Hormonal ointments from allergies

Allergy is almost always a rash, and hormonal ointments from allergies are considered to be one of the most effective outdoor remedies. However, many allergies unreasonably fear medications containing hormones. Before you reject or use this or that ointment, you need to understand what these drugs are, how and why the doctor prescribes hormonal drugs for allergies, what kinds, properties, indications and contraindications they have.

[1], [2], [3], [4], [5]

Indications for the use of hormonal ointments from allergies

Hormonal external preparations are aimed at a rapid counteraction to the release of histamine and other biologically active substances (BAS) from highly specialized immune cells called mast cells. As a rule, hormonal ointments are appointed as stabilizers of cell activity, which take a direct part in inflammation. Corticosteroids suppress the activity of the entire cellular structure, this "universal" action and is used in arresting the inflammatory process caused by allergies.

Purpose and indications for the use of hormone-containing drugs are effective in acute and slow, chronic chronic inflammation of the skin. Of course, the doctor recommends such ointments, taking into account the anatomical and physiological specificity of the skin, the age of the patient and accompanying pathologies. For example, skin integuments of children are more susceptible to any external agent in principle, since they have closely located vessels to the surface, a loose and delicate structure of the epidermis. This does not mean that hormonal drugs are not used in the treatment of allergies in children, they are prescribed, but in the absence of the effect of treatment in other ways. In addition, to date, there are practically no aggressive hormonal ointments that have absolute contraindications. All preparations of this kind have their own indications for use and occupy a certain niche in the therapeutic practice of allergists. In addition, the risk of complications caused by atopic dermatitis is much higher than the possible risk of delayed complications, therefore, hormonal ointments are indicated in such situations:

• Acute inflammation of the skin caused by allergies.
• Recurrent rash, no effect of treatment with non-hormonal agents.
• Risk of developing acute eczema.
• Photodermatitis.
• Atopic dermatitis.
• Neurodermatitis, provoked by allergy.
• Erythematous rash as a complication of drug allergy.
• Erythema multiforme as a complication of allergy.

Types of hormonal ointments from allergies

All external drugs that relieve allergic symptoms are divided into hormonal, non-hormonal and combined drugs. Combined ointments may include, in addition to hormones, antibacterial substances, antifungal or anti-inflammatory non-steroidal components.

Hormonal ointments in turn are divided into classes according to the strength of the effect and the content of the active substance:

Class of preparation	Name of the drug	Effect, action
I	Ointments: Hydrocortisone Diperzolone	Weak, short-term effect due to slow penetration into skin cells
II	Hydrocortisone Butyrate (laticort) Afloderm Lorinden Prednisolone, Prednikarbat Cinacort Lokakorten Deoxymethasone	Moderate impact
III	Elokom Celestoderm, Celederm (betamethasone) Beloderm Advantan Polcortolone Kutiweit Mometasone furoate Apulein Sinaflanc, Sinalar, Flucourt Betamethasonovaleriat Fluorocyanide	Drugs act quickly
IV	Galcinonide Dermovayt Halcederm Diflucortolonovalerate	Powerful anti-inflammatory effect, maximum penetration depth

You can not ignore other types of hormonal ointments from allergies - combined preparations:

Name	Active substance and additional components
Diprosalik	Betamethasone and salicylic acid
Triderm	Betamethasone, clotrimazole and gentamicin
Vipsogal	Betamethasone, panthenol, gentamicin and salicylic acid
Oxycourt	Hydrocortisone and cositracycline
Aurobin	Prednisolone, lidocaine, triclosan
Lorinden	Flumethasone and salicylic acid
Sinalar	Fluorocyanolone and neomycin (or clioquinol)

The activity of the drug depends not only on its main component and form of release, but also on its dose. The more powerful the effect of anti-allergic hormonal ointment, the more carefully it is prescribed, since such an effect can cause undesirable side effects.

Method of applying hormonal ointments from allergies

Usually the way of applying hormonal ointment from allergies is explained by the attending physician, taking into account all the features of the patient - age, skin condition, localization and the nature of allergic rash. Of course, the basic rule, which is followed by an allergist, is safety of use in combination with its appropriateness. These properties have new drugs that belong to the group of non-fluorinated hormonal drugs for external use. They can be applied to the skin, almost without fear of complications, in addition, the course of treatment can be quite long.

How to choose the right amount of ointment to apply to the skin?

There is a so-called "rule of one phalanx" or FTU (fingertip unit). This is the optimal unit, determined by the tip of the finger, when the cream is squeezed out onto the phalanx of the index finger (approximately 0, 5g). The calculation is simple: 

• On the groin area - 1 "phalanx" or FTU on each side.
• On the wrist - 1 FTU.
• Feet - on the 1st FTU on each leg.
• On one hand - 3 FTU.
• On the whole leg - 6 FTU.
• The whole body is about 14-15 FTU (depending on weight, physique).

