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Adults and children generally apply the over-the-counter
hydrocortisone cream (HC) in safe and appropriate amounts according to one
ANN ARBOR, Mich. -- One of the downsides of summer can be
the itchy skin that goes hand-in-hand with this season of
bug bites, sun-related rashes and poison ivy. But
researchers have some good news: Adults and children
generally apply the product that is commonly used to treat
these conditions ? over-the-counter hydrocortisone cream
(HC) ? in safe and appropriate amounts.
Charles N. Ellis, M.D., of the University of Michigan Health
System said he was pleasantly surprised by the number of study
participants who complied with the usage guidelines. Ellis is the
lead author of the study, which appears early in the online edition
of the Journal of the American Academy of Dermatology.
"The people in the study reported that they're following the
label in large part," says Ellis, professor and associate chair of
dermatology in the U-M Medical School, and chief of the Dermatology
Service at the Veterans Affairs Ann Arbor Healthcare System. "Not
many of them have used it beyond the suggested amount of time, and
not many used it more often than recommended."
"Our findings suggest that people who use over-the-counter
hydrocortisone cream generally do so in a way that is likely to be
safe," he says.
Adults were found to be compliant with the instructions about
three-quarters of the time, and they reported following the
recommendations for treating children about as often. The most
common way in which people were not compliant with directed uses was
in using the creams to treat cuts. It also was used to treat acne,
athlete's foot, arthritis and jock itch, against the recommendations
on the label. HC is not effective in treating these conditions.
The 2,000 study participants were asked in phone interviews if
they had used over-the-counter hydrocortisone products such as
Cortaid, Cortizone 10 or other similar products in the past six
months. Those who had used OTC hydrocortisone products were asked
questions about their patterns of use. They answered these questions
without being able to refer to the product label.
Respondents also were asked if they had any children younger than
18 in the house who had used HC; if so, they were asked about the
use by the youngest child in the past six months.
Respondents who had used hydrocortisone or whose children had
used it were asked what conditions they had treated with the cream
and questions about their usage patterns, including the frequency
and duration of use. They also were asked if they had discussed with
a doctor their own usage of HC and/or their use of it on the
youngest child in the household.
In all, 396 (20 percent) of the adults in the study reported
using over-the-counter HC in the previous six months. The most
common conditions they treated with the creams were rashes, insect
bites and itchy skin.
Researchers found that when adults were using HC, they did so an
average of twice a day, and 98 percent of them used it four or fewer
times a day, which complies with directions for use. That means only
2 percent of adults reported using HC more times in a day than
recommended. In all, when factors such as the type of use and the
duration of use were factored in, almost three-quarters ? 73 percent
? of adults in the study were compliant with the instructions on the
label. One-third of the adult respondents had discussed the use of
topical HC with a doctor. The compliance level rose to 89 percent
when the results were recalculated with the assumption that the
doctor had allowed for wider uses and treatment regimens.
In children, HC tended to be used primarily for insect bites,
rashes, eczema and itchy skin. Of the 2,000 households, one-third
had a child younger than 18 living at home and a quarter of those
reported treating a child with over-the-counter HC in the previous
The frequency of use was more than the recommended maximum of
four times a day in only 3 percent of cases, and only 6 percent
reported using it for longer than the recommended maximum of seven
days. More than half (55 percent) of these households reported
talking to a doctor at some time about their child's use of
In all, given the duration and frequency of use, the type of
condition treated, and the age of the child, 72 percent of the use
on children followed the recommended usage guidelines. When the
figure was recalculated to assume that the physicians who were
consulted had allowed for wider uses and treatment regimens, the
compliance level rose to 89 percent.
In addition to Ellis, the other authors on the paper were
Michelle D. Ertischek, Janine L. Pillitteri, Ph.D., and Saul
Shiffman, Ph.D. of Pinney Associates; and Theodore K. Kyle, R.Ph.,
and Steven L. Burton, M.B.A., of GlaxoSmithKline Consumer
The study was supported by GlaxoSmithKline Consumer Healthcare.
Ellis, Pillitteri, Shiffman and Ertischek serve as consultants to
GlaxoSmithKline Consumer Healthcare. Ellis also serves as a
consultant to other manufacturers of topical corticosteroids. GSK
does not sell a topical HC but does sell a low-potency
prescription-strength topical corticosteroid (Aclovate).
Reference: Journal of the American Academy of Dermatology
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