hydrocortisone
Topical hydrocortisone is a steroid medication used to treat different skin conditions, such as eczema. It's available in many different formulations, including cream, ointment, lotion, and solution. Some strengths are found over the counter (e.g., hydrocortisone 1%), while you need a prescription for others (e.g., hydrocortisone 2.5%). In general, most people experience few to no side effects while using topical hydrocortisone as directed. Rarely, topical hydrocortisone might cause topical steroid withdrawal (TSW). Watch out for skin rashes and irritations that get worse after stopping this medication.
What is Topical hydrocortisone?
What is Topical hydrocortisone used for?
Short-term relief of skin irritations (e.g., itching) due to:
Skin inflammation
Skin rashes
Eczema
Psoriasis
Insect bites
Poison ivy or oak
Skin allergies
Dry scalp
Genital or rectal irritation
How Topical hydrocortisone works
Topical hydrocortisone is a topical corticosteroid. When it’s used on the skin, it has 3 actions:
It lowers the amount of inflammatory chemicals that cause redness, itching, and swelling. This helps to lower skin inflammation.
It can also slow down how quickly new skin cells are being made, which can help minimize the amount of patches or scales in some skin problems (e.g., psoriasis).
Finally, it lessens the immune response of your body, which can help get rid of certain skin problems that are caused by a sensitive immune system (e.g., eczema).
Drug Facts
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What are the side effects of Topical hydrocortisone?
Common Side Effects
- Burning
- Itching
- Skin irritation
- Dry skin
- Inflamed hair follicles
Other Side Effects
- Acne-like bumps
- Changes in skin color
- Rash or heat rash
- Thinning skin
- Stretch marks
- Pruning or wrinkling of the skin
- Hair growth
Source: DailyMed
More on Topical hydrocortisone side effects
The following side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Incidence not known
Backache
blistering, burning, crusting, dryness, or flaking of the skin
burning, itching, and pain in the hairy areas, pus at the root of the hair
burning and itching of the skin with pinhead-sized red blisters
darkening of the skin
blurred vision
dizziness
facial hair growth in females
fainting
fractures
fruit-like breath odor
full or round face, neck, or trunk
increased hunger or thirst
increase urination
increased hair growth on the forehead, back, arms, and legs
irritability
lightening of the normal skin color
lightening of treated areas of the dark skin
loss of appetite
loss of sexual desire or ability
menstrual irregularities
mental depression
muscle wasting
reddish purple lines on the arms, face, legs, trunk, or groin
redness and scaling around the mouth
severe redness, soreness, or swelling of the skin
softening of the skin
stomach pain
sweating
thinning of the skin with easy bruising, especially when used on the face or where the skin folds together (eg, between the fingers)
thinning, weakness, or wasting away of the skin
trouble breathing
unexplained weight loss
unusual tiredness or weakness
vomiting
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Flushing or redness of the skin
unusually warm skin
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Topical hydrocortisone
Pros
Available as a lower-cost, generic medication
Available over the counter
Many formulations to choose from, such as ointment, cream, and solution
Cons
Short-term use only, otherwise it might cause skin thinning and high blood sugar
Applied multiple times a day
Might affect your body's ability to fight off infections
Pharmacist tips for Topical hydrocortisone
Topical hydrocortisone should only be used on the outside of your body on skin that's not broken. You shouldn’t use it on wounds, damaged skin, or inside the rectum (use Anusol-HC for rectal irritation instead). To avoid side effects, don't use topical hydrocortisone in your eyes, nose, or ears.
Wash your hands before and after using topical hydrocortisone to help prevent getting the medication in your eyes. If it does get into your eyes, wash your eyes with water or saline and contact your provider if irritation doesn't go away.
Don't cover the treated area with a bandage after applying topical hydrocortisone unless directed by your provider. If you're applying this medication around the diaper area, don't use tight fitting diapers or plastic pants on your toddler. Doing so might affect how much medication gets absorbed.
