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Topical hydrocortisone is used to treat inflammation, irritation, and itchiness caused by various skin conditions. Topical hydrocortisone works by calming down the body’s immune response and reducing inflammation and swelling. Common side effects include skin reactions, such as burning, itching, irritation, and dryness. Topical hydrocortisone is available by prescription and over-the-counter (OTC) in several forms, including a cream, liquid, lotion, or ointment that is applied to the skin.

Uses

What is topical hydrocortisone used for?

Topical hydrocortisone is commonly used to treat swelling (inflammation), redness, and itchiness caused by various skin conditions, including atopic dermatitis (sometimes called eczema) and seborrheic dermatitis.

Some topical hydrocortisone products are available over-the-counter (OTC). These products are commonly used to temporarily relieve itching due to minor skin irritations, inflammation, and rashes caused by various conditions, including feminine itching.

Topical hydrocortisone may also be used for other conditions as determined by your health care provider.

How does topical hydrocortisone work (mechanism of action)?

Hydrocortisone belongs to a group of medicines called corticosteroids. Topical corticosteroids may help reduce inflammation in your skin by calming down the immune system’s defense cells (white blood cells). They may also stop these cells from releasing substances that cause inflammation. These medicines may also narrow blood vessels where they are applied, which may help to reduce swelling.

How is topical hydrocortisone supplied (dosage forms)?

Brands and other names

  • Ala-Cort
  • Aquanil HC
  • Cortaid
  • Cortizone
  • Locoid
  • Pandel
  • Texacort
  • Westcort

Example dosage forms and strengths

  • 0.1%, 0.2%, 0.5%, 1%, 2.5% topical cream
  • 0.1%, 1%, 2%, 2.5% topical lotion
  • 0.1%, 0.2%, 1%, 2.5% topical ointment
  • 0.1%, 2.5% topical liquid (solution)

How should I store topical hydrocortisone?

Topical hydrocortisone should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). Some products may be able to be stored at slightly higher or lower temperatures, such as down to 59 F (15 C) or up to 86 F (30 C). Store in a cool, dry place. It is best to avoid exposing topical hydrocortisone to extreme temperatures, such as freezing or excessive heat. Check the label of your specific product or ask your pharmacist if you have questions about how to store the topical hydrocortisone product you have.

Side Effects

What are the most common side effects of topical hydrocortisone?

The most common side effects of topical hydrocortisone are skin reactions, such as burning, itching, irritation, dryness, and inflamed hair follicles (see below). Tell your health care provider if you have any of these side effects that bother you.

There may be other side effects of topical hydrocortisone that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of topical hydrocortisone?

While less common, the most serious side effects of topical hydrocortisone are described below, along with what to do if they happen.

Severe Allergic Reactions. Topical hydrocortisone may cause allergic reactions, which can be serious. Stop using topical hydrocortisone and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Skin Reactions. Topical hydrocortisone can cause skin-related side effects, which can rarely be serious. Tell your health care provider if you have any of the following side effects.

  • Inflamed hair follicles or skin swelling or burning
  • Bumps or blisters on the skin that may look like acne
  • Rash around your mouth
  • Lightening of skin color
  • Skin infections at the site of use
  • Skin thinning
  • Skin itching, dryness, or cracking or scaly skin
  • Stretch marks
  • Heat rash or sweat rash caused by blocked sweat glands

Reduced Adrenal Function. Long-term use of topical hydrocortisone can cause your body’s adrenal glands to stop making as much cortisol (the stress hormone). This is known as adrenal insufficiency. This is especially a concern if you use the medicine over large skin areas, wrap or cover the skin after applying it, or use it on damaged skin. Adrenal insufficiency can get worse if your body is under stress because of fever, surgery, or trauma. Tell your health care provider if you have any of the following symptoms of adrenal insufficiency.

  • Nausea and vomiting
  • Weakness, tiredness, or lack of energy
  • Low blood pressure

Cushing’s Syndrome. Rarely, using topical hydrocortisone may increase your risk for Cushing’s syndrome. Cushing’s syndrome is a condition that happens when your body is exposed to too much cortisol (the stress hormone). This is especially a concern if you use the medicine for a long time or over large skin areas, wrap or cover the skin after applying it, or use it on damaged skin. Stop using topical hydrocortisone and call your health care provider if you have any of the following symptoms of Cushing’s syndrome.

  • A rounded, rosy color of the face
  • Weight gain, especially in the upper body
  • Fat buildup in the upper back or base of the neck
  • Thinning skin that bruises easily
  • Feeling very weak or tired
  • Depression or anxiety
  • High blood sugar
  • High blood pressure
  • Sleep problems

High Blood Sugar. Topical hydrocortisone may increase your blood sugar levels, especially if you use it over large skin areas, wrap or cover the skin after applying, or use it on damaged skin. Talk to your health care provider about how to maintain healthy blood sugar levels. Keep all appointments with your health care provider to check your blood work. Call your health care provider if you have the following symptoms of high blood sugar.

