1. About hydrocortisone skin creams
Hydrocortisone creams, ointments and lotions contain a type of medicine known as a corticosteroid or 'steroid'. Corticosteroids are not the same as anabolic steroids.
Hydrocortisone creams are used on the skin to treat swelling, itching and irritation. They can help with skin problems such as:
Most hydrocortisone skin products are mild. You can buy them from pharmacies to use for certain health problems.
There is a stronger hydrocortisone cream called hydrocortisone butyrate. This is only available on prescription.
Sometimes hydrocortisone is mixed with antimicrobials (chemicals which kill germs) to treat skin problems caused by bacterial or fungal infections.
Other types of hydrocortisone
There are other types of hydrocortisone, including tablets, injections and foam.
2. Key facts
- Do not use hydrocortisone skin creams in children under 10 years old unless their doctor recommends it.
- Never put hydrocortisone skin creams on your face unless your doctor says it's ok and has given you a prescription for it. It can make some skin problems of the face worse - such as impetigo, rosacea and acne.
- Creams you can buy are not supposed to be used on the eyes, around the bottom or genitals, or on broken or infected skin.
- If you buy hydrocortisone cream from a pharmacy or shop, don't use it for longer than a week.
- Most hydrocortisone creams are mild and you can buy them from pharmacies and shops. They're called by brand names such as Dermacort, Dioderm, Boots Bite and Sting Relief Hydrocortisone, Derma Care Hydrocortisone, Hc45, Zenoxone, Pinewood Bites and Stings Relief 1% cream, Lanocort and Mildison Lipocream 1% cream.
- Hydrocortisone butyrate cream, ointment or lotion is stronger and is only available on prescription. It may be called by the brand name Locoid.
3. Who can and can't use hydrocortisone skin creams
Most adults and children can use hydrocortisone skin creams.
However, don't use hydrocortisone skin products on children under 10 years old unless their doctor recommends it.
Hydrocortisone skin cream isn't suitable for some people. Tell your pharmacist or doctor before starting the medicine if you:
- have had an allergic reaction to hydrocortisone or any other medicine in the past
- have a skin infection (including eye infections)
- are trying to get pregnant, are already pregnant or you're breastfeeding
4. How and when to use them
Hydrocortisone skin creams come in different strengths that vary from 0.1% (1mg hydrocortisone in each gram of cream) to 2.5% (25mg hydrocortisone in each gram of cream).
Where to get it - GP or pharmacy?
You can only buy hydrocortisone cream up to a maximum 1% strength from a pharmacy. Cream from a pharmacy should only be used for:
- contact dermatitis from allergies or chemicals
- reactions to insect bites and stings
- prickly heat
Stronger creams are only available on prescription for long-term skin problems such as:
Creams for nappy rash and other skin problems in children under 10 years old are only available on prescription.
When you start to use hydrocortisone cream, follow the instructions from your pharmacist, doctor or the patient information leaflet in the medicine packet. They will tell you how much to use and how often.
Most people only need to use hydrocortisone cream once or twice a day for a week or two. If you use it twice a day, try to leave a gap of 8 to 12 hours between times.
Cream, ointment or lotion?
There are different types of hydrocortisone skin products. Creams are most common, but there are also hydrocortisone ointments and lotions.
As a general rule:
- hydrocortisone cream is better for skin which is moist and weepy with clear or yellow fluid
- hydrocortisone ointment is thicker and greasier - it's better for dry or flaky areas of skin
- hydrocortisone lotion is a liquid - it's good for treating the scalp and large or hairy areas of skin
How much to put on
Sometimes, the amount of cream you're told to use is measured in fingertip units. This is the amount of cream you can squeeze onto your fingertip.
As a general rule, a fingertip unit of cream should be enough to treat an area of skin that's double the size of the flat of your hand.
For babies and children, the right amount of cream depends on their age. Your doctor or pharmacist can advise you.
How to put it on
- Spread the cream in a thin layer over the area of irritated skin.
- Carefully smooth it into your skin in the direction the hair grows until it disappears.
- Be careful not to get the cream into broken skin or cuts.
- Wash your hands afterwards (unless it's your hands that you're treating).
- Use the cream on all the irritated skin, not just the worst areas.
How long to use it for
Using it with other skin creams
Don't put on hydrocortisone at the same time as other creams or ointments such as your, or your child's, usual moisturiser. Wait at least 10 minutes between using hydrocortisone and any other product. Ideally, 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. This helps to prevent side effects.
What if I forget to put it on?
If you forget to use your cream, don't worry, just do it as soon as you remember. If you don't remember until it's within a few hours of your next dose, skip the missed dose and go back to your normal routine.
