When does a rash need cortisone?
introduction
Cortisone is a hormone (Glucocorticoid), which is produced in the own body (in the adrenal cortex), but is manufactured synthetically in medicine and used for drug therapies. Thus, cortisone can e.g. can also be used in the treatment of various skin diseases, whereby the anti-inflammatory effect (e.g. in the case of skin inflammation, eczema) and the effect that inhibits the immune system (in the case of autoimmune skin diseases such as lupus erythematosus, neurodermatitis) are the desired effects.
On the other hand, a skin rash can occur as a rare side effect (in 3% of cases) with cortisone therapy, which can be seen as an allergic reaction of the body to this drug.
Please also read our page Effects of cortisone.
Indications for cortisone
As a drug, regardless of the dosage form (tablet, ointment, cream, as a liquid directly into the vein), cortisone has two important modes of action, from which the various indications in the treatment result.
On the one hand it has an anti-inflammatory effect and on the other hand it is immunosuppressive, i.e. the body's own defense system is inhibited either locally or systemically. The latter is particularly useful when it comes to diseases in which the immune system is incorrectly directed against the own body (autoimmune diseases, e.g. rheumatoid arthritis, Crohn's disease, etc.).
The anti-inflammatory effect can be useful in a wide variety of diseases with an inflammatory component, such as if you have a rash, eczema, allergic reactions etc..
Another important indication is the replacement of cortisone when the own body is not able to produce enough of this hormone (e.g. in adrenal diseases).
Cortisone as a cream or ointment
Cortisone is always used as a cream or ointment when the effect of this drug is only to be applied locally, i.e. limited to (an area) of the skin or the mucous membranes. It is therefore an external application that can be initiated, for example, in the case of inflammatory skin / mucous membrane diseases (eczema, conjunctivitis), allergic reactions (rash) or autoimmune skin diseases (neurodermatitis).
There are various cortisone ointments that usually only differ in their name, but not in the active ingredient or the 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 possible side effects.
Read more about this on our website
- Cortisone ointment
- Treat rash with ointments and creams
Cortisone as a tablet
Cortisone is always prescribed or used as a tablet when the effect is not only limited locally to one (external) point, but when the effect is more systemic, i.e. in the whole body. If cortisone is taken in tablet form, it is absorbed in the gastrointestinal tract and gets into the blood, so that it is distributed in the body via the circulation and bloodstream and has an effect in places that cannot be reached from the outside.
If cortisone is used to treat a rash, a local treatment in the form of an ointment is usually started, depending on the severity of the rash and the response to the medication, but can be switched to a systemic tablet form from the outset or afterwards.
The likelihood of side effects of cortisone is higher when taking tablets than with the limited, local use of ointments on the skin or sprays for inhalation, since the cortisone reaches the whole body via the bloodstream.Whether and when side effects occur, however, varies from person to person and depends on the dose of cortisone.
Read more about this on our website Cortisone as a tablet
What to do if cortisone doesn't help
If there is no improvement under local or systemic therapy with cortisone, either the dose of cortisone should be increased or the therapy should either be supplemented by other drugs or the cortisone should be replaced by another drug.
For example, if cortisone was used on the skin mainly due to its anti-inflammatory effect on eczema, without any improvement, a possible infection of the skin areas with bacteria or fungi must be taken into account, so that an additional application of (local or systemic) antibiotics or anti - Fungi (antifungal) can be useful.
If cortisone has been prescribed with regard to its immunosuppressive effect, for example in autoimmune diseases, and the effect is not satisfactory, cortisone can be supplemented or replaced by other drugs that block or reduce the body's immune system (e.g. Methotrexate, Azathioprine, Cyclosporine etc.).
Read more on the topic: Taper off cortisone
Side effects from cortisone on the skin
A short-term application of cortisone-containing ointments or creams on the skin or the short-term or low-dose intake of cortisone as tablets for a systemic effect usually does not lead to changes in the skin.
If an ointment containing cortisone is applied to the skin for a long time or if cortisone is taken over a long period at a dose above the so-called Cushing's threshold (threshold above which possible side effects can occur), side effects on the skin can sometimes occur.
Long-term use can e.g. lead to a parchment skin. This is a very sensitive, thin skin that can tear and bleed even with low mechanical loads. An increased tendency of the skin to bleed can also result, since the small skin vessels become more fragile and more prominent through the long-term use of cortisone.
Furthermore, a so-called steroid acne can develop. This is the appearance of pimples and blackheads, preferably on the back, shoulders and face.
Hyperpigmentation (the skin takes on a slightly darker skin color) can also be noticed, but this usually disappears after stopping the ointment.
Please also read our page Side effects of cortisone
Rash after cortisone injection
Cortisone injections are often used in combination with a local anesthetic in orthopedic medicine and are used, for example, in the therapy of Pain and inflammation in joints or at Herniated discs administered in the spine.
The cortisone depot, which is then injected into a joint or near the nerves on the spine that is pinched by the bulging intervertebral discs, usually holds several weeks until the anti-inflammatory, decongestant and pain-relieving effects wear off again.
Because the cortisone is administered locally, i.e. specifically in a joint or in the vicinity of the spine, the effect is usually only locally limited and not systemic. This reduces the likelihood of major side effects occurring, such as the development of a skin rash from the cortisone injection only very rare to observe.
However, if a skin reaction occurs after an injection, it is considered to be one allergic reaction of the body to understand cortisone as an active substance. If necessary, this skin rash must also be treated; it is advisable to consult a doctor in any case.
