In the presence of dermatological infections, the use of an appropriate antifungal or antibacterial agent should be instituted. If irritation develops, topical corticosteroids should be discontinued and appropriate therapy instituted. Pediatric patients may absorb proportionally larger amounts of topical corticosteroids and thus be more susceptible to systemic toxicity (See Infrequently, signs and symptoms of steroid withdrawal may occur, requiring supplemental systemic corticosteroids. Recovery of HPA axis function is generally prompt and complete upon discontinuation of the drug.
If HPA axis suppression is noted, an attempt should be made to withdraw the drug, to reduce the frequency of application, or to substitute a less potent steroid.
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Therefore, patients receiving a large dose of a potent topical steroid applied to a large surface area or under an occlusive dressing should be evaluated periodically for evidence of HPA axis suppression by using the urinary free cortisol and ACTH stimulation tests.
Conditions which augment systemic absorption include the application of the more potent steroids, use over large surface areas, prolonged use, and the addition of occlusive dressings. Systemic absorption of topical corticosteroids has produced reversible hypothalamic-pituitary-adrenal (HPA) axis suppression, manifestations of Cushing’s syndrome, hyperglycemia, and glucosuria in some patients. Some of the topical corticosteroids and their metabolites are also excreted into the bile. Corticosteroids are metabolized primarily in the liver and are then excreted by the kidneys. Corticosteroids are bound to plasma proteins in varying degrees. Once absorbed through the skin, topical corticosteroids are handled through pharmacokinetic pathways similar to systemically administered corticosteroids. Thus, occlusive dressings may be a valuable therapeutic adjunct for treatment of resistant dermatoses. Occlusive dressings substantially increase the percutaneous absorption of topical corticosteroids.
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Inflammation and/or other disease processes in the skin increase percutaneous absorption. Topical corticosteroids can be absorbed from normal intact skin. The extent of percutaneous absorption of topical corticosteroids is determined by many factors including the vehicle, the integrity of the epidermal barrier, and the use of occlusive dressings. We do not take any responsibility for the consequences arising out of the aforementioned information and strongly recommend you for a physical consultation in case of any queries or doubts.Related/similar drugs Cosentyx, Entyvio, Taltz, Zeposia, Colazal, Simponi, Trianex Pharmacokinetics The absence of any information and/or warning to any drug shall not be considered and assumed as an implied assurance of the Company. We do not guarantee the accuracy and the completeness of the information so provided. Please note that this information should not be treated as a replacement for physical medical consultation or advice. Hydrocortisone Topical: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing – WebMDĭisclaimer: The information provided herein is accurate, updated and complete as per the best practices of the Company. Tattoo Aftercare | HOWL Tattoo & Piercing | Ft Myers – Florida () Hydrocortisone (Hydrocortisone Cream and Ointment 2.5%) Side effects, Images, Uses, Dosage, Overdose at RxList
Topical Corticosteroids – StatPearls – NCBI Bookshelf (nih.gov)
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