First Aid

Over the Counter Cortisone Creams and Skin Rashes

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Over-The-Counter Cortisone Creams and Skin Rashes

Over-the-counter cortisone creams may appear to be appropriate treatment for various kinds of skin rashes, but at the same time, there can be pros and cons regarding their use. Thus, it is important to understand what cortisone cream actually is and why you may need to be cautious.

Note that non-prescription, over-the-counter cortisone creams are low-dosage, medicated creams and as a result, they may not always be effective for every kind of rash. In fact, they may only give temporary relief. A prescription from a physician, for a more potent cortisone cream may be indicated, in order to effectively resolve a skin rash.

Looking at the number of cortisone creams that are currently on the market, a patient might begin to wonder how to determine the right kind of cortisone cream for any specific rash. Cortisone creams are not all the same and neither are rashes.

First, let's look at some basic information about cortisone and then weigh the pros and cons of using over-the-counter cortisone creams for skin rashes.

What is cortisone?

"Cortisone is a hormone isolated from the cortex of the adrenal gland and also prepared synthetically. It is closely related to cortisol; and is largely inactive in man until converted to cortisol. It is important for its regulatory action in metabolism if fats, carbohydrates, sodium, potassium, and proteins." (1)

Cortisone cream is used as an anti-inflammatory agent that helps to reduce the degree of vascular dilation, fluid exudation and the accumulation of leukocytes or white blood cells that accumulate when a skin rash occurs. (2)

What is cortisol?

Cortisol is an adrenocorticol hormone that is referred to pharmaceutically as hydrocortisone and is closely related to cortisone in terms of physiological effects. (3)

The kind of cortisone cream that is indicated depends upon the type of skin rash that you have. Note that not all rashes will respond well to the same kind of treatment. Having the right kind of treatment immediately, can reduce your discomfort as well as the length of time that treatment is necessary.

"All types of cortisone cream should only be used under the supervision of a doctor to determine the appropriate strength and length of time of use necessary to treat the condition." (4)

Pros for using cortisone cream include the following benfits:

Relief of inflammation and pruritic manifestations of corticosteroid sensitive dermatoses

Temporary relief of minor skin irritations, itching and rashes - over-the-counter prescriptions (5)

Cons regarding the use of cortisone cream include the following adverse side effects:

Local: Burning, irritation, acneiform lesions, striae, skin atrophy, secondary infection

CNS: Glaucoma, cataracts after periorbital use that allows the drug to enter the eyes

Systemic: Systemic absorption, leading to the adverse effects experienced with system use; growth retardation and suppression of the HPA (6)

Guidelines for use of cortisone cream:

Use cortisone cream sparingly.

Rub the cortisone cream into the skin, gently.

Be aware that washing the skin prior to the application of the cortisone cream, may increase the drug penetration.

Do not use occlusive dressings, tight-fitting diapers or plastic pants over the area that has been treated with cortisone cream.

Avoid prolonged use of cortisone cream on the face and near the eyes. Also avoid long term usage on the genitals, rectal area or in skin creases.

Avoid direct contact of cortisone cream with the eyes.

Use the cortisone cream only for the purpose for which it is indicated.

Do not apply cortisone cream to any open lesions.

Always notify your physician if the skin condition appears to be getting worse. If the rash persists or there is burning of the skin, irritation or infection, medical advice should be sought. (7)

Relax knowing that your physician will be able to advise you regarding which over-the-counter cortisone cream is the most appropriate for the kind of skin rash that you have.

(1) Taber's Cyclopedic Medical Dictionary, Edition 14, F.A. Davis Company, Philadelphia, 1981, p. 342

(2) Ibid.

(3) Ibid.


(5) Amy R. Karsh, RN, MS., 2000 Lippincott's Nursing Drug Guide, Lippincott Williams and Wilkins, Philadelphia PA, 2000, p. 1332

(6) Ibid.

(7) Ibid.

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