Q:What are the side-effects of hydrocortisone purchased over the counter and used for contact dermatitis? E. J., Hampstead, London.
A:According to Side Effects, by Trevor Smith (Insight Editions, Sussex), a book well worth having by your bedside, hydrocortisone cream has a myriad of side effects. These include, he says: "thinning and atrophy of the skin, especially the face, from a reduction of cell numbers and size in the epidermis (skin), with increased skin transparency. Collagen (elastic cells) breakdown may occur leading to striae formation (stretch marks) on the thighs and abdomen. In severe cases the striae may break down and ulcerate. The skin is weakened as well as thinned. Small fine local blood vessels may become dilated and obvious, more fragile and likely to rupture."And that's not all. He continues:
"The skin may be much more vulnerable to damage from minor wounds and trauma with healing delayed. When used on ulcers or burns of the skin, there may be delayed healing or ulceration. There is a loss of subcutaneous fat. Local steroid use can also lead to suppression of the adrenals by absorption through the skin causing hyperglycaemia (raised blood sugar levels) and glycosuria (sugar in the urine). Raised intraocular pressure, glaucoma and cataract have also been associated with the use of steroids to the eye, by drops or as an ointment."
All this in a drug you can get without a prescription.