Cortisone: the limits of a "miracle" - includes related articles

Nutrition Health Review, Fall, 1991

The comprehensive nature of these labeling instructions (essentially the same for all the cortisone-type drugs) is commensurate with their powerful nature and is necessary to help ensure that they are used safely and effectively.

An essential condition for over-the-counter dispensing of hydrocortisone and hydrocortisone acetate is cautionary labeling for consumers detailing the conditions for which the product could be used, when it should not be used, its length of use, and so forth. For example, since some skin conditions may result from a serious underlying disease, the labeling must state that the product should be discontinued and a physician consulted if the symptoms persist for more than seven days or clear up and then recur within a few days.

Although prolonged topical application of some prescription corticosteroids have been associated with development of such skin conditions as stretch marks, acne, blood vessels becoming visible, bruises and paper-thin skin, and although there have been reports suggesting growth retardation after chronic use by children, such reactions are rarely associated with nonprescription topical hydrocortisone.

Ralph Waldo Emerson once said, "Nature never gives anything to anyone; everything is sold. It is only in the abstractions ... that choice comes withut consequences." In choosing to discover, develop and deploy cortisone, scientists and physicians have also learned the cost and the consequences. It is the task of both the art and science of medicine and pharmacy to minimize the costs while attaining all the benefits.