Topical hydrocortisone

Topical hydrocortisone is indicated for relieving swelling, irritation and redness in a number of skin conditions, including insect bites, heat rash, eczema, psoriasis, contact dermatitis and nappy rash. It could be formulated as a single active ingredient in some medications, e.g. Cortaid, which is applied for anal itchiness. On some occasions, this drug may be used in combination with other types of drugs to alleviate skin problems. For example, it could be used together with antibiotics such as polymyxin, neomycin and bacitracin to improve dermal conditions. == Adverse effects ==

Some common side effects include burning and stinging sensations. Colour change of the skin, bump formation on the skin and additional hair growth could also occur. == Pharmacology ==

Pharmacodynamics Hydrocortisone binds to glucocorticoid receptors in the human body, which, among other mechanisms and pathways, reduces the production of inflammatory transcription factors, phospholipase A2, and NF-kappa B. It also increases the expression of anti-inflammatory genes. Firstly, hydrocortisone can bind to glucocorticoid receptors in the cytoplasm, causing alterations in the conformation of the receptors. This promotes the exchange and binding of proteins at the site of the receptors. Regarding the distribution of topical hydrocortisone, it binds to plasma proteins such as globulin and albumin, then the drug is mainly metabolized in the liver, and the metabolite will be excreted through bile or by kidneys. == Chemistry ==

Structure-activity relationship Hydrocortisone, or 17-hydroxycorticosterone, is under the class of glucocorticoids, which are steroids synthesized in the adrenal cortex of the kidneys. In order to illustrate its glucocorticoid activity, the A ring of hydrocortisone has a keto group in the 3rd carbon and a double bond between the 4th and 5th carbon. For the C ring of the compound, the 11th carbon has a beta hydroxyl substitution, which is also necessary for the drug to demonstrate glucocorticoid effects. pKa The estimated pKa values of hydrocortisone are 12.59 and -2.8 respectively. Solubility The log P value of hydrocortisone is 1.61, which was derived from experiments done by pharmacologist Corwin Hansch and his research team. In addition, the predicted water solubility of hydrocortisone is 0.199 mg/mL. These values indicate that hydrocortisone has a low solubility in water and is more soluble in organic solvents. For other chemical information of topical hydrocortisone, please refer to the 'Topical hydrocortisone' table. == Formulations ==

Topical hydrocortisone is formulated as liquid, solution, lotion, cream, gel, ointment, foam, and spray. The strength of topical hydrocortisone products ranges from 0.1% to 2.5%, which means there could be 1 mg to 25 mg hydrocortisone in 1g of the products. Regarding the method of applying the medications, please refer to the package insert or consult a pharmacist. Some less common forms of topical hydrocortisone are also available in the market. For example, hydrocortisone butyrate is a relatively potent topical hydrocortisone cream that can only be purchased when you have a valid prescription. Besides, some forms of topical hydrocortisone are mixed with antimicrobial drugs to treat bacterial or fungal problems of the skin. == History ==

In the 1930s, hydrocortisone was found by biochemist Edward C. Kendall and rheumatologist Philip S. Hench, who were both Nobel laureates. When they were investigating therapies for rheumatoid arthritis, they discovered that female patients of the disease would experience an alleviation of their condition if they were pregnant at the same time. It was also found that patients suffering from both rheumatoid arthritis and jaundice would have fewer symptoms associated with rheumatoid arthritis. Following this finding, they extracted different hormones from the adrenal cortex of cows in search of a suitable drug. 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. After the discovery of hydrocortisone, the earliest application of hydrocortisone as a topical form in humans was recorded in 1952. Its successful utilization facilitated more research on topical corticosteroids, which helped the development of similar drugs with higher activity. ==External links==