Hydrocortisone Cream

Hydrocortisone 1% is the mildest topical steroid, and the fear that surrounds steroid creams causes more problems than the creams themselves. Used properly, for the right length of time, it settles inflamed skin quickly. Used too sparingly and stopped too soon, it does not work and the eczema stays inflamed.

What it is used for

Mild to moderate eczema and dermatitis, irritant and allergic contact dermatitis, insect bite reactions, and mild inflammatory itchy rashes.

It treats the inflammation. It does not replace an emollient — in eczema the moisturiser is the ongoing treatment and the steroid handles flares.

It is not for infected skin, acne, rosacea, fungal infections such as athlete’s foot or ringworm, or cold sores. Used on those it can make things considerably worse.

How to use it

Apply a thin layer once or twice a day to the affected skin only. The fingertip unit is a useful measure: the amount squeezed from the tip of an adult index finger to the first crease covers an area about the size of two adult palms.

Keep going until the skin is smooth and the itch has settled — usually a few days beyond the point where it starts to look better — rather than stopping the moment it improves. Pharmacy hydrocortisone should not be used for more than seven days without advice.

If you also use an emollient, leave around 20 to 30 minutes between them so one does not dilute the other.

Where not to use it

• The face, unless a doctor has told you to — facial skin is thin and absorbs more
• The eyes or eyelids
• The genitals or anal area, without advice
• Broken, weeping or infected skin
• Children under 10, without advice
• In pregnancy, without checking first

Thinning of the skin is the effect people worry about. It comes from prolonged use of stronger steroids over long periods, particularly on thin skin — not from a week of hydrocortisone 1% on a patch of eczema.

When to get further advice

Come and see us, or your GP, if there is no improvement after a week, if the rash keeps returning as soon as you stop, if it is spreading, or if it becomes weepy, crusted golden-yellow or painful — which suggests infection and needs different treatment.

Frequently asked questions