  • Feeling thirstier than usual
  • Peeing more than usual
  • Increased hunger
  • Tiredness
  • Feeling sick to your stomach
  • Confusion
  • Fruity-smelling breath

Vision Problems. Rarely, topical hydrocortisone may cause cataracts and glaucoma, which can lead to blindness. Tell your health care provider right away if you have any of the following symptoms.

  • Cloudy or foggy vision
  • Nearsightedness
  • Changes in how you see colors
  • Problems with glare (such as traffic lights when driving at night)
  • Loss of vision
  • Eye pain or redness
  • Severe headache or vomiting
  • Seeing bright, colorful circles around lights (vision halos)

Warnings & Precautions

Who should not use topical hydrocortisone?

Allergies to Ingredients. People who are allergic to any of the following should not use topical hydrocortisone.

  • Alacort
  • Ala-Scalp
  • Hydrocortisone
  • Hydroxym
  • Locoid
  • Pandel
  • Texacort
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific topical hydrocortisone products they stock.

What should I know about topical hydrocortisone before using it?

If topical hydrocortisone was prescribed to you by a health care provider, use it as prescribed. If you are using over-the-counter (OTC) topical hydrocortisone, follow the instructions that come with the product. 

Do not share topical hydrocortisone that was prescribed to you by a health care provider with other people, even if they have the same condition as you. It may harm them.

Keep topical hydrocortisone out of the reach of children.

Topical hydrocortisone is for use on the skin only. Keep the medicine away from your eyes or the inside of your mouth or vagina.

There are multiple forms of topical hydrocortisone available. Read and follow the instructions for the product you have and make sure you understand how to use it properly. Some topical hydrocortisone products should not be used on your face, groin, or armpits, unless your health care provider tells you to do so. Some products are not recommended for children below a certain age. If you have any questions, talk to your health care provider.

Do not use OTC topical hydrocortisone products for diaper rash unless your health care provider tells you to. Do not apply OTC topical hydrocortisone in your rectum. If you have vaginal discharge, do not use OTC topical hydrocortisone for genital or feminine itching. Ask your health care provider if you have any of these symptoms. 

Use the smallest amount needed to cover the affected area. Do not bandage, wrap, or otherwise cover the area where topical hydrocortisone is applied, unless your health care provider told you to do so. This includes not using diapers or plastic pants if topical hydrocortisone is used in the diaper area. These steps will help reduce your risk of serious side effects.

Stop using topical hydrocortisone once the skin condition is better. Tell your health care provider if your symptoms do not get better or worsen after using this medicine. If you are using an OTC topical hydrocortisone product, do not use it for longer than seven days without talking with your health care provider.

People who are under 18 can be at greater risk for some side effects from topical hydrocortisone. Talk to your health care provider about the risks if you are under 18 or if you are treating someone under 18.

What should I tell my health care provider before using topical hydrocortisone?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if topical hydrocortisone is right for you.

In particular, make sure that you discuss any of the following.

Other Medicines and Supplements. Topical hydrocortisone may interact with other medicines and supplements. Before using topical hydrocortisone, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Adrenal Gland Problems. Topical hydrocortisone can cause reduced adrenal function, also known as adrenal insufficiency. See the Side Effects section for more details. Tell your health care provider if you have any adrenal gland problems.

Diabetes. Topical hydrocortisone may increase your blood sugar. See the Side Effects section for more details. Tell your health care provider if you have high blood sugar or diabetes.

Skin Infections. Tell your health care provider if you currently have a skin infection. The infection may need to be treated before you use topical hydrocortisone.

Other Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • Liver problems
  • Broken skin or thinning of the skin where you will be applying the medicine

Pregnancy. It is not known if or how topical hydrocortisone could affect pregnancy or harm an unborn baby. Tell your health care provider if you are or plan to become pregnant.

Breastfeeding. It is not known if topical hydrocortisone passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will advise you if you should use topical hydrocortisone while breastfeeding.

Interactions

Does topical hydrocortisone interact with foods or drinks?

There are no known interactions between topical hydrocortisone and foods or drinks.

It is unknown if drinking alcohol will affect topical hydrocortisone.

Does topical hydrocortisone interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure you discuss if you are using or taking any other corticosteroid, such as dexamethasone, methylprednisolone, or prednisone, which are medicines for certain inflammatory conditions.

This may not be a complete list of medicines that can interact with topical hydrocortisone. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much topical hydrocortisone?

If you or someone else has used too much topical hydrocortisone, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of topical hydrocortisone?

If you miss your scheduled dose of topical hydrocortisone, apply it as soon as you remember. If it is almost time for your next dose, skip the missed dose and follow the original schedule. If you are using OTC topical hydrocortisone, do not use it more often than directed in the product label. Do not use double or extra doses or use this medicine more often than recommended.