When does a skin rash need cortisone?

Introduction

Cortisone is a hormone (glucocorticoid) that is produced in the body (in the adrenal cortex), but in medicine it is produced synthetically and used for drug therapies. Cortisone can therefore also be used in the treatment of various skin diseases, whereby the anti-inflammatory effect (e.g. skin inflammation, eczema) and the effect inhibiting the immune system (in autoimmune skin diseases such as lupus erythematosus, neurodermatitis) are the desired effects. On the other hand, a skin rash can also occur as a rare side effect (in 3% of cases) of cortisone therapy, which can be seen as an allergic reaction of the body to this drug.

Indications for cortisone

Cortisone as a drug, regardless of its dosage form (tablet, ointment, cream, as a liquid directly into the vein) has two important modes of action from which the various indications in treatment result. Firstly, it has an anti-inflammatory effect and secondly, it has an immunosuppressive effect, i.e. the body’s own defense system is either locally or systemically inhibited. The latter is particularly useful in the case of diseases in which the body’s defense system is mistakenly directed against its own body (autoimmune diseases, e.g. rheumatoid arthritis, Crohn’s disease, etc.). The anti-inflammatory effect can be useful in various diseases with an inflammatory component, such as rashes, eczema, allergic reactions, etc. Another important indication is the replacement of cortisone when the body is not able to produce enough of this hormone (e.g. adrenal gland diseases).

Cortisone as cream or ointment

Cortisone is always used as a cream or ointment when the effect of this drug is to be applied only locally, i.e. limited to (an area of) the skin or mucous membranes. It is therefore an external application, which can be initiated for example in inflammatory skin/mucosal diseases (eczema, conjunctivitis), allergic reactions (skin rash) or autoimmune skin diseases (neurodermatitis). There is a wide variety of cortisone ointments, which usually differ only in their name, but not in their active ingredient or mode of action. The cream or ointment containing cortisone is applied thinly to the affected skin areas, true to the motto: “As much and often as necessary, as little as possible”, in order to avoid any side effects that may occur.