Hydrocortisone Cream (Cortef)

What is Hydrocortisone cream?

Hydrocortisone cream is a topical corticosteroid used in the treatment of eczema and other inflammatory skin conditions. It is applied to affected areas of skin, and works by reducing inflammation, which also reduces symptoms such as itching and redness.

What is Hydrocortisone used for?

Topical Hydrocortisone has various uses, including eczema, allergies, insect bites, poison oak and others. Hydrocortisone is also available in other non-topical forms, such as oral tablets and intravenous solution, to treat systemic conditions.

How Hydrocortisone cream works

Hydrocortisone is a corticosteroid; it helps to reduce inflammation associated with eczema. Specifically, it causes the blood vessels near the skin's surface to constrict, reducing the itch and redness associated with eczema.

Hydrocortisone and eczema

Hydrocortisone cream is one of the first-line treatments for eczema. It is a comparatively low-strength eczema medication but is still very effective. Your doctor will always start by prescribing the least potent medication that can treat you effectively. This reduces the chance of side effects while still treating your condition. Hydrocortisone cream may not always be effective, and sometimes your doctor may need to prescribe something stronger.  If you don't see any improvement after 4-7 days of treatment, you should let your doctor know that you may need an alternative. 

Active ingredient

The active ingredient in Hydrocortisone cream is Hydrocortisone. Hydrocortisone is a corticosteroid that works by reducing the inflammation associated with eczema.

Inactive ingredients

The inactive ingredients in Hydrocortisone cream can vary between different manufacturers. 2.5% Hydrocortisone cream manufactured by Lannett contains the following inactive ingredients: ethyl alcohol, isopropyl palmitate, methylparaben, mineral oil, lanolin alcohol, polysorbate 40, propylene glycol, propylene glycol stearate, propylparaben, water, sorbic acid, sorbitan monopalmitate, stearyl alcohol, xanthan gum. 

Which ingredients can cause an allergic reaction?

The active and inactive ingredients of hydrocortisone cream are not common allergens known to cause a severe allergic reaction. Hydrocortisone cream does contain alcohol which can cause burning or irritation to the area it is used on during the first few days of use. This should disappear after a few days of use. 

Using Hydrocortisone to treat eczema

Use Hydrocortisone cream as recommended by your doctor. Usually, Hydrocortisone cream is applied twice daily. When you're ready to apply the cream, follow the instructions below:

1. Wash your hands and ensure the affected area is also clean. 
2. Squeeze a small amount of cream out of the tube onto your fingertip, from the tip of your finger to the first crease. This is called a fingertip unit. One fingertip unit will cover an area of skin the size of both of your palms. 
3. Apply the cream to the affected area and gently rub it in until it has been absorbed. This may take a little time. 
4. Once you have finished applying the cream, wash your hands, unless your hands are the area that you have applied the cream to. 

What to do when Hydrocortisone doesn't work

Hydrocortisone is one of the weaker corticosteroid creams. To help you avoid side effects, your doctor will always try to prescribe the least potent medication that can treat your condition. Therefore, if you find that Hydrocortisone does not improve your skin condition within a week, you may need stronger treatment. You should let the prescribing doctor know, as they can find you a more suitable alternative. 

Can Hydrocortisone be used on the scalp?

Hydrocortisone cream can be thick and is not ideal for scalp application. However, it is also available in lotion forms, which can be applied more easily to the scalp if required. You should only apply Hydrocortisone to your scalp if instructed to do so by a doctor. 

Can Hydrocortisone be used on the face?

Hydrocortisone should only be applied to the face if you are instructed to do so by your doctor. This is because Hydrocortisone can worsen conditions that affect the face, such as acne and rosacea. 

Can Hydrocortisone be used on lips?

