Danger in cortisone cream steroids

Dear Dr. Gott: Does the skin absorb all the bath oils and lip creams that we apply? I use so much lotion and cocoa butter on my hands and feet in the winter that I am concerned about the cholesterol and triglyceride fats that may be entering my body.

Dear Reader: Under ordinary circumstances, the substances in topical products are not absorbed through the skin into the body, although they are absorbed into the skin itself.

Therefore, you needn’t worry that the fats in soaps, salves and lotions will enter your system. The only glaring exception to this is cortisone creams. The steroids in these products may be absorbed into the system, especially if the treated skin is raw, abraded or irritated. Thus, a person can develop the complications of steroid therapy (such as diabetes and osteoporosis) if the affected skin surface is large and the cortisone cream is used regularly for a protracted time.

To give you related information, I am sending you a copy of my Health Report “Understanding Cholesterol.” Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Dear Dr. Gott: I am taking triamterene/hydrochlorothiazide for high blood pressure. One pharmacist suggested that I take a potassium supplement as well, but other resources (including my doctor) indicate that this is not necessary. I’m confused.

Dear Reader: As well you might be. Let me help.

Many diuretic medications have the potential to cause inappropriate losses of potassium. Hydrochlorothiazide is such a drug.

Triamterene, however, isn’t. It may raise potassium levels. Therefore, when the two drugs are combined (as in your case), the end result — from the potassium-losing drug coupled with the potassium-sparing one — is a neutral balance. When taking this combination of medication, your potassium level should neither rise nor fall. This is one reason why this treatment for hypertension has been popular for decades. Along with being safe and inexpensive, it is not ordinarily associated with the mineral imbalances that can complicate therapy with other kidney stimulants. Follow your doctor’s advice.

I should mention that I have seen extremely rare instances in which combination therapy has resulted in low potassium levels. The cause of this phenomenon is unclear, but it can be easily treated with high-potassium foods, such as prunes, apricots, bananas and orange juice.

Although this reaction is very unusual, your primary-care physician may choose to monitor your potassium level with a blood test once or twice a year. Also, you should report to him if you experience any unexplained muscle weakness and/or cramps, the primary symptoms of low potassium.