5. Side effects
Mild hydrocortisone creams are very safe. Most people don't 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 cream on their skin. This stops happening after you've been using the cream for a few days.
Serious side effects
You're more likely to have a serious side effect if you use a strong hydrocortisone cream (such as hydrocortisone butyrate) or if you use hydrocortisone cream over a large patch of skin for a long time.
Side effects to the skin
If you have a skin infection, using a hydrocortisone cream can make it worse and cause it to spread.
Using hydrocortisone cream for many months at a time can cause your skin to thin or give you stretch marks. Stretch marks are likely to be permanent, but they usually fade over time.
Stop using the cream and tell your doctor straight away if your skin:
- becomes redder
- has white patches
- weeps yellow fluid
These can be signs of a new or worsening skin infection.
Side effects in the rest of the body
Very rarely, hydrocortisone from a skin cream gets through the skin into the bloodstream to cause side effects in other parts of your body.
Stop using the cream and tell your doctor straight away if you get:
- a very upset stomach or vomiting, very bad dizziness or fainting, muscle weakness, feeling very tired, mood changes, loss of appetite and weight loss - these can be signs of adrenal gland problems
- confused, sleepy, more thirsty, more hungry, peeing more often, flushing, breathing quickly or having breath that smells like fruit - these can be signs of high blood sugar
Children and teenagers
In rare cases, using hydrocortisone skin cream for a long time can slow down the normal growth of children and teenagers.
Your child's doctor will watch their growth carefully while they're using hydrocortisone cream. That way the doctor can pick up any slowing of growth quickly and change your child's treatment if necessary.
Talk to your doctor about the risks of your child using hydrocortisone cream if you're concerned.
Serious allergic reaction
It's extremely rare to have an allergic reaction (anaphylaxis) to hydrocortisone skin products but if this happens to you, contact a doctor straight away.
Immediate action required: Call 999 or go to A&E if:
- you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
- you're wheezing
- you get tightness in the chest or throat
- you have trouble breathing or talking
- your mouth, face, lips, tongue or throat start swelling
You could be having a serious allergic reaction and may need immediate treatment in hospital.
These are not all the side effects of hydrocortisone skin creams. For a full list see the leaflet inside your medicine packet.
You can report any suspected side effect to the UK safety scheme.
6. Pregnancy and breastfeeding
Mild hydrocortisone creams that you buy from a pharmacy are safe to use during pregnancy or 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 dermatologist (skin specialist) prescribes it and supervises your treatment.
Tell your pharmacist or doctor if you're trying to get pregnant, are already pregnant or if you're breastfeeding.
7. Cautions with other medicines
It's very unlikely that other medicines - either prescribed or ones you buy from a pharmacy or shop - will interfere with the way hydrocortisone skin products work.
For safety, tell your doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins or supplements.
8. Common questions
How do hydrocortisone skin creams work?
Hydrocortisone creams contain the active ingredient hydrocortisone which is a corticosteroid or 'steroid'. Hydrocortisone reduces inflammation in the skin.
The skin gets inflamed when an allergic reaction or irritation causes various chemicals to be released in the skin. These make blood vessels widen and the irritated skin becomes red, swollen, itchy and painful.
Hydrocortisone acts inside the skin cells to stop the release of these chemicals. This reduces the swelling, redness and itching.
When will my skin get better?
Your skin should start to get better after you've used the cream for a few days.
How long should I use hydrocortisone cream for?
That depends on why you're using it.
To lessen the risk of side effects your doctor may recommend that you only use hydrocortisone creams for a few weeks at a time. Once your skin is better, use moisturisers to keep it from becoming inflamed again.
Why can't I use it on my face?
Don't use a hydrocortisone skin cream on your face unless a doctor says you should and has given you a prescription for it.
The skin on your face is delicate so if hydrocorticosone cream damages it, it's particularly noticeable.
Is it safe to use for a long time?
As a general rule, once your skin has settled down your doctor will recommend that you stop using this medicine.
Using hydrocortisone skin cream continuously for a long time can mean some of the medicine gets into your bloodstream. If this happens, there's a very small chance it can cause serious side effects.
Can I drink alcohol with it?
Yes, you can drink alcohol while using hydrocortisone skin cream.
Is there any food or drink I need to avoid?
No, you can eat and drink normally while using hydrocortisone skin cream.
Can I still have vaccinations?
Using hydrocortisone cream doesn't stop you or your child having vaccinations.
But tell the healthcare professional that you're using hydrocortisone cream so they can give the vaccine in an untreated area of your skin.
Will it affect my fertility?
Hydrocortisone creams have no effect on the fertility of men or women.