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Clinical Dermatology and SmartLotion®

For decades clinical dermatology has been dominated by strategies for addressing two major problems: microbes out of balance on the skin and inflammation caused by immune dysregulation. 


The use of antibiotics and safely using topical corticosteroids (cortisone-based products) have formed a core part of a dermatologist’s strategy. More specifically, using antibiotics short term directly helps microbe problems (Board-certified dermatologists are more likely to identify the pathogen involved correctly). Then, relatively long-term use of other antibiotics was selected for their ability to improve immune dysregulation and thereby down-regulate (reduce) inflammation.


SmartLotion®: Inception and Efficacy


Since 2005 I’ve been manufacturing a commercial product that contains 0.75% hydrocortisone USP as the active ingredient. For quality assurance, I tested both the concentration and its stability. Is there an argument for a safer topical steroid than this? No, not really. I designed the product as a “smarter” topical steroid, with the base lotion made to promote the activities of a pre-biotic for improving the microflora. We developed a proprietary way of preparing Grapefruit seed extract in the base lotion and non-monograph glycerin and sulfur (the pure element, not “sulfa”) for a pre-biotic strategy that downregulates inflammation, independent of the hydrocortisone. We shared Smartlotion® with several other dermatologists who enthusiastically incorporated it into their Practices.

with several other dermatologists who enthusiastically incorporated it into their Practices.


Sharing Smartlotion® further was necessary for producing excellent results for people with frustrating chronic dermatitis conditions. Eczema is a major type of dermatitis. It comes from a Greek word that means to “bubble up” and get moist. 


SmartLotion® and TSW


It was a matter of not just establishing the safety of 0.75% hydrocortisone but making it safer still while also ensuring it was a smarter hydrocortisone. Safe topical usage was also crucial for the smarter use of antibiotics because the product worked well with all antibiotic strategies prescribed by physicians. Before SmartLotion® was commercially manufactured, clinical data was collected for nearly twenty years, showing that this smarter product did not cause TSW (Topical Steroid Withdrawal, formerly known as Steroid Rebound Effect). Following this, our network of Board Certified Dermatologists collected another 16 years of unmatched experience with the product.


For patients struggling with TSW, this product rapidly helped antibiotic therapies to correct and fix the problem of TSW (a condition caused by prolonged use of strong steroids on the face). Moreover, it became popular with dermatologists who understood it, because instead of months on oral antibiotics, the SmartLotion® + oral antibiotics program required only days to help patients with TSW. In addition, for mild cases of TSW, and for ordinary spontaneous perioral dermatitis (chin rashes), the SmartLotion® by itself could greatly help the immune dysregulation and microbe imbalance.


Creating the HarlanMD website has allowed me to help more people, sharing with them how my own patients use this product.  


I must sincerely thank my Board-certified Dermatologist colleagues, who have used this product thousands of times, and helped establish an unmatched body of experience. I also must thank our terrific HarlanMD staff, and our enthusiastic customers. 


Steve Harlan, MD

Board-certified Dermatologist   

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