Hydrocortisone Butyrate

Product Information

Introduction

Hydrocortisone butyrate is the butyrate salt form of hydrocortisone with the chemical name (11β)-11,17,21-trihydroxypregnan-4-ene-3,20-dione-17α-butyrate. It is a corticosteroid with anti-inflammatory, antipruritic and vasoconstrictive effects. Hydrocortisone butyrate is used to treat a variety of skin conditions, especially dermatitis. The structure is shown in fig. 1.

Fig. 1 Structure of hydrocortisone butyrate

Application in the treatment of dermatitis

• Introduction of dermatitis

Dermatitis is an inflammation of the skin typically characterized by itchiness, redness and a rash. In short-term cases, there may be small blisters, while the skin may thicken in long-term cases. There are several types of dermatitis, including atopic dermatitis, contact dermatitis, stasis dermatitis and seborrheic dermatitis. It was estimated that dermatitis affected 245 million people globally in 2015, about 3.34% of the world's population. Dermatitis can be treated with hydrocortisone butyrate.

Hydrocortisone butyrate has been available as a first-line therapy for inflammatory skin conditions since the 1950s. One study surveyed 89 patients (86 with chronic hand dermatitis and 3 with atopic dermatitis). Comparing the safety, efficacy, and cosmetic acceptability of 4 medium-potency topical corticosteroid products: hydrocortisone butyrate (HB) 0.1% cream, fluticasone propionate (FP) 0.05% cream, prednicarbate (PC) 0.1% cream, and mometasone furoate (MF) 0.1% cream. The results indicated comparable efficacy of all 4 medium-potency corticosteroid products, but HB 0.1% cream exhibits excellent soothing and moisturizing qualities. Therefore, HB is especially friendly to dermatitis patients with dry skin. Fig. 2 illustrates the results, with the largest percentage of subjects (61%) preferring HB to PC for better moisturizing^[1].

Fig. 2 Percentage of subjects preferring study product as "more soothing" (A) and "better moisturizing" (B)

• Mechanism of action

Hydrocortisone butyrate is a synthetic glucocorticoid. Binding and activation of the glucocorticoid result in the activation of lipocortin that inhibits cytosolic phospholipase A2. Lack of phospholipase A2 prevents the release of arachidonic acid, a precursor for inflammatory mediators prostaglandins and leukotrienes, thereby inhibiting inflammation. In addition, glucocorticoid also stimulates lipocortin-1 release into the extracellular space, where it binds to the leukocyte membrane receptors and inhibits various inflammations.

• Side effects

Common side effects of hydrocortisone butyrate mainly include:

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Reference

1. Lassus, A. Clobetasone butyrate and hydrocortisone butyrate in the treatment of eczema: a double-blind comparison. Current Medical Research and Opinion. 1979, 6: 165-167.