Children are advised to apply the ointment on a basic basis, this involves smearing the baby's skin with an emotion, for example, such as Topikrem.

How many times to smear rashes, a rash, also determines an allergist. General recommendations for the use of modern external corticosteroids for children are as follows: •

• Advantan - for children from 6 months once a day, the course - up to 1 month.
• Elokom - children from 2 years once a day, a maximum of a week.
• Afloderm - for children from 6 months twice a day.
• Lokoid - for children from 6 months to 3 times a day.

Children up to six months of age are usually not treated with hormonal drugs, however, in acute, complex allergic conditions, hydrocortisone ointment (1%) can be used no more than twice a day.

External preparations with glucocorticosteroids can be produced in various forms, the choice of dosage form in turn should be due to the localization of the inflammatory process, the nature of the inflammation. Of great importance is what zone is lubricated with the hormonal agent. For dry skin, ointment is needed, for the face and area of the ears - emulsion, lotion, with soaking dermatitis - cream.

Features of some form of hormonal ointments:

Form of the preparation	When applied	Advantages and disadvantages
Hormonal Cream	Rash in the folds of the skin, intertriginous dermatitis	It is convenient in application, penetrates into hard-to-reach areas of the skin, but with prolonged use it provokes dry skin
Hormonal ointment	Macerates the wetting manifestations of the rash, works well for peeling, skin irritation	Slowly absorbed, the active substance slowly penetrates into the skin cells
Lotion, emulsion	Neurodermatitis, atopic dermatitis, application on the face, rash on the scalp	Disadvantages have almost no effect on exudative rashes

Algorithm for the application of topical hormonal agents:

• The appointment of corticosteroid drugs of external action is possible only after examination and diagnosis.
• Hormonal external drugs (GCS) are intended for treatment, not for prevention.
• The form of the drug should be adequate to the degree of allergic skin damage, the severity of the process.
• Children under the age of 6 months do not use GCS containing fluoride.
• Children are not recommended hormonal ointments for the treatment of diaper rash, are not used to treat rashes on the face.
• Preference in the treatment of allergic rashes is given to prolonged corticosteroid ointments.
• All hormonal ointments are applied only to the cleansed skin.
• It is forbidden to apply one-step application of GCS to more than 1/5 of the skin of the body.
• Applications with corticosteroid ointments should not exceed 20 minutes.
• If after 7 days after application of GCS the effect of treatment is not obvious, the administration of the drug is corrected or canceled.
• Fluorinated hormonal ointments do not apply for more than 2 weeks.

Contraindications

If you need to quickly remove the inflammation, itching, burning and prevent the development of atopic dermatitis, usually used strong drugs, which include hormonal drugs. However, hormonal drugs, despite their obvious benefits and effectiveness, have contraindications, this is due to their systemic effect on the entire body, and not just on the skin. So it really was a few dozen years ago, but today the pharmaceutical industry has developed completely new ways and means of treating hormones, which have been called topical steroids. Topical preparations have an effective effect on the outer integument, that is, on the skin, such local application allows almost completely to exclude side effects and contraindications. In most cases, external means include corticosteroids, which quickly and effectively stop the development of allergic manifestations. Nevertheless, as with any medicine, hormonal ointments have indications and special recommendations that exclude the use of these forms. Even advertised Advantan, Elokom doctors appoint in accordance with age, taking into account the characteristics of the patient and the localization of allergic rash.

General contra-indications, concerning almost all hormonal external preparations, are familiar to practicing allergists. This prohibition on the use of ointments more than 12 weeks for adult patients and more than a month for children. Also, caution is being used to treat these rashes on the face.

Absolute contraindications to the use of glucocorticosteroid ointments (GCS): 

• Acne rosacea, acne - acne.
• Scabies.
• Tuberculosis.
• Periodic dermatitis.
• Venereal diseases.
• Fungal diseases of the skin (fungal infections).
• Bacterial skin diseases.
• Allergy after vaccination.
• Viral lesions of the skin (herpes, shingles).
• Helminthiases.
• Relative contraindication is pregnancy.
• It is used with caution in the treatment of allergies in children under 7 years of age.

It is impossible to apply hormonal ointments to young children if they have such conditions, symptoms: 

• "Diaper" dermatitis.
• Chickenpox.
• Sensitivity to the applied ointment, revealed by a skin test.

In order to avoid complications, hormonal ointments from allergies can not be purchased and assigned to themselves, guided by advertising information or advice of relatives. Even if the medicine is prescribed by a doctor, it is superfluous to make a skin test, that is, to apply a minimum amount of the drug on the hand closer to the palm (the back side). The test lasts only 15 minutes, if the skin does not show "resistance", the ointment can be safely applied.

