Can I Use Hydrocortisone Cream While I’m Pregnant?
Key takeaways:
If over-the-counter (OTC) hydrocortisone cream is applied sparingly and for short periods of time, you won’t absorb much into your system. Using it in this way during pregnancy shouldn’t harm your unborn baby.
If you’re pregnant, talk to your pharmacist or healthcare provider about the potential risks of using hydrocortisone cream, especially if it’s a prescription-strength hydrocortisone cream.
There are a lot of non-medication approaches to treating and preventing itchy skin that can be helpful if you don’t want to use medications while pregnant.
When a minor health problem pops up, most people don’t hesitate to use over-the-counter (OTC) medications to treat it. And if you’re pregnant, you may start to experience certain minor health problems that you didn’t have before. Problems like constipation, itching, and morning sickness are just a few examples.
And while many of these discomforts can be relieved with OTC medications, you might wonder if these medications are still safe to use during pregnancy. It’s always best to ask your healthcare provider before you take any medication, including OTCs, while pregnant.
Below we’ll discuss one specific OTC medication — topical hydrocortisone — and whether or not it’s safe to use during pregnancy.
What is hydrocortisone?
Hydrocortisone is a topical (applied to the skin) corticosteroid that’s available OTC as a cream, gel, or an ointment. The highest strength available OTC is a 1% formulation. Higher strengths can be prescribed to you.
Corticosteroids, like hydrocortisone, work by calming your body’s immune response. This lowers inflammation (swelling) in the body. When it’s applied to the skin, hydrocortisone can help relieve redness, itching, and swelling.
Hydrocortisone 1% cream or ointment (the OTC formulation) can be used to treat itching due to the following:
Insect bites
Poison oak, ivy, and sumac
Soaps
Detergents
Cosmetics
Jewelry
External genital or anal itching
Talk to your healthcare provider if you still have itching after using topical hydrocortisone for 7 days. This may mean you need to use a stronger corticosteroid. Or, that your itching is being caused by something different, like a fungal infection.
Is it safe to use OTC hydrocortisone in pregnancy?
Yes, OTC hydrocortisone is considered safe during pregnancy.
When a medication is applied to the skin, much less of it gets into your blood than if you were taking it by mouth. So if less of the medication is in your blood, that means less of it is able to get to your unborn baby.
You only absorb about 1% to 7% of topical OTC hydrocortisone into your bloodstream, depending on where you apply it and the skin condition you’re treating. You should apply the smallest amount necessary for the shortest amount of time possible.
Applying a large amount of hydrocortisone to a large area, or applying the medication to thinner skin (like the face, groin, or underarms) can cause you to absorb more. If you use hydrocortisone sparingly and apply it only as directed by your healthcare provider, it’s unlikely to cause harm to your unborn baby.
You’ll also absorb more hydrocortisone if you apply it to broken skin (like an open wound), or if you cover the treated area with a bandage or dressing. Generally, you want to avoid covering an area where you applied hydrocortisone, unless otherwise directed by your healthcare provider.
What are the risks of using hydrocortisone while pregnant?
One small study showed a higher rate of babies born with orofacial clefts — cleft lip or palate — when mothers used topical corticosteroids during the first trimester of pregnancy. But other, much larger studies have found no link between topical corticosteroids and orofacial clefts.
Another study showed a link between very strong (potent) topical corticosteroid use during pregnancy and slower growth of the unborn baby. But a follow-up study found no link between strong topical corticosteroid use and low birth weight, early delivery, or birth defects.
OTC hydrocortisone is the lowest strength topical corticosteroid you can use. So it has the lowest risk of all topical corticosteroids. If you’re concerned, talk to your healthcare provider about the safest way to use hydrocortisone while pregnant.
What can I use instead of hydrocortisone while I’m pregnant?
For itching or an allergic reaction, your provider might suggest you use an antihistamine like diphenhydramine (Benadryl). Diphenhydramine is available OTC as an oral medication and a topical cream. It’s also helpful for treating itching due to poison ivy or insect bites, among other things. It’s generally considered safe to use during pregnancy. But you should always ask your healthcare provider before using any OTC medications.
Calamine lotion is another OTC topical treatment that’s helpful for itching, especially if you have a rash from being exposed to poison ivy, oak, or sumac. Calamine lotion is considered safe to use during pregnancy. However, the phenolated version hasn’t been as studied as much and should be avoided out of caution. If you’re unsure about which kind of calamine lotion to use, ask your pharmacist or healthcare provider.
If you have a rash or itching that isn’t relieved with OTC medications, talk to your healthcare provider about what to do next. There are some skin conditions that occur during pregnancy that might be causing your symptoms. It’s best for your healthcare provider to check these out. You might need to use a stronger, prescription-strength corticosteroid to treat more serious skin conditions.
What are other things I can do to soothe itching while I’m pregnant?
There are several non-medication treatments for itchy skin that you can try if you’re concerned about using medications while pregnant. To help soothe itchy skin you can:
Apply a cold cloth or ice pack for 5 to 10 minutes to the itchy area.
Take an oatmeal bath (like Aveeno Soothing Bath Treatment).
Use fragrance-free moisturizers (placing moisturizer in the refrigerator to cool it prior to use can be helpful).
Avoid taking long, hot showers (lukewarm water for 10 minutes or less is best).
Wear breathable clothing (i.e. loose-fitting cotton).
Try to avoid temperature extremes (or big changes in temperatures).
Try at-home stress reduction techniques to help keep your stress level low.
Talk to your healthcare provider about other tips to help soothe itchy skin, and the best ways to tackle itchy skin while pregnant.
The bottom line
Topical OTC hydrocortisone is an effective treatment for itching due to things like insect bites and poison ivy. And, it’s generally considered safe to use during pregnancy. Apply it as directed by your healthcare provider for the shortest time possible. Be sure to follow up with them if you have severe itching or a rash that’s not relieved by OTC hydrocortisone.
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References
Alabdulrazzaq, F., et al. (2012). Topical corticosteroid use during pregnancy. Canadian Family Physician.
American Academy of Dermatology Association. (n.d.). How to relieve itchy skin.
Coutinho, A. E., et al. (2011). The anti-inflammatory and immunosuppressive effects of glucocorticoids, recent developments and mechanistic insights. Molecular and Cellular Endocrinology.
DailyMed. (2020). Assured calamine.
DailyMed. (2020). Calamine phenolated topical suspension.
DailyMed. (2021). Aveeno soothing bath treatment.
Dolgencorp, LLC. (2022). Rexall anti-itch maximum strength relief [OTC monograph].
Edwards, M. J., et al. (2003). Case-control study of cleft lip or palate after maternal use of topical corticosteroids during pregnancy. American Journal of Medical Genetics - Part A.
Joy, N. (2022). Calamine lotion. Journal of Skin and Sexually Transmitted Diseases.
MotherToBaby. (2020). Topical corticosteroids. Organization of Teratology Information Specialists.
MotherToBaby. (2021). Diphenhydramine. Organization of Teratology Information Specialists.
National Psoriasis Foundation. (2022). Topical steroid potency chart.
Office on Women’s Health. (2019). Body changes and discomforts.
Servey, J., et al. (2014). Over-the-counter medications in pregnancy. American Family Physician.
The American College of Obstetricians and Gynecologists. (2020). Skin conditions during pregnancy.
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