Most hydrocortisone skin treatments are mild and are available to buy from pharmacies. They come as cream, ointment or lotion. Creams for nappy rash and other skin problems in children under 10 years old are only available on prescription.
Hydrocortisone is a type of medicine known as a steroid (corticosteroid). Steroids are not the same as anabolic steroids. The strength of the products range from 0.1% (1mg of hydrocortisone in each gram) to 2.5% (25mg of hydrocortisone in each gram). Pharmacies sell hydrocortisone skin cream up to a maximum 1% strength.
There is a stronger hydrocortisone cream called hydrocortisone butyrate. This is only available with a prescription. Sometimes hydrocortisone is mixed with antimicrobials (chemicals that kill germs). This is used to treat skin problems caused by bacterial or fungal infections.
Other types of hydrocortisone
There are other ways of taking or using hydrocortisone, including tablets and injections. Find out more about other ways you can use hydrocortisone to treat different health problems.
Who can and cannot use hydrocortisone skin treatments
Most adults and children aged 10 years and over can use hydrocortisone skin treatments. Do not use hydrocortisone skin treatments on children under 10 years old unless their doctor recommends it. Hydrocortisone is not suitable for some people. Tell your pharmacist or doctor before starting the medicine if you:
- have ever had an allergic reaction to hydrocortisone or any other medicine
- have a skin infection or eye infection
- are trying to get pregnant, are already pregnant or you're breastfeeding
How and when to use hydrocortisone skin treatments
When using hydrocortisone on your skin, follow the instructions from your pharmacist, doctor or the leaflet that comes with your treatment. Hydrocortisone is available as a cream, ointment and lotion.
Hydrocortisone cream and ointment
Creams are better for skin that is moist and weepy. Ointments are thicker and greasier, and are better for dry or flaky areas of skin. Most people need to use hydrocortisone cream or ointment once or twice a day. If you use it twice a day, try to leave a gap of 8 to 12 hours before putting on any more.
Skin creams can dry onto your clothes and bedding. This makes them more likely to catch fire. Avoid naked flames.
The amount of cream or ointment you need to use is sometimes measured in fingertip units. This is the amount of you can squeeze onto the end of your finger. A fingertip unit is generally enough to treat both sides of your hand. For babies and children, the right amount depends on their age. Your doctor or pharmacist can advise you.
How to use hydrocortisone skin lotion
Lotion is better for treating large or hairier areas of skin. You will usually use hydrocortisone skin lotion once or twice a day. Use a small amount of lotion on the affected areas of skin.
- Wash and dry your hands.
- Spread the lotion in a thin layer over the area of irritated skin.
- Carefully smooth it into your skin in the direction that your hair grows.
- Use the lotion on all the irritated skin, not just the worst areas.
- Be careful not to get the lotion on broken skin or cuts.
- Wash your hands afterwards (unless you are treating the skin on your hands).
Using hydrocortisone with other skin creams
Do not apply hydrocortisone at the same time as other creams or ointments such as a moisturiser. Wait at least 10 minutes between using hydrocortisone and any other product. Try to use different skin products at different times of the day.
If you're using a dressing like a bandage or plaster, wait at least 10 minutes after putting hydrocortisone on.
How long to use it for
Most people only need to use hydrocortisone skin treatments for a short time. Stop as soon as your skin is better. Sometimes you only need to use the skin treatments for a few days.
For insect bites and stings, nappy rash or contact dermatitis you'll probably only need to use a skin cream for up to 1 week. For long-term skin conditions such as eczema and psoriasis you may need to use treatments for longer. If you buy hydrocortisone from a pharmacy or shop, do not use it for more than 1 week without talking to your doctor.
What if I forget to put it on?
If you forget to use a hydrocortisone skin treatment, do not worry. Just use it as soon as you remember, unless it's within a few hours of your next dose. In this case, skip the missed dose and go back to your usual routine.
Mild hydrocortisone treatments are very safe. Most people do not have any side effects when they use them for less than 4 weeks. Some people get a burning or stinging feeling for a few minutes when they put the hydrocortisone on their skin. This stops happening after you've been using it for a few days.