If you have eczema on your lips, your doctor may recommend that you use a small amount of Hydrocortisone on your lips. However, you should not use Hydrocortisone on your lips prior to being evaluated by a doctor.  Some conditions affecting the lips, such as cold sores and angular cheilitis, can look like eczema, but could worsen if treated with hydrocortisone. Additionally, it is generally recommended that you avoid applying Hydrocortisone to your face, as it can exacerbate skin conditions such as acne and rosacea. 

Can Hydrocortisone help acne?

Topical hydrocortisone is not recommended for the treatment of acne, and in some cases can cause acne to worsen. 

Can Hydrocortisone be used for yeast infections?

Hydrocortisone should not be applied to infected areas, including areas affected by a yeast infection. Hydrocortisone is a corticosteroid, and can reduce your immune system's ability to fight off the fungus which causes a yeast infection. 

Hydrocortisone cream side effects

Common side effects of topical Hydrocortisone include:

• Skin reactions 
• Spider veins (telangiectasia)

Rare side effects include:

• Excessive hair growth (hypertrichosis)
• Skin depigmentation
• Reduced function of your adrenal gland (adrenal suppression)

Other possible side effects include:

• Allergic reaction

If you experience a serious allergic reaction (anaphylaxis), you need to seek emergency medical attention. Symptoms of anaphylaxis include: 

• Difficulty breathing
• Lightheadedness or fainting
• Wheezing
• Fast heartbeat
• Clammy skin
• Collapsing or Loss of consciousness
   

Contraindications

Hydrocortisone cream should be avoided if you have any of the following conditions:

• Perioral dermatitis
• Rosacea
• Untreated bacterial, fungal or viral skin lesions

You should always let the doctor know about any other health conditions you have to ensure that the most appropriate treatment is prescribed.

Drug interactions

Other medications containing corticosteroids and immunosuppressive medications, such as Cyclosporin, may interact with Hydrocortisone. Therefore, it is important to let the prescribing doctor know of any medications or other treatments that you are taking. 

Hydrocortisone and pregnancy

There is insufficient evidence to show that using Hydrocortisone when pregnant is safe. While the mother and fetus's risk is considered to be small, Hydrocortisone should generally be avoided by pregnant women. A doctor may still prescribe Hydrocortisone to a pregnant patient if they feel the benefits outweigh the risks.

Hydrocortisone when breastfeeding

It is not known if Hydrocortisone cream can lead to the presence of Hydrocortisone in breast milk. Therefore, a doctor will only prescribe Hydrocortisone cream to breastfeeding women if the benefits outweigh the risks. 

Can Hydrocortisone cause acne?

Hydrocortisone can cause worsening of acne in some people. For this reason, it is best to avoid applying Hydrocortisone to the face. 

Which Hydrocortisone cream is most effective?

Hydrocortisone cream comes in a range of different strengths (potencies). The most potent medication is not necessarily the best one for you, as stronger medication can also produce more substantial side effects. Therefore, your doctor will try to prescribe the weakest medication that will treat your condition. 

Hydrocortisone vs antihistamines

Antihistamines work by blocking the effects of histamine - a chemical involved in allergic reactions. Hydrocortisone is a corticosteroid that works by reducing inflammation. Hydrocortisone cream can be used with antihistamines to treat allergy symptoms, such as itching and rashes. Hydrocortisone cream may be a more appropriate first treatment option as some oral antihistamines can cause drowsiness and affect your ability to work or drive. 

Hydrocortisone vs calamine lotion

Calamine lotion is a soothing over-the-counter medication used to treat mild itchiness and contact dermatitis (a type of allergic eczema). Hydrocortisone is available over the counter, although higher strengths may only be available by prescription.  If calamine lotion does not have the desired effect, Hydrocortisone cream may be a good alternative for you. 

Hydrocortisone vs Triamcinolone

Both Hydrocortisone and Triamcinolone are corticosteroids and work by a similar mechanism. Triamcinolone is generally the more potent of the two medications, but that does not necessarily mean that it is a better treatment. This is because stronger medications can produce greater side effects. Therefore, your doctor will try to prescribe the least potent medication that will treat your condition effectively.