Wikipedia:WikiProject Chemicals/Chembox validation/VerifiedDataSandbox and Topical hydrocortisone: Difference between pages

{{Short description|Pharmaceutical drug}}

{{cs1 config|name-list-style=vanc}}

<!--EDIT BELOW THIS LINE-->{{Infobox drug

| drug_name = Topical hydrocortisone

| IUPAC_name = (8''S'',9''S'',10''R'',11''S'',13''S'',14''S'',17''R'')-11,17-Dihydroxy-17-(2-hydroxyacetyl)-10,13-dimethyl-2,6,7,8,9,11,12,14,15,16-decahydro-1''H''-cyclopenta[''a'']phenanthren-3-one

| image = Cortisol2.svg

| width = 225

| alt =

| image2 =

| alt2 = <!--Clinical data -->

| tradename = Ala-Cort, Aquanil HC, Beta HC, others

<ref>{{cite web | title=Hydrocortisone topical Uses, Side Effects & Warnings | website=Drugs.com | url=https://www.drugs.com/mtm/hydrocortisone-topical.html | access-date=11 March 2023}}</ref>

| Drugs.com = {{drugs.com|monograph|Hydrocortisone-topical}}

| MedlinePlus = a682793

| DailyMedID = Hydrocortisone

| pregnancy_AU = A

| pregnancy_AU_comment = <ref>{{cite web | title=Hydrocortisone topical Pregnancy and Breastfeeding Warnings | website=drugs.com | url=https://www.drugs.com/pregnancy/hydrocortisone-topical.html | access-date=26 February 2023}}</ref>

| legal_AU = S4

| legal_AU_comment = /&nbsp;S3&nbsp;/&nbsp;S2<ref>{{cite web | title=Part A - Interim decisions on matters referred to an expert advisory committee: ACMS#14 (1.1-1.3) | website=Australian Government | url=https://www.tga.gov.au/resources/publication/scheduling-decisions-interim/scheduling-delegates-interim-decisions-and-invitation-further-comment-acms-june-2015/part-interim-decisions-matters-referred-expert-advisory-committee-acms14-11-13 | access-date=13 April 2023}}</ref>

| legal_BR = <!-- OTC, A1, A2, A3, B1, B2, C1, C2, C3, C4, C5, D1, D2, E, F -->

| legal_BR_comment =

| legal_CA = <!-- OTC, Rx-only, Schedule I, II, III, IV, V, VI, VII, VIII -->

| legal_CA_comment =

| legal_DE = <!-- Anlage I, II, III or Unscheduled -->

| legal_DE_comment =

| legal_EU = OTC

| legal_EU_comment = /&nbsp;Rx-only<ref>{{cite web | title= Patterns of OTC use in the Netherlands | work = The Pharma Letter | location = London | url=https://www.thepharmaletter.com/article/patterns-of-otc-use-in-the-netherlands | access-date=13 April 2023}}</ref>

| legal_NZ = <!-- Class A, B, C -->

| legal_NZ_comment =

| legal_UK = POM

| legal_UK_comment = /&nbsp;P&nbsp;/&nbsp;GSL<ref>{{cite web | title=Rules for the sale, supply and administration of medicines for specific healthcare professionals | publisher = National Health Service UK | url=https://www.gov.uk/government/publications/rules-for-the-sale-supply-and-administration-of-medicines/rules-for-the-sale-supply-and-administration-of-medicines-for-specific-healthcare-professionals | access-date=13 April 2023}}</ref>

| legal_US = OTC

| legal_US_comment = /&nbsp;Rx-only<ref>{{cite web |url=https://s3.amazonaws.com/archives.federalregister.gov/issue_slice/1991/8/30/43023-43026.pdf#page=3 |title=Hydrocortisone Notice of enforcement policy |publisher= U.S. Food and Drug Administration |format=PDF |access-date=13 April 2023}}</ref><ref>{{cite web | title=Ala-cort- hydrocortisone cream | work = DailyMed | publisher = U.S. National Library of Medicine | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=de000081-a245-4f6b-9e7c-e47d84b82338 | access-date=13 April 2023}}</ref><ref>{{cite web | title=Ala-scalp- hydrocortisone lotion | work = DailyMed | publisher = U.S. National Library of Medicine | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ecba1d44-33a9-44d7-ad06-13ada2375c72 | access-date=13 April 2023}}</ref><ref>{{cite web | title=Anusol HC- hydrocortisone acetate suppository | work = DailyMed | publisher = U.S. National Library of Medicine | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=a562f3d7-2692-4357-aade-ae50afcbfddd | access-date=13 April 2023}}</ref>

