear more easily and the development of open wounds is encouraged. This in turn increases the risk of infection. The visible expansion of vessels on the surface of the skin is called telangieectasia. To prevent these side effects from occurring, the correct dose of cortisone should be used and not used for too long. The treatment of cortisone is only suitable for acute therapy.

If the findings are pronounced, local application cannot provide relief. In this case, the cortisone is administered orally and acts throughout the body. This results in other side effects, such as osteoporosis, increased susceptibility to infections due to immunosuppression, increased blood pressure and depression. In exceptional cases, Cushing's syndrome can even occur. In addition to the side effects described, there is a loss of glucose tolerance and a shift in body fat (so-called trunk obesity).

Find out all about the topic here: The side effects of cortisone.

Can neurodermatitis get worse with cortisone?

Cortisone leads to an inhibition of the body's own inflammatory reaction. This improves symptoms and shortens the duration of an acute attack. Hence, cortisone should not worsen it.

However, some patients are allergic to the additives contained in cortisone creams. This can lead to a worsening of the clinical picture. In this case one should consult the attending physician. The doctor should clarify the situation and possibly prescribe a different cream or take other therapeutic measures.

Can you cure neurodermatitis? Read on here.