Hydrocortisone for mild inflammatory skin conditions

About hydrocortisone

Hydrocortisone is classed as a mild topical corticosteroid. Topical corticosteroids are also referred to as topical steroids. Topical steroids are used in addition to moisturisers (emollients) for treating inflammatory skin conditions such as eczema and dermatitis. A topical steroid can be used to relieve the symptoms when patches of eczema or dermatitis flare up. Hydrocortisone is also useful in reducing inflammation due to insect bites and stings. A doctor may also prescribe hydrocortisone to treat nappy rash in a baby or infant.

Hydrocortisone is available on prescription. It can also be bought without a prescription for the treatment of mild inflammatory conditions such as allergic contact dermatitis and insect stings in adults and older children. Hydrocortisone is also an ingredient in a number of preparations which contain an antibacterial or antifungal agent. These preparations are for use when there is a skin infection also present, such as in athlete's foot.

Do not confuse hydrocortisone creams and ointments with a much more potent topical steroid preparation which contains an ingredient called 'hydrocortisone butyrate'. Hydrocortisone butyrate is a potent topical steroid prescribed for severe skin conditions.

Before using hydrocortisone

To make sure this is the right treatment for you, before you start using hydrocortisone it is important that your doctor or pharmacist knows:

• If you have any areas of infected skin.

• If you have rosacea or acne.

• If it is for a child under 10 years of age. This is because hydrocortisone should only be used in children on the recommendation of a doctor.

• If you are pregnant or breastfeeding. This is because, while you are expecting or feeding a baby, you should only use medicines on the recommendation of a doctor.

• If you have ever had an allergic reaction to a skin preparation.

How to use hydrocortisone

• Before you start using the preparation, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about topical steroids and will provide you with a full list of the side-effects that you may experience from using them.

• Apply a small amount to the areas of skin which are inflamed. Then gently rub it into the skin until it has disappeared. Do not use it on areas of broken skin or on open sores. Unless you have been supplied with a preparation which also contains an anti-infective agent (such as miconazole or clotrimazole), do not use it on any areas of infected skin.

• Apply the cream/ointment once or twice a day. It must not be applied more often than twice a day, and once a day is often sufficient.

• If you are using more than one topical corticosteroid, make sure you know when and where to use each one. If you are unsure, check with your doctor or ask your pharmacist for further advice.

• After you have applied hydrocortisone, remember to wash your hands (unless your hands are the treated area).

• Children are susceptible to side-effects from topical steroids. The main concern is for children who need frequent courses, as it can have an effect on their growth and this may need to be monitored. If your child has been prescribed hydrocortisone, follow the directions you have been given very carefully, and do not use it for longer than you have been told to. As a general rule, it should not be used for more than one week in children. It is not suitable for children under 10 years of age unless it has been prescribed by a doctor.

Getting the most from your treatment

• If you are using a moisturiser along with hydrocortisone, apply the moisturiser first. Then wait 10-15 minutes before applying hydrocortisone. This allows time for the moisturiser to be absorbed before the topical corticosteroid is applied. If hydrocortisone has been prescribed for nappy rash and you are also using a barrier cream, apply the hydrocortisone first and the barrier cream afterwards.

• Do not use the cream/ointment on your face unless it has been prescribed by a doctor for this reason. If so, be careful not to get any near your eyes and do not use it for a longer period of time than you have been advised.

• Unless advised to do so by your doctor, do not apply a bandage or dressing to the area being treated, as this will increase absorption of the steroid through your skin and increase the risk of side-effects.

• Your doctor or pharmacist will tell you how long to use the preparation for. If you have bought the hydrocortisone from a retail outlet, you must not use it for more than one week. If your symptoms have not improved after this time (or if they get worse), you should speak with a doctor for advice. Hydrocortisone should not be used for long periods of time or on large areas of the body, especially in children.

• If you have eczema or dermatitis, continue to use a moisturiser every day after you finish using hydrocortisone. This will help to prevent a further flare-up.

Can hydrocortisone cause problems?

Short courses (of less than four weeks) of hydrocortisone are usually safe and do not cause any problems. If used for long periods, topical steroids can thin your skin, or you may develop permanent stretchmarks, allergic contact dermatitis, acne, rosacea, and hair growth at the site of application. Although such side-effects from a mild topical steroid like hydrocortisone occur only rarely, you can reduce the risk further by applying the preparation thinly, no more than twice a day, and to the affected areas only.

There is a risk of fire when creams and ointments are absorbed by fabrics (such as clothing or bedsheets), making them flammable. A spark or flame can easily ignite the fabric. The risk is highest when large amounts of paraffin-based products are applied and absorb into fabrics. However there is also a risk when non-paraffin products are used. Be aware of this fire hazard when repeatedly using large amounts of any skin product. Do not smoke or go near naked flames. When used as directed by your doctor or pharmacist, steroid creams will be applied in small quantities on small areas of skin. There should be minimal absorption into fabrics and a lower risk of fire.

How to store hydrocortisone

• Keep all medicines out of the reach and sight of children.

• Store in a cool, dry place, away from direct heat and light.

Important information about all medicines