Introduction
Cortisone and cortisol (hydrocortisone) are endogenous hormones and belong to the so-called glucocorticoids. As a drug, cortisone is one of the drugs with the most applications and indications, not least because of its many effects, including the reduction of inflammatory reactions. If there is a deficiency or complete absence of cortisone in the body due to certain diseases, it must be supplied throughout life. However, if the aim is to reduce inflammatory reactions and symptoms, it can be used for short-term therapy. With local treatment, for example with ointments or eye drops, the side effects can be kept to a minimum.
Effect and indications
In substitution therapy, cortisone is used for adrenocortical insufficiency (Addison’s disease) and in adrenogenital syndrome also for babies. Cortisone production in the body does not function properly, which is why cortisone has to be supplied externally. Besides substitution therapy, cortisone is also used for symptomatic therapy: In the acute situation, for example in allergic reactions up to anaphylactic shock, in acute asthma attacks and in an acute episode of an autoimmune disease.
In babies these are mainly various inflammations of the blood vessels. Long-term therapy is used for chronic inflammatory diseases such as asthma and rheumatological diseases – certain forms of these can already occur in babies. If cortisone is used for lung diseases such as asthma or other, rarer diseases, it also has the additional effect of preventing chronic changes in the lungs.
For inflammatory skin diseases – such as neurodermatitis – cortisone can be used in the form of ointments, for eye diseases, for example, in the form of drops. This is referred to as a local therapy. The therapy always has the purpose of avoiding inflammation and consequential damage.
If bronchitis occurs in a baby, it is usually accompanied by a narrowing of the airways, as the still very small airways of babies swell more quickly due to the inflammation than in older children (obstructive bronchitis). Cortisone should be used here for pronounced symptoms such as shortness of breath. If obstructive bronchitis occurs repeatedly, for example three or more in six months, or if asthma is present, long-term therapy with inhaled cortisone must be initiated.
The aim is to enable the baby/child to lead a life without restrictions. The cortisone reduces the risk of renewed bronchitis and prevents irreversible remodelling processes that occur in the lungs when bronchitis is frequent. In severe cases of neurodermatitis (atopic eczema), ointments and creams containing cortisone are used.
A distinction is made between classes 1 to 4 in ascending order of strength in cortisone. In general, these creams should only be used in acute attacks as they show the best effect and only with long-term application side effects will slowly become apparent. Nowadays it is regarded as secured that an application of these creams at the baby is harmless in contrast to tacrolimus ointments. Inform yourself here more about the topic: Neurodermatitis in babies
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