| legal_UN = <!-- N I, II, III, IV / P I, II, III, IV -->

| legal_UN_comment =

| legal_status = <!-- For countries not listed above -->

<!-- Pharmacokinetic data -->| routes_of_administration = Topical

| bioavailability =

| protein_bound =

| metabolism =

| metabolites =

| >

| duration_of_action =

| excretion = <!--Identifiers -->

| CAS_number = 50-23-7

| CAS_number_Ref = {{cascite|correct|??}}

| ATC_supplemental = {{ATC|D07|AA02}}

<!-- Legal status -->| PubChem = 5754

| DrugBank = DB00741

| DrugBank_Ref = {{drugbankcite|changed|drugbank}}

| ChemSpiderID = 5551

| ChemSpiderID_Ref = {{chemspidercite|correct|chemspider}}

| UNII = WI4X0X7BPJ

| UNII_Ref = {{fdacite|correct|FDA}}

| KEGG = D00088

| KEGG_Ref = {{keggcite|correct|kegg}}

| ChEBI = 17650

| ChEBI_Ref = {{ebicite|correct|EBI}}

| ChEMBL = 389621

| ChEMBL_Ref = {{ebicite|correct|EBI}}

| synonyms = Cortisol; 11β,17α,21-Trihydroxypregn-4-ene-3,20-dione

<!--Chemical data -->| C = 21

| H = 30

| O = 5

| SMILES = O=C4\C=C2/[C@]([C@H]1[C@@H](O)C[C@@]3([C@@](O)(C(=O)CO)CC[C@H]3[C@@H]1CC2)C)(C)CC4

| StdInChI = 1S/C21H30O5/c1-19-7-5-13(23)9-12(19)3-4-14-15-6-8-21(26,17(25)11-22)20(15,2)10-16(24)18(14)19/h9,14-16,18,22,24,26H,3-8,10-11H2,1-2H3/t14-,15-,16-,18+,19-,20-,21-/m0/s1

| StdInChIKey = JYGXADMDTFJGBT-VWUMJDOOSA-N

| StdInChIKey_Ref = {{stdinchicite|correct|chemspider}}

| StdInChI_Ref = {{stdinchicite|correct|chemspider}}

| verifiedrevid = 464366483

| Verifiedfields = changed

| Watchedfields = changed

| class = [[Corticosteroid]]; [[Glucocorticoid]]; [[Mineralocorticoid]]

| KEGG2 = D00165

| KEGG2_Ref = {{keggcite|correct|kegg}}

'''Topical hydrocortisone''' is a [[drug]] under the [[Drug class|class]] of [[corticosteroid]]s, which is used for the treatment of skin [[inflammation]], [[itch]]iness and [[Allergy|allergies]].<ref name="Medscape">{{cite web |title=Pandel (hydrocortisone probutate topical) dosing, indications, interactions, adverse effects, and more |url=https://reference.medscape.com/drug/vusion-miconazole-petrolatum-zinc-oxide-topical-999778 |access-date=2023-02-26 | work = Medscape | publisher = WebMD LLC }}</ref> Some examples include [[insect bites]], [[dermatitis]] and [[rash]].<ref name="WebMD LLC">{{cite web |title=Hydrocortisone Topical: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing - WebMD |url=https://www.webmd.com/drugs/2/drug-10402-859/hydrocortisone-topical/hydrocortisone-topical/details |access-date=2023-02-26 | publisher = WebMD LLC |language=en}}</ref><ref name="nhs.uk_2019">{{cite web |date=2019-01-17 |title=Hydrocortisone for skin: a steroid medicine for treating eczema, psoriasis and insect bites |url=https://www.nhs.uk/medicines/hydrocortisone-skin-cream/ |access-date=2023-02-26 |website=nhs.uk |language=en}}</ref><ref name="MedicineNet">{{cite web |title=What Is Hydrocortisone Cream Used For? Side Effects |url=https://www.medicinenet.com/what_is_hydrocortisone_cream_used_for/article.htm |access-date=2023-03-04 |website=MedicineNet |language=en}}</ref>

