With the successful treatment of the young American cortisone was quickly established as a drug. In the fifties, the new drug was mainly used internally for the treatment of rheumatism with great success. And also in dermatology cortisone prevailed quickly. In fact, by that time, there was no agent that was as fast and effective in the treatment of inflammatory skin diseases.
The effect of cortisone as an active ingredient
It is now known that cortisone has different effects and can be used differently, because it:
- inhibits inflammation
- suppresses immunological / allergic reactions
- slows down an accelerated cell division
- can reduce brain edema
- prevents vomiting after taking certain cancer drugs
These effects are based on the fact that the hormone in the cell nucleus triggers the formation of certain protein bodies, which in turn generate reactions. Therefore, the effect of the drug occurs at the earliest after 30 minutes. However, this effect is only achieved if the hormone is administered at a higher dosage than is present in the body.
At extremely high dosages, the hormone accumulates directly in the cell walls and can then act immediately. Doctors make use of this mechanism when, for example, tissue swelling conditions hinder breathing or even shock states threaten the patient's life.
Variety of cortisone preparations
The original cortisone is still used in patients with limited adrenal cortex. For other therapeutic purposes, various cortisone preparations have been developed by chemical changes, all of which have the same effect in the body, but differ by the strength of action and their behavior in the organism.
Especially the cortisone-containing ointments that are used in skin diseases have benefited from drug research in recent years. Today, there are a number of ointments and creams that have no effect on the whole organism even after prolonged use on the skin, but only have an effect locally on the skin.
Also, patients with inflammatory bowel disease, asthma or inflammatory rheumatic diseases have benefited from this development.
Descendants of cortisone
There are now numerous synthetically produced derivatives of cortisone, such as betamethasone, triamcinolone, dexamethasone, prednisolone, prednisone, mometasone and fluticasone. The active ingredient is used in:
- Asthma and nasal sprays
- eye drop
- Liquid for spraying (injections)
For the long-term treatment of chronic diseases, they can be dosed very low or used selectively and therefore cause hardly any problems.
Internal use of cortisone
Inflammatory reactions are symptoms of many diseases such as asthma, chronic obstructive pulmonary disease (COPD), rheumatism or kidney disease. Cortisone and its derivatives are indispensable for therapy as they are still the most effective anti-inflammatories that medicine knows.
Allergic diseases are also often associated with the inflammation of the affected organs. Corticosteroids are also used here to stem the inflammatory reactions.
The symptoms can be lessened with this therapy or sometimes disappear altogether. Cortisone preparations can also prevent a so-called change of floors from hay fever to chronic asthma.
Here are 3 rules for the internal use of cortisone:
- Since the adrenal cortex pours out most of the cortisone in the morning, you should take the entire daily dose before 8 o'clock. This is how you imitate the natural daily rhythm of the body.
- Corticosteroids must be gradually withdrawn in order to prevent the symptoms from increasing when the medication is suddenly discontinued (rebound effect). One then speaks of a tapering of the therapy.
- The systemic, ie the internal use of corticosteroids must not take place without medical control for a long time (longer than 3 to 4 weeks) and in high doses (more than 10 milligrams / day), otherwise the known side effects such as weight gain, water retention im Tissue, osteoporosis or a disorder of sugar metabolism.
External use of cortisone
Corticosteroids are particularly effective against inflammatory skin diseases - typical signs such as redness, swelling, warming and pain pass quickly. In particular itching, the classic symptom of, for example, atopic dermatitis, can be dealt with quickly with cortisone therapy.
However, when cortisone ointments are used incorrectly (for example, over a long period of time), they can make the skin thinner and ultimately cause the skin to become more susceptible to infection. Therefore, you should pay attention to the following rules:
- As long as the condition is acute, apply as often as necessary.
- When the symptoms subside, apply as little as necessary.
- Use as rarely as possible in the chronic phase.