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Steroid-induced skin atrophy is thinning of the skin as a result of prolonged exposure to topical steroids. In people with psoriasis using topical steroids it occurs in up to 5% of people after a year of use. [5] Intermittent use of topical steroids for atopic dermatitis is safe and does not cause skin thinning. [6] [7] [8]
Cortisone is a pregnene (21-carbon) steroid hormone. It is a naturally-occurring corticosteroid metabolite that is also used as a pharmaceutical prodrug . Cortisol is converted by the action of the enzyme corticosteroid 11-beta-dehydrogenase isozyme 2 into the inactive metabolite cortisone, particularly in the kidneys.
The neuropsychiatric effects are partly mediated by sensitization of the body to the actions of adrenaline. Therapeutically, the bulk of corticosteroid dose is given in the morning to mimic the body's diurnal rhythm; if given at night, the feeling of being energized will interfere with sleep. An extensive review is provided by Flores and Gumina ...
[15] [16] [18] They first identified cortisone to be one of the possible drugs, and further research led them to discover an effective drug for human dermal problems, which was hydrocortisone. [15] [16] [18] After the discovery of hydrocortisone, the earliest application of hydrocortisone as a topical form in humans was recorded in 1952.
Cortisol is a steroid hormone in the glucocorticoid class of hormones and a stress hormone.When used as medication, it is known as hydrocortisone.. It is produced in many animals, mainly by the zona fasciculata of the adrenal cortex in an adrenal gland. [1]
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Long-term use of topical steroids can lead to secondary infection with fungus or bacteria (see tinea incognito), skin atrophy, telangiectasia (prominent blood vessels), skin bruising and fragility. [11] The use of the finger tip unit may be helpful in guiding how much topical steroid is required to cover different areas of the body.
Long-term exposure to glucocorticoid medications, such as asthma and anti-inflammatory medication, has been shown to create deficits in memory and attention both during and, to a lesser extent, after treatment, [14] [15] a condition known as "steroid dementia". [16]