Hydrocortisone was discovered by [[List of Nobel laureates|Nobel laureates]] [[Edward Calvin Kendall|Edward C. Kendall]] and [[Philip Showalter Hench|Philip S. Hench]] in the 1930s while they were conducting research on [[rheumatoid arthritis]].<ref name="go.drugbank.com">{{cite web |title=Hydrocortisone |url=https://go.drugbank.com/drugs/DB00741 |access-date=2023-02-26 |website=go.drugbank.com}}</ref><ref name="NobelPrize.org">{{cite web |title=The Nobel Prize in Physiology or Medicine 1950 |url=https://www.nobelprize.org/prizes/medicine/1950/kendall/biographical/ |access-date=2023-03-04 |website=NobelPrize.org |language=en-US}}</ref><ref name="Saenger_2010">{{cite journal | vauthors = Saenger AK | title = Discovery of the wonder drug: from cows to cortisone. The effects of the adrenal cortical hormone 17-hydroxy-11-dehydrocorticosterone (Compound E) on the acute phase of rheumatic fever; preliminary report. Mayo Clin Proc 1949;24:277-97 | journal = Clinical Chemistry | volume = 56 | issue = 8 | pages = 1349–1350 | date = August 2010 | pmid = 20538878 | doi = 10.1373/clinchem.2010.149120 | s2cid = 1784993 | doi-access = free }}</ref> Its topical use was first recorded in the 1950s.<ref name="Mukhopadhyay_2018">{{cite book | vauthors = Mukhopadhyay S, Kwatra G | chapter = Evolution and Development of Topical Corticosteroids |date=2018 | veditors = Lahiri K | title = A Treatise on Topical Corticosteroids in Dermatology: Use, Misuse and Abuse |pages=1–9 |place=Singapore |publisher=Springer |language=en |doi=10.1007/978-981-10-4609-4_1 |isbn=978-981-10-4609-4 }}</ref><ref name="Mehta_2016">{{cite journal | vauthors = Mehta AB, Nadkarni NJ, Patil SP, Godse KV, Gautam M, Agarwal S | title = Topical corticosteroids in dermatology | journal = Indian Journal of Dermatology, Venereology and Leprology | volume = 82 | issue = 4 | pages = 371–378 | date = 2016-07-01 | pmid = 27279294 | doi = 10.4103/0378-6323.178903 | s2cid = 37156776 | doi-access = free }}</ref>

The most common [[adverse effect]]s after the application of topical hydrocortisone are burning and stinging sensations.<ref name="Medscape" /><ref name="WebMD LLC" /> Side effects after long-term usage include [[Visual impairment|eyesight damage]], elevated [[blood sugar level]]s and [[adrenal gland disorder]]s.<ref name="nhs.uk_2019" />

Topical hydrocortisone is available in several [[dosage form]]s such as [[Solution (chemistry)|solution]], [[lotion]], [[Cream (pharmacy)|cream]], [[ointment]] and [[Spray (liquid drop)|spray]].<ref name="MedlinePlus Drug Information">{{cite web |title=Hydrocortisone Topical | work = MedlinePlus Drug Information | publisher = U.S. National Library of Medicine |url=https://medlineplus.gov/druginfo/meds/a682793.html |access-date=2023-02-26 |language=en}}</ref> Some [[brand names]] for topical hydrocortisone include [[Anusol HC]], [[Cortizone 10]], and [[Synacort]].<ref name="MedlinePlus Drug Information" />