Serious side effects
You're more likely to have a serious side effect if you use a strong hydrocortisone treatment (such as hydrocortisone butyrate) or if you use hydrocortisone on a large patch of skin for a long time. Using hydrocortisone for many months at a time can make your skin thinner or cause stretchmarks. Stretchmarks are likely to be permanent, but they usually fade over time. Stop using hydrocortisone and tell a doctor straight away if:
- your skin becomes redder or swollen, or yellow fluid is weeping from your skin these are signs of a new skin infection or an existing one getting worse
- you have a very upset stomach or you're being sick (vomiting), have very bad dizziness or fainting, muscle weakness, feel very tired, have mood changes, loss of appetite and weight loss these can be signs of adrenal gland problems
- you feel confused, sleepy, more thirsty or hungry than usual, pee more often, have hot flushes, start breathing quickly or your breath smells of fruit these can be signs of diabetes or complications of diabetes
- you are depressed (including having suicidal thoughts), feeling high, having mood swings, feeling anxious, seeing or hearing things that are not there, or having strange or frightening thoughts these can be signs of mental health problems
- you get a moon face (puffy, rounded face), weight gain in your upper back or belly this happens gradually and can be a sign of Cushing's syndrome
- you have any muscle pain or weakness, muscle cramps, or your heartbeats suddenly become more noticeable these can be signs of low potassium levels
- you get severe stomach pain, severe back pain, or a severe upset stomach or vomiting these can be signs of pancreas problems
Children and teenagers
In rare cases, using hydrocortisone for a long time can slow down the normal growth of children and teenagers. Your child's doctor will monitor their height and weight carefully for as long as they're using hydrocortisone. This will help them spot any slowing down of your child's growth and change their treatment if needed. Even if your child's growth slows down, it does not seem to have much effect on their overall adult height. Talk to your doctor if you're worried about the risks of your child using hydrocortisone.
Serious allergic reaction
It's extremely rare to have an allergic reaction (anaphylaxis) to hydrocortisone, but if this happens to you get medical help straight away.
Pregnancy and breastfeeding
Hydrocortisone creams that you buy from a pharmacy can be used in pregnancy or while you're breastfeeding. As a precaution, if you're breastfeeding, wash off any cream you put on your breasts before feeding your baby. Hydrocortisone butyrate is not normally recommended for pregnant or breastfeeding women. Only use this treatment if a skin specialist (dermatologist) prescribes it and supervises your treatment. Your doctor will only prescribe hydrocortisone butyrate for you while you're pregnant or breastfeeding if the benefits of the medicine outweigh the risks.
Cautions with other medicines
It's very unlikely that other medicines either prescribed or ones you buy from a pharmacy or shop will affect the way hydrocortisone works.
Tell your doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins or supplements.
Common Facts about hydrocortisone skin treatments
- Hydrocortisone is a steroid (also called a corticosteroid). Steroids help to reduce swelling (inflammation) in the skin (and other parts of the body).
- Skin gets inflamed when an allergic reaction or irritation causes chemicals to be released in the skin. These make blood vessels widen and the irritated skin becomes red, swollen, itchy and painful.
- Hydrocortisone skin treatments work on your skin's cells to stop these chemicals being released. This reduces symptoms like swelling, redness and itching.
- Your skin should start to get better after using hydrocortisone for a few days. If you're using a treatment you've bought from a pharmacy or shop, speak to your doctor if you still have symptoms after 1 week, or if your skin gets worse at any time.
- How long you use it for depends on why you're using it? For insect bites and stings, nappy rash or contact dermatitis you'll probably only need to use hydrocortisone for up to 1 week. For long-term skin problems such as eczema and psoriasis you may need to use hydrocortisone for longer.
- To reduce the risk of side effects your doctor may recommend that you only use hydrocortisone for a few weeks at a time. Once your skin is better, use moisturisers to keep it from becoming inflamed again.
- Do not use a hydrocortisone on your face unless a doctor has told you to and given you a prescription for it. The skin on your face is delicate, so if hydrocortisone damages it, it's particularly noticeable.
- Some common skin problems that affect the face, such as impetigo, rosacea and acne, can be made worse by hydrocortisone. If your doctor has prescribed hydrocortisone for your face, follow their instructions carefully.
- Do not put hydrocortisone near your eyes or on your eyelids.
- Using hydrocortisone for a long time without stopping can mean some of the medicine gets into your blood. If this happens, there's a very small chance it can cause serious side effects, such as adrenal gland problems, high blood sugar (hyperglycaemia), or problems with your eyesight.
- If you have been using hydrocortisone for a long time, your doctor may tell you to gradually reduce the amount you use before stopping completely.
- Yes, you can drink alcohol while using hydrocortisone.
- No, you can eat and drink normally while using hydrocortisone.
- Using hydrocortisone cream does not stop you or your child having vaccinations. But tell the doctor or nurse that you're using hydrocortisone cream so they can give the vaccine in an untreated area of skin.
- There's no clear evidence that hydrocortisone skin treatments affect male or female fertility.
- Hydrocortisone for skin does not affect any types of contraception, including the combined pill or the emergency contraception.
- Hydrocortisone does not make you sleepy, so it's safe to drive, ride a bike, or use tools and machinery when using this medicine.