[6], [7], [8], [9], [10]

Special instructions

Previously existing hormonophobia in our time is at least inexpedient, as a maximum - can postpone the result of treating allergies and provoke serious complications.

Special instructions on the therapy of external corticosteroid drugs are given by an allergist, he prescribes an ointment taking into account all the features of the patient and recommends ways of applying it. From the patient only strict fulfillment of medical prescriptions is required. Almost all the complications in statistics are associated only with the uncontrolled use of hormonal ointments, when allergic or overly active parents are guided by television advertising tips and begin to treat themselves or the child themselves.

Modern hormonal drugs are highly effective ways to quickly eliminate the first manifestations of allergies that are most often on the skin. In addition, in favor of hormonal ointments of the latest generation, you can bring such arguments: 

• Creams, ointments and emulsions containing hormonal components can be applied to virtually any area of the body, excluding the skin of the eyelids and the area around the eyes.
• The pharmacological properties of corticosteroid external preparations allow them to be used for a long time before the onset of stable remission, but the course should not exceed 1 month.
• Hormonal antiallergic drugs are effective not only in the stage of exacerbation, they are effective in the treatment of chronic allergic processes.

Special instructions for the use of corticosteroids are related to the dose, frequency and duration of treatment. These issues are supervised and controlled only by an allergist who can prescribe, adjust or cancel hormonal therapy.

Side effects of hormonal ointments from allergies

Unfortunately, even effective in the treatment of allergic skin manifestations, hormonal ointments can have their pro and contra.

Side effects of corticosteroids, especially modern drugs, are most often associated with patients' independent experiments, when they seek to quickly eliminate the rash. It should also take into account the degree of activity of the drug, that is, its class. Hormonal IV-class ointments can cause far more negative consequences than their less active "brethren".

More often, prolonged use of corticosteroids provokes suppression of local immunity, which is complicated by the development of infection in the zone of localization of the rash. Therefore, preventing such phenomena, allergists can prescribe a combination drug containing an antibiotic or an antifungal component. In addition, hormones can affect the production of collagen, that is, to dry out the skin and provoke its atrophy, especially it is important for facial skin and inguinal folds. A long course of the hormonal external agent promotes the development of acne, irritation, skin pigmentation. This is due to the ability of corticosteroids to quickly enter the bloodstream and to affect the body systematically. However, such side effects are possible only with excessive doses and violation of the rules for the application of the ointment. It should be noted that usually with the withdrawal of the drug, all complications are neutralized, that is, the consequences are reversible, the duration depends on the duration of the course, but the full withdrawal of steroid substances takes a maximum of 6 months, a minimum of 2 weeks.

What complications are possible with the use of external steroid drugs: 

• Acne rash, acne.
• With prolonged use of corticosteroids of III - IV class, dry skin is possible.
• Stria.
• Periodic dermatitis.
• Folliculitis.
• Hypertrichosis is symptomatic.
• Teleangiectasia.
• Erythema.
• Hypopigmentation.
• Activation of existing mycosis (fungal infection).
• Contact dermatitis.
• It is extremely rare - Cushing's syndrome.
• When applied to the skin of the eyelids, which is strictly prohibited, cataracts or glaucoma.

Shelf life

Although many hormonal preparations can be stored for about 5 years, according to the instructions in the original packaging, allergists give more detailed advice on this matter.

The shelf life of any GCS means, especially for external use, should be minimal. Everything is explained by the fact that in a closed, hermetically sealed state, the ointment is really capable of preserving its healing properties for many years. But in practice the tube is opened, otherwise it is simply impossible to use the drug. Therefore, an open ointment, cream or emulsion in a printed form should not be stored for months, and especially for years. To do this, the pharmaceutical industry produces similar products in small packages, tubes.

The optimal storage periods for GCS can be such periods (the shelf life of the opened packaging should be discussed with a pharmacist or pharmacist): 

• Water solutions of GCS for external use - no more than a day.
• Hormonal ointments - no more than 4 weeks.
• Gormonosoderzhaschaya emulsion - no more than 7 days.

Also important is the temperature of the environment, which should not exceed 20-25 degrees, in addition, similar drugs, as well as other drugs, should be stored in places inaccessible to children.

Hormonal ointments from allergies have long deserved a more respectful attitude from patients, the old times when corticosteroids were associated with negative phenomena are gone. Of course, side effects can be avoided only if the GCS-ointment is prescribed by the doctor after the examination. A competent application of glucocorticosteroid external agents will only accelerate recovery, because their unwanted systemic actions are virtually eliminated, and the therapeutic effect is confirmed by many thousands of cured allergies.