[Paths to a rational cortisone therapy via urea supplements--countering cortisone phobia]

Not until corticosteroids came into use did it become possible for modern dermatotherapy to cure numerous skin diseases, and if not cure them, at least rapidly lead to major improvements and the transition to symptom-free intervals. Through indiscriminate use, corticosteroid therapy has become discredited by patient and doctor alike due to the increased incidence of side effects. Due to this intensified rejection--bordering on "cortisone phobia"--corticosteroids today are often not being used when justifiable or even when mandatory. Most side effects can be avoided or reduced if the instructions for use are properly adhered to, thus increasing acceptance. Another way of further improving compliance is the use of low-side effect corticosteroids, such as hydrocortisone, since now the difference in effective strength compared to potent halogenated preparations can be compensated by the addition of 10% urea. With regard to active strength, a hydrocortisone/urea combination preparation should be used like a medium-strength cortisone preparation and is particularly suited for the long-term therapy of chronic dermatosis. Additional properties of urea, such as alleviation of itching and water binding, which are important in the treatment of chronic eczemas, enhance hydrocortisone in combination preparations.