HYDROCORTISONE 0.5%
Place in Therapy
The mainstay of management is the use of topical corticosteroids. Steroids are nonspecific inhibitors of inflammation and have proven to be effective in the treatment of dermatitis. They are available in a wide range of potencies. The lowest potency should be used for the shortest amount of time in treating flare ups associated with dermatitis. Short courses of higher potency steroids can be used in cases of resistant diseases.
Topical steroids are usually trouble-free and highly effective although more potent steroids are associated with increased risk of side effects. The least systemic absorption occurs on the palms and soles while maximum systemic absorption occurs in intertriginous areas. Children have an increased surface area to weight ratio and are therefore at increased risk for developing systemic adverse effects. Ointment formulations have shown increased effectiveness over cream based formulations. According to literature, hydrocortisone 0.5% is rarely used due to its limited effectiveness in comparison to higher potency corticosteroids, however effectiveness versus placebo has been demonstrated. (3) More effective/potent corticosteroids (hydrocortisone 1%) are preferred alternatives. (1-5) In short, the use of hydrocortisone can be recommeneded for acute, mild or chronic atopic or contact dermatitis however, it is recommended that a treatment course of hydrocortisone may not exceed 2 weeks. In addition to non-pharmacological considerations, utilizing other non-steroid treatment options to reduce hydrocortisone use can be considered an approach to chronic atopic dermatitis that maximized the effectiveness and safety of pharmacotherapy for the patient.
Topical steroids are usually trouble-free and highly effective although more potent steroids are associated with increased risk of side effects. The least systemic absorption occurs on the palms and soles while maximum systemic absorption occurs in intertriginous areas. Children have an increased surface area to weight ratio and are therefore at increased risk for developing systemic adverse effects. Ointment formulations have shown increased effectiveness over cream based formulations. According to literature, hydrocortisone 0.5% is rarely used due to its limited effectiveness in comparison to higher potency corticosteroids, however effectiveness versus placebo has been demonstrated. (3) More effective/potent corticosteroids (hydrocortisone 1%) are preferred alternatives. (1-5) In short, the use of hydrocortisone can be recommeneded for acute, mild or chronic atopic or contact dermatitis however, it is recommended that a treatment course of hydrocortisone may not exceed 2 weeks. In addition to non-pharmacological considerations, utilizing other non-steroid treatment options to reduce hydrocortisone use can be considered an approach to chronic atopic dermatitis that maximized the effectiveness and safety of pharmacotherapy for the patient.