== Medical uses ==

Topical hydrocortisone is indicated for relieving [[Swelling (medical)|swelling]], irritation and redness in a number of skin conditions, including insect bites, [[heat rash]], [[eczema]], [[psoriasis]], [[contact dermatitis]] and [[nappy rash]].<ref name="nhs.uk_2019" /><ref name="MedlinePlus Drug Information" /><ref>{{cite web |date=2019-03-26 |title=Hydrocortisone: a steroid used to treat many health conditions |url=https://www.nhs.uk/medicines/hydrocortisone/ |access-date=2023-02-26 |website=nhs.uk |language=en}}</ref><ref name="Drug Office, Department of Health, Hong Kong">{{cite web |date= |title= Topical Corticosteroids |url=https://www.drugoffice.gov.hk/eps/do/en/consumer/news_informations/dm_14.html |access-date=2023-03-04 |website=Drug Office, Department of Health, Hong Kong}}</ref> It could be formulated as a single active ingredient in some medications, e.g. [https://www.rxlist.com/cortaid-drug.htm Cortaid^®], which is applied for [[Anus|anal]] itchiness.<ref name="MedicineNet" /><ref>{{cite web |date=2015-01-26 |title=Pruritus Ani (Anal Itch) |url=https://colorectalsurgery.wustl.edu/patient-care/cope-center/anorectal-disorders/pruritus-ani-anal-itch/ |access-date=2023-03-04 |website=Section of Colon and Rectal Surgery |language=en-US}}</ref><ref>{{cite web |title=Cortaid (Hydrocortisone Cream and Ointment 1.0%): Uses, Dosage, Side Effects, Interactions, Warning |url=https://www.rxlist.com/cortaid-drug.htm |access-date=2023-03-04 |website=RxList |language=en}}</ref> On some occasions, this drug may be used in combination with other types of drugs to alleviate skin problems.<ref name="MedicineNet" /><ref name="MedlinePlus Drug Information_2">{{cite web |title=Neomycin, Polymyxin, Bacitracin, and Hydrocortisone Topical| work = MedlinePlus Drug Information | publisher = U.S. National Library of Medicine |url=https://medlineplus.gov/druginfo/meds/a601061.html |access-date=2023-03-04 |language=en}}</ref> For example, it could be used together with antibiotics such as [[polymyxin]], [[neomycin]] and [[bacitracin]] to improve dermal conditions.<ref name="MedlinePlus Drug Information_2" />

== Adverse effects ==

[[File:Overview of glucocorticoid-associated side effects.png|thumb|500x500px|Possible adverse effects of topical hydrocortisone]]

Some common side effects include burning and stinging sensations.<ref name="Medscape" /><ref name="WebMD LLC" /><ref name="Drug Office, Department of Health, Hong Kong" /><ref name="Mayo Clinic">{{cite web |title=Hydrocortisone (Topical Application Route) Side Effects | work = Mayo Clinic |url=https://www.mayoclinic.org/drugs-supplements/hydrocortisone-topical-application-route/side-effects/drg-20073814?p=1 |access-date=2023-03-04 }}</ref> Colour change of the skin, bump formation on the skin and additional hair growth could also occur.<ref name="WebMD LLC" /><ref name="MedlinePlus Drug Information" /> Consult a doctor if these side effects persist or become worse.<ref name="WebMD LLC" /><ref name="MedlinePlus Drug Information" />

Some severe side effects are severe rash, swelling of the skin, and skin infection.<ref name="MedlinePlus Drug Information" /> Rare but serious allergic reactions, also known as [[anaphylaxis]], could also occur.<ref name="nhs.uk_2019" /> If you encounter any of these side effects, you should approach a doctor immediately.<ref name="MedlinePlus Drug Information" />

Adverse effects after a long-term use of topical hydrocortisone include adrenal gland disorders.<ref name="Mayo Clinic" /> This problem can be more severe when you use excess topical hydrocortisone for a prolonged period of time.<ref name="Mayo Clinic" /> Other adverse effects include [[Blurred vision|blurry vision]], [[dizziness]], [[fainting]], [[Arrhythmia|unusual heartbeat]], [[thirst]]y sensation, frequent [[urination]], and [[fatigue]].<ref name="Mayo Clinic" /> Please inform your doctor if you experience any of these symptoms.<ref name="Mayo Clinic" />

The impact of ingestion (eating) of such products has not been reported systematically, but a case report published in 2022 suggests this can lead to hospitalization and be potentially life threatening.<ref>{{Cite journal |vauthors=Saha A, Balakrishnan S, Trivedi N, Agraham GM |date=21 October 2022<!--online publication date--> |title=Hypertension and Severe Hypokalemia Associated With Oral Ingestion of Topical Hydrocortisone Cream |journal=[[AACE Clinical Case Reports]] |language=en |volume=9 |issue=1 |pages=2–4 |doi=10.1016/j.aace.2022.10.004 |pmc=9837079 |pmid=36654996}}</ref>

== Pharmacology ==

=== Pharmacodynamics ===

Hydrocortisone would bind to [[glucocorticoid receptors]] in the human body, which reduces the production of inflammatory [[transcription factor]]s, [[phospholipase A2]], and [[NF-κB|NF-kappa B]], as well as increases the expression of anti-inflammatory [[gene]]s.<ref name="go.drugbank.com" /> In addition, hydrocortisone has a relatively wide [[Therapeutic index|therapeutic window]],<ref name="go.drugbank.com" /> implying that [[toxicity]] is less likely to occur.

