Topical corticosteroids often produces dramatic suppression of skin diseases, such as eczema, infantile eczema, atopic dermatitis, dermatitis herpetiformis, contact dermatitis, seborrhoeic dermatitis, neurodermatitis, some forms of psoriasis, and intertrigo, in which inflammation is a prominent feature. However, the disease may return or be exacerbated when corticosteroids are withdrawn.
Application of the corticosteroids to the skin has lead to loss of skin collagen, subcutaneous atrophy local hypo pigmentation of deeply pigmented skins. Topical corticosteroids should not be applied with an occlusive dressing to large areas of the body because of the risk of systemic absorption. Also they should not be used for the treatment of rosacea and should not be used indiscriminately for pruritus. Corticosteroids should not be applied to ulcers of the leg and long term topical use is best avoided, especially in children. Patients should be advised that topical corticosteroids should be applied sparingly in thin layers, by smoothing gently into the skin preferably after a bath and that no benefit is gained from more frequent than twice daily application or by vigorous rubbing
Indications: - symptomatic relief of inflammation and/or pruritus associated with acute and chronic adrenocorticoid - responsive disorders.
Cautions: - pregnancy and breast-feeding i.e. avoid extensive use during pregnancy and topical adrenocorticoids should not be applied to the breasts prior to nursing. Caution is also required in children and elderly patients. Caution is also taken in patients with infection at treatment site, intolerance to hydrocortisone, pre-existing atrophy.
Contraindications: - untreated bacterial, fungal or viral skin lesions.
Side effects: - contact dermatitis (burning and itching of skin, apparent chronic therapeutic failure), folliculitis, furunculosis, pustules, pyoderma, or vesiculation (painful, red or itchy, pus containing blisters in hair follicles), hyperaesthesia (increased skin sensitivity). Burning, dryness, irritation, itching, or redness of skin, mild and transient increased redness or scaling of skin lesions, minor and transient skin rash.
Dose and Administration:
Usual Adult dose - topical, to the skin, as a 0.1 - 1% cream or 0.5 - 2.5% ointment one to four times a day.
Children 2 years of age and older - topical, to the skin, as 0.5% cream one to four times a day or as a 1% ointment one or two times a day.
Note:- Advise patient not to use it in or around the eye.
Storage:- at room temperature in a well closed container, protect from freezing.