Cortisone as a drug

With the successful treatment of the young American, cortisone was quickly established as a drug. In the 1950s, the new drug was used internally to treat rheumatism with great success. And cortisone quickly caught on in dermatology as well. Up to this point in time, there was no remedy for the treatment of inflammatory  skin diseases  that was so quick and so effective.

The effect of cortisone as an active ingredient

It is now known that cortisone  has different effects  and can be used in different ways because it:

• inhibits inflammation
• suppresses immunological/allergic reactions
• slows down accelerated cell division
• can reduce cerebral edema
• prevents vomiting after taking certain anti-cancer drugs

These effects are based on the fact that the hormone in the cell nucleus triggers the formation of certain proteins, which in turn produce reactions. Therefore, the effect of the drug occurs  after 30 minutes at the earliest  . However, this effect is only achieved if the hormone is administered in a higher dose than is present in the body.

At extremely high doses, the hormone is stored directly in the cell walls and can then take effect immediately. Doctors take advantage of this mechanism when, for example, swelling in the tissue impedes breathing or shock states acutely threaten the patient’s life.

Variety of cortisone preparations

The original cortisone is still used in patients with impaired adrenal cortex. For other therapeutic purposes, various cortisone preparations have been developed through chemical changes, which all have the same effect in the body, but differ in terms of their effectiveness and their behavior in the organism.

In particular, the cortisone-containing  ointments that  are used for skin diseases have benefited from drug research in recent years. Today there are a number of ointments and creams that have no effect on the entire organism, even when used on the skin for a long time, but only develop their effect locally on the skin.

Patients with inflammatory bowel diseases,  asthma  or inflammatory rheumatic diseases have also benefited from this development.

derivatives of cortisone

There are now numerous synthetically produced derivatives of cortisone such as betamethasone, triamcinolone,  dexamethasone ,  prednisolone , prednisone, mometasone and fluticasone. The active ingredient is used in:

• Asthma and nasal sprays
• eye drop
• Liquid for squirting (injections)
• Anoint
• Creams
• suppository
• tablets

For the long-term treatment of chronic diseases, they can be used in very low doses or in a targeted manner and therefore hardly cause any problems.

Internal use of cortisone

Inflammatory reactions are symptoms of many diseases such as asthma,  chronic obstructive bronchitis  ( COPD ), rheumatism or kidney diseases. Cortisone and its derivatives are indispensable for therapy, as they are still the most effective anti-inflammatory drugs known to medicine.

Allergic diseases are also often associated with inflammation of the affected organs. Corticoids are also used here to curb the inflammatory reactions.

The symptoms can be reduced with this therapy or sometimes disappear completely. Cortisone preparations can also prevent a so-called stage change from  hay fever  to chronic asthma.

Here are  3 rules  when using internal cortisone:

1. Since the adrenal cortex releases most of the cortisone in the morning, the entire daily dose should be taken  before 8  a.m. This mimics the body’s natural daily rhythm.
2. Corticoids must be discontinued gradually in order to prevent the symptoms from occurring more frequently when the medication is suddenly discontinued (rebound effect)   . One then speaks of a tapering off of the therapy.
3. The systemic, i.e. the internal use of corticosteroids must not take place over a long period of time (more than 3 to 4 weeks) and in high doses (more than 10 milligrams/day) without  medical supervision  , otherwise the well-known  side effects  such as weight gain, water retention in the tissue,  osteoporosis  or a disorder of sugar metabolism.

External use of cortisone

Corticoids work particularly well against inflammatory skin diseases  –  the typical signs such as redness, swelling, heat and pain disappear quickly. Above all  , itching , the classic symptom of  neurodermatitis , for example, can be quickly brought under control with cortisone therapy.

However, if cortisone ointments are used incorrectly (for example over a long period of time), they can thin the skin and ultimately make the skin more prone to infection. Therefore, the following rules should be observed:

• As long as the condition is acute, apply the medication as often as necessary.
• When symptoms subside, apply as little as necessary.
• Use as little as possible in the chronic phase.