Don't use these skin products on your face, underarms, or groin areas unless your provider tells you to do so. The skin in these areas are more sensitive and side effects are more likely to happen.
If you're using a prescription-strength topical hydrocortisone, ask your provider how long you need to use it. Typically, you shouldn't use these skin products for longer than 2 weeks unless directed by your provider.
If you're using other corticosteroid-containing products, check with your provider first before using these topical hydrocortisone skin products. Using multiple corticosteroids can raise your risk of side effects.
OTC topical hydrocortisone skin products
Stop using topical hydrocortisone and talk with your provider if you've been using this medication for more than a week or if symptoms (e.g., rash, itching) come back after clearing up. There might be some other problem going on that your provider can help you with.
Before using topical hydrocortisone, ask your provider if this medication is right for you. This is especially true if you experience the following: vaginal discharge, rectal bleeding, and diaper rash.
Store topical hydrocortisone up and away and out of children's reach and sight. This prevents them from accidentally swallowing medicine that was left out. Always put medication away every time you use it. If you think that your child might’ve accidentally swallowed topical hydrocortisone, call your Poison Control Center at 1-800-222-1222 right away even if you aren't completely sure.
Frequently asked questions about Topical hydrocortisone
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What are the risks and warnings for Topical hydrocortisone?
Topical hydrocortisone can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Hormone problems and withdrawal
Risk factors: Using topical hydrocortisone for a long period of time | Using more topical hydrocortisone than recommended| Covering applied area with a bandage | Young children
In some rare cases, using topical topical hydrocortisone for a long time and over a large skin area can cause a medical condition called adrenal suppression. This is when your body stops making its own steroid hormones because of the presence of the steroid medication. And if you suddenly stop the medication, it can lead to symptoms of withdrawal include skin swelling, rash, and burning. To prevent adrenal suppression from happening, your provider will prescribe the lowest possible dose of topical hydrocortisone that works well for you for the shortest amount of time. If you need to use topical hydrocortisone for a long period of time or for a large area, your provider might ask you to do some lab work to test how well your adrenal gland works. Don't suddenly stop using topical hydrocortisone without talking to your provider first.
High blood sugar
Risk factors: Using topical hydrocortisone for a long period of time | Using more topical hydrocortisone than recommended
Using topical topical hydrocortisone for a long period of time or over large areas of the body can sometimes raise your blood sugar levels. If your blood sugar level isn't controlled, this can lead to diabetes. If you have diabetes, your provider might ask you to check your blood sugar level regularly to make sure this medication is safe for you. Let your provider know if you feel more thirsty or are urinating more than usual.
New or worsened skin infection
Risk factors: Using topical hydrocortisone for more than 7 days
Using topical hydrocortisone long term can raise the risk of skin or mouth infections, such as fungal or bacterial infections. Don't use topical hydrocortisone if you have a skin infection because it can make your infection worse. Let your provider know if you have redness, swelling, pain, pus, or if your current symptoms don't improve after 7 days of treatment. These can be signs and symptoms of a new infection.
Skin problems
Risk factors: Excessive and inappropriate use of topical hydrocortisone | Using a lot of topical hydrocortisone
Using topical hydrocortisone longer than directed by your provider can raise your risk of different skin reactions, including skin thinning, stretch marks, spider veins, burning, itching, irritation, dry skin, inflamed hair follicles, changes in skin color, or rash. To prevent severe skin reactions from happening, your provider will prescribe the lowest possible dose of topical hydrocortisone to treat your symptoms for the shortest amount of time. Let your provider know right away if you notice any new or worsening skin problems.
Topical hydrocortisone dosage forms
Typical dosing for Topical hydrocortisone
Different formulations of topical hydrocortisone have different strengths, directions, and age-cut offs. To make sure you're using this medication correctly, follow the specific product instructions on the package or talk with your provider or pharmacist about how to use it.
Examples of some topical topical hydrocortisone include:
Prescription-strength:
Pandel 0.1% topical cream (adults only): Apply a small amount to the affected area(s) 1 to 2 times daily.