Topical hydrocortisone contributes to inflammatory-reducing activity in various ways.<ref name="Kwatra_2018">{{cite book | vauthors = Kwatra G, Mukhopadhyay S | chapter = Topical corticosteroids: pharmacology. | veditors = Lahiri K | title = A Treatise on Topical Corticosteroids in Dermatology: Use, Misuse and Abuse | date = 2018 | pages = 11–22 | publisher = Springer | doi = 10.1007/978-981-10-4609-4_2 | isbn = 978-981-10-4609-4 }}</ref> Firstly, hydrocortisone can bind to glucocorticoid receptors in the [[cytoplasm]], causing alterations in the conformation of the receptors.<ref name="Kwatra_2018" /><ref name="tmedweb.tulane.edu">{{cite web |title=glucocorticoid_pharmacology [TUSOM {{!}} Pharmwiki] |url=https://tmedweb.tulane.edu/pharmwiki/doku.php/glucocorticoid%20pharmacology |access-date=2023-04-13 |website=tmedweb.tulane.edu |language=en}}</ref> This promotes the exchange and binding of proteins at the site of the receptors.<ref name="tmedweb.tulane.edu" /> The activated receptors then enter the nucleus to upregulate genes for reducing inflammation such as [[lipocortin]].<ref name="Kwatra_2018" /><ref name="tmedweb.tulane.edu" /> Next, lipocortin inhibits phospholipase A2, an [[enzyme]] preventing the synthesis of [[prostaglandin]]s and [[lipoxygenase]]s from [[arachidonic acid]].<ref name="Kwatra_2018" /><ref name="tmedweb.tulane.edu" /> After that, hydrocortisone stabilises the [[lysosome]]s in [[neutrophil]]s, which are a type of [[white blood cell]].<ref name="Kwatra_2018" /> Hence, the neutrophils would not [[Degranulation|degranulate]], preventing inflammation.<ref name="Kwatra_2018" /> Eventually, [[Messenger RNA|mRNA]] segments are destabilized, affecting [[Transcription (biology)|gene transcription]] and interrupting the gene production of [[cytokine]]s, [[chemokine]]s, [[Cyclooxygenase 2|cyclooxygenase-2]], etc.<ref name="Kwatra_2018" />

=== Pharmacokinetics ===

Topical hydrocortisone has minimal [[Absorption (pharmacology)|absorption]] into the body: Only 4-19% of the topical hydrocortisone cream applied would be absorbed into the human [[Circulatory system|bloodstream]].<ref name="go.drugbank.com" /> After a certain extent of absorption, it undergoes [[Distribution (pharmacology)|distribution]], [[metabolism]] and [[Elimination (pharmacology)|elimination]] pathways that are similar to systemic hydrocortisone.<ref name="Drugs.com">{{cite web |title=Hydrocortisone Cream: Package Insert / Prescribing Information |url=https://www.drugs.com/pro/hydrocortisone-cream.html |access-date=2023-02-26 |website=Drugs.com |language=en}}</ref> 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 [[kidney]]s.<ref name="Drugs.com" />

== Chemistry ==

[[File:Annotated chemical structure of hydrocortisone.jpg|thumb|350x350px|This is a chemical structure of hydrocortisone with markings of the functional groups that contribute to its glucocorticoid activity.]]

=== Structure-activity relationship ===

Hydrocortisone, or 17-hydroxycorticosterone, is under the class of [[glucocorticoid]]s, which are steroids synthesized in the adrenal cortex of the kidneys.<ref>{{cite book | vauthors = Chourpiliadis C, Aeddula NR | chapter = Physiology, Glucocorticoids |date=2023 | chapter-url=http://www.ncbi.nlm.nih.gov/books/NBK560897/ | title = StatPearls |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=32809732 }}</ref><ref>{{cite web | work = PubChem |title=Hydrocortisone |url=https://pubchem.ncbi.nlm.nih.gov/compound/5754 |access-date=2023-04-13 | publisher = U.S. National Library of Medicine |language=en}}</ref> In order to illustrate its glucocorticoid activity, the A ring of hydrocortisone has a [[Ketone|keto group]] in the 3rd carbon and a [[double bond]] between the 4th and 5th carbon.<ref name="Buchwald_2004">{{cite journal | vauthors = Buchwald P, Bodor N | title = Soft glucocorticoid design: structural elements and physicochemical parameters determining receptor-binding affinity | journal = Die Pharmazie | volume = 59 | issue = 5 | pages = 396–404 | date = May 2004 | pmid = 15212309 | url = https://pubmed.ncbi.nlm.nih.gov/15212309/ }}</ref> For the C ring of the compound, the 11th carbon has a beta [[Hydroxy group|hydroxyl]] [[Substitution reaction|substitution]], which is also necessary for the drug to demonstrate glucocorticoid effects.<ref name="Buchwald_2004" />

