How Cortisone Travels to the Dermis of the Skin.

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What is Cortisone?

Cortisone is an adrenocorticoid hormone which occurs naturally and is produced through the secretion of the adrenal cortex, adrenal glands and the cortex. It was coined as the first “miracle drug” for the treatment of rheumatoid arthritis. The main function of cortisone is to suppress the immune system which in turn reduces inflammation and swelling at the point of the injury. The medicine can be administered in four different ways; intravenously, orally, intraarticularly and cutaneously. Cortisone is the synthetic version of cortisol, that is, it is manufactured, while cortisol is the body’s natural hormone secreted by the adrenal glands. It is released by the outer parts of the glands, also known as the cortex. Cortisol can be referred to as hydrocortisone and is usually released in response to a low level of blood glucocorticoids or stress. It is defined as a glucocorticoid or corticosteroid hormone and usually has a robust and vigorous circadian rhythm. When the body is relaxed, serotonin and dopamine levels are increased and therefore cortisol levels are low. When stress levels are heightened, cortisol levels are elevated. These high levels are often associated with skin conditions, muscle tension and perspiration.

The dermis is the second layer of the skin. It is located below the epidermis and above the subcutaneous tissue. It is comprised of three varieties of tissues including the collagen, elastic tissue, and reticular fibers. It is made up of two layers; the papillary layer and reticular layer. The papillary layer is the upper layer and it contains a thin assortment of collagen fibers. The reticular layer is the lower and thicker layer and is comprised of thick collagen fibers. These fibers are parallel to the skin’s surface. Collagen, along with elastin fibers, give support, elasticity and resilience to the skin. Blood and lymph vessels, sweat glands, hair follicles and sebaceous glands are also found in the dermis.

The epidermis is the outer layer of the skin, above the dermis. Cortisone is lipid soluble, meaning it can travel through the epidermis in order to reach the dermis. The epidermis is comprised of 4-5 layers, including (in ascending order) the basal/germinal layer, the spinous layer, the granual layer, the clear/translucent layer and and the outer surface, which is referred to as the cornified layer. Ninety-five percent of the epidermis is made up of keratinocytes. The other 5 percent consists of melanocytes, langerhans cells and merkel cells. The main function of the keratinocytes is to form the keratic layer which acts as a barrier for the skin. The layer protects the skin from environmental damage including UV radiation, water loss and heat.

How Does Cortisone Travel to the Dermis of the Skin?

Lipid-soluble substances can penetrate through the skin through the lipid bilayers of the plasma membranes of the epidermal cells. The lipid bilayer is comprised of two layers of lipid molecules which form a thin membrane. The role of these membranes is to create a continuous barrier around the cells in the form of flat sheets. The plasma membrane is also referred to as plasmalemma or simply the “membrane”. Its function is to protect the interior of the cells from the outside environment. There are a number of benefits in being a lipid-soluble solution as the skin has a strong barrier which is resistant to most materials trying to infiltrate the body through this surface.

Cream consisting of cortisone is applied topically and is absorbed into the skin, but is not infiltrated through the blood stream. It is commonly used to treat psoriasis, dandruff, eczema, diaper rash, insect bites, and rashes. The medicine is not a solution for fungal or bacterial skin infections. There are also some potential side effects which include dryness, thinning of the skin and allergic reactions.

Resources about Cortisone

Will a cortisone shot help delay hip or knee repla?

Two questions: 1) What`s the difference between prednisone and cortisone? For some reason, I thought they were the same. 2) I`m trying to picture in my mind what the cortisone is doing inside my body. I tend to think of it keeping my airways open so I don`t develop pneumonia or have an asthma attack. Anything you can add to this or correct would be most appreciated.

Resource by Paige

Paige is a Licensed Esthetician at Thrive Skin Institute. She obtained a Bachelor of Science from Penn State. She earned her Esthetician degree from The California Academy

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