Delster Cream (TOPICAL CORTICOSTEROID) Back
COMPOSITION
Hydrocortisone (as Acetate)                         1% w/w
In a cream base

CLINICAL PHARMACOLOGY : The primary therapeutic effect of Hydrocortisone Acetate is due to the anti-inflammatory activity which is nonspecific. Topically applied corticosteroids like Hydrocortisone Acetate binds with receptor proteins in the cytoplasm of target cells. This leads to the formation of phospholipase A2 inhibitory proteins, collectively called lipocortins. Phospholipase A2 is known to catalyze the conversion of membrane phospholipids to Arachidonic acid. Arachidonic acid binds with cyclo-oxygenase to form highly inflammation prostaglandins, PGE2. Lipocortins inhibits phopholipase A2, and thereby controls the biosynthesis of potent mediators of inflammatory like prostaglandin E2 (PGE2) and leukotrienes, kinins, histamine, liposomal enzymes and the complement system. Thus, when Hydrocortisone is applied to inflamed area of skin it acts by acting inside the skin cells to decrease the release of these inflammatory substances and inhibits the migration of leukocytes into the area by reversing vascular dilatation and permeability. The clinical result is a decrease in edema (swelling), erythema (redness) and pruritus (itch).
Hydrocortisone is a mild corticosteroid that is applied to the skin to treat a wide variety of inflammatory skin disorders, such as eczema or insect bite reactions.

INDICATIONS :
DELSTER can be conveniently prescribed for
  • Eczema (Atopic Eczema) -Mild to moderate.
  • Insect Bite Reactions.
  • Skin inflammation due to allergies or irritants (allergic or irritant contact dermatitis).
DOSAGE AND ADMINISTRATION :
To be applied as a thin film over a small area 1-2 times daily.

Notes on Application : The length of cream equivalent to one fingertip unit (the distance from the tip of an adult index finger to the first crease) is sufficient to cover an area that is twice that of the flat adult hand.
Duration :
  1. 2-3 days for insect bites.
  2. 5-7 days for conditions such as allergic or irritant contact dermatitis
  3. 7 days for Atopic Eczema or as advised by treating physician
Treatment should not be continued for more than 7 days without review.

CONTRAINDICATIONS :
DELSTER is contraindicated in patients who are hypersensitive to Hydrocortisone Acetate, to other corticosteroids, or to any ingredients in these preparations. If any allergic reaction is experienced,
Not to be used in
  1. Acne rosacea.
  2. Acne vulgaris.
  3. Children under the age of two years, except on medical advice.
  4. Infections of the skin with virus (eg. herpes simplex, chickenpox, etc.), fungi (eg. thrush, ringworm, athlete´s foot, etc) or bacteria (eg. impetigo).
  5. Inflammatory rash around the mouth (perioral dermatitis).
WARNINGS AND PRECAUTIONS :
  1. DELSTER is for external use only. So not to be applied to the mucosal surfaces, lining of mouth or nose, areas around the genitals or anus, unless instructed by the physician.
  2. DELSTER should not be used long-term, on large areas of skin, raw or open skin, skin folds, or under airtight dressings (including nappies), since it may increase systemic absorption and elevate the risks of local side effects. Airtight dressings should be used over the affected varea only if instructed by the physician.
  3. DELSTER should be applied thinly and evenly on the affected areas only.
  4. Avoid contact of this medicine with the eyes.
  5. Hands should be thoroughly washed after application, unless they are the area under treatment.
  6. If there is no improvement within seven days, or if any infection of the skin appears, consulting physician should be immediately contacted.
Pregnancy and Lactation :
  • DELSTER should not be used during pregnancy unless considered essential by the consulting Physician. Other precautions remain applicable as above.
  • DELSTER should not be used during breastfeeding unless considered essential by the consulting physician. If prescribed and has to be applied to the breasts, it should be washed off thoroughly before breastfeeding and reapplied afterwards.
Pediatric Use :
To be used with caution.

ADVERSE REACTIONS :
Since Hydrocortisone belongs to the Class VII steroids, it is among the most well tolerated ones. Adverse reactions are rare, and the commonest ones are as follows -
  • Thinning of the skin.
  • Changes in skin pigmentation.
  • Skin irritation, burning, itching.
  • Hypertrichosis (excess hair growth).
STORAGE INSTRUCTIONS : Store in a cool, dry place.