8 Hydrocortisone Cream Side Effects You Should Know About

Hydrocortisone cream is a common topical corticosteroid medication. It can treat skin conditions like inflammation, rashes, and itching as both an over-the-counter (OTC) and prescription-only product. Both types of hydrocortisone cream are generally safe and effective, but they can sometimes cause side effects.

Hydrocortisone’s most common side effects occur on the skin in the areas where it’s applied. Usually, these side effects are mild and go away on their own. This is especially true when you’re only using hydrocortisone for a short period of time. Applying hydrocortisone cream too often or for a long time (more than 4 weeks) can cause excess absorption into the body. This may lead to more substantial side effects.

Here, we’ll cover what you need to know about eight hydrocortisone side effects.

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1. Burning and skin irritation

As with many topical medications, hydrocortisone cream can sometimes cause burning and irritation where it’s applied. These reactions are fairly common and mild. What’s more, these effects are sometimes caused by other, inactive ingredients in the cream — not always by hydrocortisone itself.

While some burning or irritation is normal with hydrocortisone cream, it should resolve on its own after a few days. If these symptoms become bothersome or they won’t go away, let your healthcare provider know. You may need to use less cream or switch to another product that’s less irritating. If you experience severe burning or irritation, stop using the cream and let your healthcare provider know right away.

2. Skin dryness and itching

Hydrocortisone cream may cause dry skin and itchiness. This may seem odd. After all, hydrocortisone can be used to treat dry skin and itching. But you may be sensitive to an ingredient in the cream, and that can cause you to have dry skin or itching. Dry skin itself may also lead to itching symptoms.

If you have mild skin dryness or itching that shows up after you start using hydrocortisone cream, you can try using a skin moisturizer for relief. Just make sure you don’t place hydrocortisone and a moisturizer on your skin at the same time. It’s a good idea to apply them at different times of day.

If you’re using hydrocortisone for skin dryness or itching and it gets worse when you apply the cream, contacting your healthcare provider is another option. They may recommend a different medication to help with your symptoms.

3. Skin thinning

Topical steroids like hydrocortisone cream can cause skin thinning, also called skin atrophy. Steroids cause thin skin due to their effects on skin cells. Symptoms can include transparent, wrinkled, and shiny skin. This side effect tends to worsen with stronger, more potent steroids; hydrocortisone is considered to be a weak steroid.

Luckily, thin skin from topical steroid use is reversible. It should slowly go back to normal after you stop applying the medication.

Let your healthcare provider know if you see skin changes while using hydrocortisone cream. They may suggest a lower-strength product or recommend using it less often.

4. Excessive hair growth

Hydrocortisone cream and other steroid medications can cause excess hair growth — also called hypertrichosis. This condition is more common with oral and injectable steroids, but it’s still possible with hydrocortisone cream.

Experts aren’t sure exactly how steroids cause excess hair growth. Extra hair growth from steroids can stick around for months. If you spot abnormal hair growth while using hydrocortisone cream, let your healthcare provider know.

5. Pimples and other manifestations of acne

Hydrocortisone cream can sometimes lessen acne symptoms. But, experiencing worsening pimples, comedones (small, rough bumps), and/or pustules (pus-filled sores) is also possible.

If you have acne, it’s best to check with your healthcare provider before using hydrocortisone cream. They may tell you to avoid applying the cream on areas where acne is present.

6. High blood glucose

Although rare, hydrocortisone cream could contribute to high blood glucose (hyperglycemia) when it’s used for a long time. In some cases, this can lead to a new start or worsening of diabetes. Symptoms of high blood glucose include greater thirst and urination, nausea and vomiting, and blurry vision.

Check with your healthcare provider if you see symptoms of high blood glucose. They can help figure out whether hydrocortisone cream is a probable cause.

7. Cushing’s syndrome

Long-term use of topical steroids has occasionally been linked to Cushing’s syndrome. But, it’s very rare.

People with Cushing’s syndrome can experience growth reduction, weight gain, and features like “moon face” or “buffalo hump.” Other symptoms can include high blood pressure and high blood glucose. Children seem to be more prone to developing Cushing’s syndrome from steroid exposure.

Luckily, if this condition is caused by steroids, it’s generally reversible. Stopping hydrocortisone helps things return to normal, but it can take some time. If you see any of these symptoms while using hydrocortisone cream, contact your healthcare provider. They can help find out whether the medication may be causing the symptoms.

8. Topical steroid withdrawal

Applying topical steroids for longer than recommended can raise the risk of topical steroid withdrawal (TSW). TSW is a rare but serious skin condition that can occur when you suddenly stop using a topical steroid.

The symptoms are generally inflammation (swelling), irritation, and skin rashes. They can appear any time after you stop using the medication. Treatment for TSW is different for everyone. And, there’s no specific timeline for how long the symptoms may last.

If you’ve been using hydrocortisone cream for a long time, you may need to lower the dose bit by bit before stopping it. Your healthcare provider can help you do this safely. This will help you avoid TSW.

How much hydrocortisone is safe to use?

Hydrocortisone cream is applied in small amounts, usually 2 to 4 times daily. How often you use it will depend on your skin condition and how severe your symptoms are. It also will depend on whether you’re using the OTC or prescription version.

But, unlike oral and injectable medications, the cream doesn’t necessarily come in exact doses. It’s usually recommended to apply a thin layer on the affected skin area. A pharmacist or healthcare provider may recommend different directions depending on your situation.

Is it possible to overuse hydrocortisone cream?

Yes. It’s possible to overuse hydrocortisone cream. This can happen in a few ways, such as using it too often, applying too much, or using the cream for a long time. These can all make it more likely to experience side effects. In rare cases, overusing hydrocortisone cream can also lead to serious side effects.

It’s important to only apply the smallest amount needed and as instructed by your healthcare provider.

Are the risks different for hydrocortisone cream, ointment, or lotion?

In general, no. The side effects of hydrocortisone are similar for each formulation. Side effects are more likely with stronger formulations of steroid creams.

What can I do to control the side effects of hydrocortisone?

Preventing side effects from hydrocortisone and other steroid creams usually involves using lower strengths and/or applying it less often. It’s also helpful to use the lowest effective amount of cream. You should also avoid applying the cream to sensitive areas, like the face, around the eyes, and the genital area.

When should I contact my healthcare provider about hydrocortisone cream side effects?

You can contact your healthcare provider any time you have questions about hydrocortisone side effects. Even if your side effects are mild, it’s best to double-check. It’s also a good idea to contact them if you’ve been taking hydrocortisone for 2 weeks and haven’t seen any improvement in your symptoms.

If you have bothersome or severe side effects, you should make a point to contact your healthcare provider right away. Signs of severe side effects include worsening rash or skin irritation, fatigue or feeling tired, and nausea or vomiting.

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Written by:

Austin Ulrich, PharmD, BCACP

Austin Ulrich, PharmD, BCACP, is a board-certified ambulatory care clinical pharmacist. In his early career, he provided direct patient care in a variety of settings, including hospital and community pharmacies, and in a primary care clinic as a clinical pharmacist.

Edited by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Reviewed by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

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