Topical hydrocortisone valerate 0.2% topical cream and ointment (adults only): Apply a small amount to the affected area(s) 2 to 3 times daily.
Topical hydrocortisone butyrate 0.1% topical cream, ointment, and solution: Apply a small amount to the affected area(s) 2 to 3 times daily.
Topical hydrocortisone 2% cream or gel or 2.5% topical ointment, cream, and lotion: Apply a small amount to the affected area(s) 2 to 4 times daily.
OTC-strength
Topical hydrocortisone 1% topical ointment and cream (adults and children age 2 years and older): Apply a small amount to the affected area(s) 3 to 4 times daily.
Please note: OTC topical hydrocortisone topical products are only for adults and children age 12 years and older when it's used for rectal irritations.
Interactions between Topical hydrocortisone and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.
How much does Topical hydrocortisone cost?
What are alternatives to Topical hydrocortisone?
Short-term relief of skin irritations (e.g., itching) due to:
Skin inflammation
Skin rashes
Eczema
Psoriasis
Insect bites
Poison ivy or oak
Skin allergies
Dry scalp
Genital or rectal irritation
Treatment of skin rashes and other skin irritation - cream, lotion, and ointment
Treatment of eczema in adults and children 3 months and older - foam and gel only
Topical hydrocortisone images
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References
Best studies we foundAmerican Academy of Dermatology Association. (n.d.). Shingles: Diagnosis and treatment.
American Academy of Dermatology Association. (n.d.). Shingles: Tips for managing.
American Academy of Pediatrics. (2021). Treatment of atopic dermatitis.
ANI Pharmaceuticals, Inc. (2021). Pandel- hydrocortisone probutate cream [package insert]. DailyMed.
BluePoint Laboratories. (2023). Hydrocortisone- antipruritic (anti-itch) ointment. DailyMed.
Centers for Disease Control and Prevention. (2023). Put your medicines up and away and out of sight.
Cortisone-10. (2021). Maximum strength 1% hydrocortisone itch relief water resistant ointment.
Dynarex Corporation. (2022). Hydrocortisone [package insert]. DailyMed.
E. Fougera & Co. a division of Fougera Pharmaceuticals Inc. (2020). Hydrocortisone- hydrocortisone ointment. Hydrocortisone- hydrocortisone cream [package insert]. DailyMed.
Ference, J. D., et al. (2009). Choosing topical corticosteroids. American Family Physician.
Lam, L., et al. (2016). Adrenal suppression with chronic topical corticosteroid use in psoriasis patients. Journal of Drugs in Dermatology.
National Capital Poison Center. (n.d.). Hydrocortisone: Uses and safety considerations.
National Institute of Diabetes and Digestive and Kidney Disease. (2018). Symptoms and causes of adrenal insufficiency and Addison's disease.
Organization of Teratology Information Specialists. (2022). Topical corticosteroids.
Padagis Israel Pharmaceuticals Ltd. (2021). Hydrocortisone- hydrocortisone lotion. DailyMed.
Phan, K., et al. (2019). Topical corticosteroids and risk of diabetes mellitus: Systematic review and meta-analysis. Journal of Dermatological Treatment.
PureTek Corporation. (2023). Hydroxym- hydrocortisone gel [package insert]. DailyMed.
SOLA Pharmaceuticals. (2022). Hydrocortisone cream 1%- hydrocortisone cream 1% cream. DailyMed.
Taro Pharmaceuticals U.S.A., Inc. (2021). Hydrocortisone butyrate- hydrocortisone butyrate solution. Hydrocortisone butyrate- hydrocortisone butyrate cream. Hydrocortisone butyrate- hydrocortisone butyrate ointment. DailyMed.
Taro Pharmaceuticals U.S.A., Inc. (2023). Hydrocortisone valerate cream. Hydrocortisone valerate ointment [package insert]. DailyMed.
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