In a double-blind two week clinical trial in chronic eczema, ZCort outperformed the market-leading hydrocortisone brand, Cortizone-10 Max Strength*
ZCort® is Specially Formulated to Protect Collagen During Hydrocortisone Treatment
Topical hydrocortisone is the mainstay of over-the-counter (OTC) dermatitis treatment worldwide and is significantly more effective overall than non-steroidal alternatives. However, topical hydrocortisone has long been known to promote skin atrophy (mild thinning of the skin) -- for example, Marks et al 1976; Tan et al 1981; Thomas et al 2002 (and see Marks 1985) -- and to markedly decrease collagen synthesis. Collagen propeptides (precursors) in hydrocortisone-treated skin are decreased by 66% after just one week of twice-daily topical 1% hydrocortisone (Haapasaari et al 19997) and by 80 to 90% after 3 weeks of twice-daily topical treatment (Nuutinen et al 2003).
Collagen is the main structural component of skin dermis -- comprising about 85% of the dry weight of skin -- and is critical in the maintenance of skin firmness and elasticity. Collagen is lost during aging which contributes to skin atrophy, sagging, and wrinkles.
ZCORT's patented formula includes a small amount of DHEA as an emollient that is intended to help protect the skin against the collagen-inhibiting effects of hydrocortisone. In this regard, topical DHEA has been found to dose-dependently stimulate collagen-synthesizing genes in human thigh skin (Calvo et al 2008; El-Alfy et al 2010). Similarly, topical DHEA has been found to potently increase the number and size of fibroblasts in the skin dermis (El-Alfy 2010). DHEA also has been found to prevent ultraviolet light-induced inhibition of collagen synthesis. Specifically, a Korean group exposed cultured human skin to a solution of less than 0.04% DHEA (10 micromolar DHEA) and found significant increases in both procollagen synthesis and protection against the decrease in collagen synthesis caused by UV light (Shin et al 2005). Topical DHEA may also decrease skin atrophy, wrinkles ("crow's feet" near the eye) and skin "papery" appearance in post-menopausal women (Nouveau et al 2008).
References
Calvo E, Luu-The V, Morissette J, Martel C, Labrie C, Bernard B, Bernerd F, Deloche C, Chaussade V, Leclaire J, Labrie F. Pangenomic changes induced by DHEA in the skin of postmenopausal women. J Steroid Biochem Mol Biol. 2008 Dec;112(4-5):186-93.
El-Alfy M, Deloche C, Azzi L, Bernard BA, Bernerd F, Coutet J, Chaussade V, Martel C, Leclaire J, Labrie F. Skin responses to topical dehydroepiandrosterone: implications in antiageing treatment? Br J Dermatol. 2010 Nov;163(5):968-76. doi: 10.1111/j.1365-2133.2010.09972.x. Erratum in: Br J Dermatol. 2011 Jul;165(1):228.
Haapasaari KM, Risteli J, Karvonen J, Oikarinen A. Effect of hydrocortisone, methylprednisolone aceponate and momethasone furoate on collagen synthesis in human skin in vivo. Skin Pharmacol. 1997;10(5-6):261-4. doi: 10.1159/000211513. PMID: 9449164.
Haapasaari KM, Risteli J, Koivukangas V, Oikarinen A. Comparison of the effect of hydrocortisone, hydrocortisone-17-butyrate and betamethasone on collagen synthesis in human skin in vivo. Acta Derm Venereol. 1995 Jul;75(4):269-71.
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Marks R. Methods for the assessment of skin atrophogenicity of topical corticosteroids. Dermatologica. 1976;152 Suppl 1:117-26.
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Nouveau S, Bastien P, Baldo F, de Lacharriere O. Effects of topical DHEA on aging skin: a pilot study. Maturitas. 2008 Feb 20;59(2):174-81.
Nuutinen P, Riekki R, Parikka M, Salo T, Autio P, Risteli J, Oikarinen A. Modulation of collagen synthesis and mRNA by continuous and intermittent use of topical hydrocortisone in human skin. Br J Dermatol. 2003 Jan;148(1):39-45.
Shin MH, Rhie GE, Park CH, et al. Modulation of collagen metabolism by the topical application of dehydroepiandrosterone to human skin. J Invest Dermatol. 2005;124(2):315‐323.
Tan CY, Marks R, Payne P. Comparison of xeroradiographic and ultrasound detection of corticosteroid induced dermal thinning. J Invest Dermatol. 1981 Feb;76(2):126-8.
Thomas KS, Armstrong S, Avery A, Po AL, O'Neill C, Young S, Williams HC. Randomised controlled trial of short bursts of a potent topical corticosteroid versus prolonged use of a mild preparation for children with mild or moderate atopic eczema. BMJ. 2002 Mar 30;324:768-775.