Usage
Desonide is a low-potency topical corticosteroid indicated for the relief of inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses. These include conditions like atopic dermatitis (eczema), allergic contact dermatitis, psoriasis, and seborrheic dermatitis. It is classified as a corticosteroid. Desonide works by mimicking the effects of cortisol, a naturally occurring hormone produced by the adrenal glands, thereby reducing inflammation, itching, and redness in the skin.
Alternate Names
Desonide is also known by its various brand names such as Desonate, DesOwen, LoKara, Tridesilon, and Verdeso. There are no widely recognized international or regional variations of the generic name “Desonide”.
How It Works
Pharmacodynamics: Desonide exerts its anti-inflammatory, antipruritic, and vasoconstrictive effects by binding to glucocorticoid receptors in the cytoplasm of target cells within the skin. This binding leads to the modulation of gene expression and ultimately reduces the production of inflammatory mediators such as prostaglandins, leukotrienes, and cytokines. Consequently, it suppresses the migration of neutrophils and macrophages to the inflamed site, thereby reducing inflammation and its associated symptoms.
Pharmacokinetics: Topical application of desonide results in minimal systemic absorption. When absorbed, it is metabolized primarily in the liver and excreted through the kidneys. The elimination half-life is relatively short. CYP enzyme interactions have not been extensively documented.
Dosage
Standard Dosage
Adults:
Apply a thin layer of desonide cream, ointment, or lotion to the affected skin area two to three times daily, depending on the severity of the condition. If using the gel formulation, apply twice daily.
Children:
For children aged 3 months and older, apply a thin layer of desonide cream, ointment, or lotion to the affected skin area two times a day. For the gel and foam, the dosage is also twice daily. For children under 3 months of age, desonide use should be determined and closely monitored by a doctor.
Special Cases:
- Elderly Patients: Similar to adults, but monitor for increased skin thinning due to age-related skin changes. Limit treatment duration as much as possible.
- Patients with Renal Impairment: No dosage adjustment is typically necessary due to minimal systemic absorption.
- Patients with Hepatic Dysfunction: No dosage adjustment is typically necessary due to minimal systemic absorption.
- Patients with Comorbid Conditions: Caution is advised in patients with diabetes or Cushing’s syndrome, as topical corticosteroids can potentially exacerbate these conditions due to systemic absorption, albeit minimal.
Clinical Use Cases
Desonide is not indicated for use in situations like intubation, surgical procedures, mechanical ventilation, intensive care unit (ICU) use, or emergency situations. It’s strictly for topical dermatological use.
Dosage Adjustments
No specific dosage adjustments are usually necessary based on patient factors, as systemic absorption is minimal. However, always consider the patient’s age, the severity of the dermatosis, and potential drug interactions.
Side Effects
Common Side Effects:
Burning, stinging, itching, dryness, irritation, and redness at the application site may occur, especially in the initial days of treatment.
Rare but Serious Side Effects:
Skin atrophy, telangiectasias, hypopigmentation, hypertrichosis, perioral dermatitis, allergic contact dermatitis, and secondary infections. With prolonged or extensive use, HPA axis suppression, Cushing’s syndrome, and hyperglycemia are possible.
Long-Term Effects:
Skin thinning, striae, and changes in skin pigmentation.
Adverse Drug Reactions (ADR):
Severe allergic reactions, skin infections, adrenal suppression.
Contraindications
Hypersensitivity to desonide or any of the components of the formulation.
Drug Interactions
Clinically significant drug interactions are rare due to minimal systemic absorption. However, concomitant use of other topical medications on the same area should be discussed with a physician.
Pregnancy and Breastfeeding
Desonide is classified as Pregnancy Category C. Use during pregnancy only if the potential benefit outweighs the potential risk to the fetus. It’s unknown if desonide is excreted in breast milk. Consult with a doctor before using it while breastfeeding.
Drug Profile Summary
- Mechanism of Action: Binds to glucocorticoid receptors, modulating gene expression, and reducing inflammation.
- Side Effects: Local skin reactions (burning, itching, dryness), rarely skin atrophy, HPA axis suppression with extensive use.
- Contraindications: Hypersensitivity.
- Drug Interactions: Minimal.
- Pregnancy & Breastfeeding: Category C; use with caution.
- Dosage: Apply thinly 2-3 times/day (cream/ointment/lotion), 2 times/day (gel).
- Monitoring Parameters: Monitor the treated skin area for adverse effects and treatment response. Periodically assess for signs of systemic absorption if used extensively or for prolonged periods.
Popular Combinations
Desonide is not typically used in combination with other drugs. However, emollients can be used concomitantly to manage skin dryness.
Precautions
- General Precautions: Avoid contact with eyes. Use the minimum quantity for the shortest duration necessary.
- Specific Populations: Use with caution in children and the elderly. Avoid use in infants under 3 months old without close medical supervision.
- Pregnant Women: Use only if clearly needed and under medical supervision.
- Breastfeeding Mothers: Consult a physician before use.
- Children & Elderly: Monitor closely for adverse reactions.
- Menstruating Individuals: No specific precautions.
- Lifestyle Considerations: No specific considerations related to lifestyle.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Desonide?
A: Adults and children 3 months and older: Apply a thin layer of desonide cream, ointment, or lotion to the affected skin area two to three times daily or as directed by a physician. Gel formulations should be applied twice daily. Children under 3 months: Use only as directed by a physician.
Q2: What skin conditions is Desonide used to treat?
A: Desonide is used to treat a variety of inflammatory and pruritic skin conditions, including atopic dermatitis (eczema), allergic contact dermatitis, psoriasis, and seborrheic dermatitis.
Q3: What is the mechanism of action of Desonide?
A: Desonide works by binding to glucocorticoid receptors in the skin cells, which reduces inflammation, itching, and redness.
Q4: What are the common side effects of Desonide?
A: Common side effects can include mild burning, stinging, itching, dryness, and redness at the application site, especially at the beginning of treatment.
Q5: Can Desonide be used during pregnancy or while breastfeeding?
A: Desonide should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Consult with a physician before using desonide while breastfeeding.
Q6: What should I do if I miss a dose of Desonide?
A: If you miss a dose, apply it as soon as you remember. However, if it’s almost time for your next dose, skip the missed dose and continue your regular dosing schedule. Do not apply extra to make up for a missed dose.
Q7: How long can I use Desonide continuously?
A: Generally, Desonide should not be used continuously for more than 4 weeks. Your doctor will determine the appropriate duration of treatment based on your specific condition and response to therapy.
Q8: Can Desonide be used on the face?
A: While Desonide can be used on the face, caution is advised, as prolonged use can lead to skin thinning and other adverse effects in this sensitive area.
Q9: Is it safe to use Desonide with other topical medications?
A: Consult your doctor before using Desonide with other topical medications on the same area, as there might be potential interactions or additive effects.
Q10: What should I do if my skin condition worsens or doesn’t improve with Desonide?
A: Consult your doctor if your skin condition does not improve or if it worsens after using Desonide for the prescribed duration. You may need a different treatment or further evaluation.
