Hydrocortisone Cream: Uses, side-effects and who should avoid

Hydrocortisone is suitable for most adults and children over 10 years old. If you have a flare of eczema, the first step is usually to try a medical-grade moisturiser, aka emollients. If you have tried moisturising and seen no improvement, another option could be to try a steroid cream such as hydrocortisone. The cream aims to help inflammatory skin conditions by reducing inflammation and irritation for a short period of time. They are particularly useful at controlling short-term flares of skin and breaking the itch-scratch cycle. Steroid creams for nappy rash and other skin problems in children under 10 years old are only available on prescription.

Often, hydrocortisone is mixed with many other ingredients such as treatments for bacteria or fungi. This is used to treat skin problems caused by certain infections. Antifungal combination creams like Daktacort can be found behind the counter, however, antibacterial creams are through a prescription from your doctor only.

Hydrocortisone is a steroid (corticosteroid) and reduces the body's response to inflammatory reactions. By applying it directly to inflamed skin, the aim is to reduce inflammation in that area using the least amount of steroid possible.

Side effects of hydrocortisone cream

While hydrocortisone cream is generally safe for short-term use, prolonged or excessive use may lead to adverse effects. Long-term use of hydrocortisone cream can cause thinning of the skin, making it more susceptible to injury, bruising, and tearing. Prolonged application of hydrocortisone cream may lead to changes in skin pigmentation, resulting in lighter or darker areas of skin. Corticosteroids can impair the skin's ability to heal properly, prolonging the recovery time for wounds, cuts, or abrasions. Some individuals may experience increased sensitivity or allergic reactions to hydrocortisone cream, resulting in itching, redness, or irritation.

Like all medications, don’t take them if you have previously had an allergic reaction to the medication, or if you have other medications or medical conditions where you would normally discuss with your doctor or pharmacist before starting something new.

Hydrocortisone cream available over the counter should normally be used for a maximum of 7 days in a row and should not be used on any children under the age of 10 (unless recommended by your doctor). It cannot be used on any open skin and on any sensitive areas of the body, such as the face. Some people complain of a burning sensation when first applied, however, this sensation tends to disappear after a few days of applying.

When to See Your Doctor

While hydrocortisone cream is generally safe for short-term use, it is essential to consult your healthcare provider if:

• your symptoms do not improve or worsen after using hydrocortisone cream as directed
• you experience severe or prolonged side effects, such as skin thinning, skin discolouration, or delayed wound healing
• you have underlying medical conditions or are taking medications that may interact with hydrocortisone cream
• you are pregnant, breastfeeding, or planning to use hydrocortisone cream on a child, as special precautions may be necessary

Wash and dry your hands, and then squeeze out the required amount of cream. A pea-size amount is recommended for a palm-size surface area. Spread the cream in a thin layer over the area of irritated skin.

Follow these guidelines for proper application of hydrocortisone cream:

1. Wash the affected area with mild soap and water, and pat it dry gently with a clean towel. Ensure that the skin is clean and free from any dirt or debris before applying the cream.

2. Squeeze a small amount of hydrocortisone cream onto your fingertip and apply a thin layer to the affected area. Avoid using excessive amounts of cream, as this can increase the risk of side effects.

3. Gently massage the cream into the skin using circular motions until it is fully absorbed. Take care not to rub the skin vigorously, especially if it is inflamed or sensitive.

4. Wash your hands thoroughly after applying hydrocortisone cream to prevent inadvertently transferring the medication to other areas of the body or mucous membranes.

5. Follow the instructions provided by your professional or the product label regarding the frequency of application.

6. If your symptoms persist or worsen despite using hydrocortisone cream, or if you experience any adverse reactions, discontinue use and consult your healthcare provider for further evaluation and management.

Be careful not to get the cream into broken skin or cuts. Wash your hands afterwards (unless you are treating the skin on your hands). Make sure, if treating eczema, that you are moisturising up to 4 times a day to maximise the effect of the cream and also to ensure the irritation isn’t being caused by dry skin.