=== pKa ===

The estimated [[Acid dissociation constant|pKa]] values of hydrocortisone are 12.59 and -2.8 respectively.<ref name="go.drugbank.com" />

=== Solubility ===

The [[log P]] value of hydrocortisone is 1.61, which was derived from experiments done by pharmacologist [[Corwin Hansch]] and his research team.<ref name="go.drugbank.com" /> In addition, the predicted water solubility of hydrocortisone is 0.199&nbsp;mg/mL.<ref name="go.drugbank.com" /> 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 ==

[[File:Tube_of_hydrocortisone_cream.jpg|thumb|Topical hydrocortisone cream available in the United States]]

[[File:Topical_hydrocortisone_cream_with_neomycin.jpg|alt=available in Hong Kong|thumb|Topical hydrocortisone cream with neomycin available in Hong Kong]]

Topical hydrocortisone is formulated as liquid, solution, lotion, cream, [[gel]], ointment, [[foam]], and spray.<ref>{{cite web |title=Hydrocortisone (Topical Application Route) Description and Brand Names | work = Mayo Clinic |url=https://www.mayoclinic.org/drugs-supplements/hydrocortisone-topical-application-route/description/drg-20073814 |access-date=2023-02-26 }}</ref> The strength of topical hydrocortisone products ranges from 0.1% to 2.5%, which means there could be 1&nbsp;mg to 25&nbsp;mg hydrocortisone in 1g of the products.<ref name="nhs.uk_2019" /> Some formulations for topical hydrocortisone include hydrocortisone 0.5% cream or ointment, hydrocortisone 1% cream or ointment, and hydrocortisone 2.5% cream or ointment.<ref>{{cite web |title=Search results for hydrocortisone |url= https://www.medicines.org.uk/emc/search?q=hydrocortisone&offset=1&limit=50&orderBy=product&refreshFilters=true |access-date=2023-02-26 | publisher = Datapharm | work = Electronic Medicines Compendium }}</ref> Regarding the method of applying the medications, please refer to the [[Medication package insert|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 drug|prescription]].<ref name="nhs.uk_2019" /> Besides, some forms of topical hydrocortisone are mixed with [[antimicrobial drugs]] to treat [[bacteria]]l or [[Fungus|fungal]] problems of the skin.<ref name="nhs.uk_2019" />

== History ==

In the 1930s, hydrocortisone was found by [[biochemist]] Edward C. Kendall and [[Rheumatology|rheumatologist]] Philip S. Hench, who were both Nobel laureates.<ref name="go.drugbank.com" /><ref name="NobelPrize.org" /><ref name="Saenger_2010" /> 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 [[Pregnancy|pregnant]] at the same time.<ref name="NobelPrize.org" /><ref name="Saenger_2010" /> It was also found that patients suffering from both rheumatoid arthritis and [[jaundice]] would have fewer symptoms associated with rheumatoid arthritis.<ref name="NobelPrize.org" /><ref name="Saenger_2010" /> Following this finding, they extracted different [[hormone]]s from the [[adrenal cortex]] of cows in search of a suitable drug.<ref name="NobelPrize.org" /><ref name="Saenger_2010" /><ref name="Mehta_2016" /> They first identified [[cortisone]] to be one of the possible drugs, and further research led them to discover an effective drug for human [[Dermis|dermal]] problems, which was hydrocortisone.<ref name="NobelPrize.org" /><ref name="Saenger_2010" /><ref name="Mehta_2016" />

After the discovery of hydrocortisone, the earliest application of hydrocortisone as a topical form in humans was recorded in 1952.<ref name="Saenger_2010" /><ref name="Mukhopadhyay_2018" /><ref name="Mehta_2016" /> Its successful utilization facilitated more research on topical corticosteroids, which helped the development of similar drugs with higher activity.<ref name="Saenger_2010" /><ref name="Mukhopadhyay_2018" /><ref name="Mehta_2016" />

== References ==

{{Reflist}}

[[Category:Corticosteroids]]