Hydrocortisone Cream for Itchy Skin Rashes

Hydrocortisone cream is a topical corticosteroid used to treat mild inflammatory skin conditions, commonly referred to as dermatitis. Hydrocortisone cream is available over the counter without a prescription in different strengths (such as 0.5% and 1%) as well as in prescription strength (2.5%). 

Hydrocortisone works by alleviating the swelling, itching, and redness caused by dermatitis. Corticosteroids are a class of steroid hormone closely related to cortisol, a naturally occurring hormone produced in the adrenal gland.

Hydrocortisone is also an ingredient used in a number of antibacterial or antifungal preparations, such as in athlete's foot creams or diaper ointments.

Hydrocortisone cream is an appropriate treatment for many allergic skin rashes, such as atopic dermatitis (atopic eczema) and allergic contact dermatitis (including poison ivy and poison oak). It is also good for treating insect bites or stings.

Other conditions hydrocortisone creams can treat include:

• Irritant contact dermatitis (caused by contact with a chemical or physical irritant)
• Seborrheic dermatitis (a type affecting the scalp, face, ears, and trunk)
• Psoriasis
• Anal itching
• Itching of the outer female genitals
• Hemorrhoids

The choice and strength of hydrocortisone cream product depend largely on the specific skin condition.

Hydrocortisone is not particularly useful for the treatment of hives (urticaria) since they are caused by histamines rather than by skin inflammation.

Histamines are chemicals produced by the immune system to rid your body of allergens (allergy-causing substances). Overreaction of this response can sometimes cause a rash outbreak. In this instance, an oral antihistamine may be the best choice of treatment, although a topical hydrocortisone cream may be prescribed to alleviate local itchiness and swelling.

Other conditions for which hydrocortisone creams are ineffective:

• Hydrocortisone cannot be used to treat acne and can, in fact, make the condition worse. It should also not be used to treat a skin infection or any broken skin, including blisters, boils, ulcers, or chancre sores.
• While hydrocortisone cream can be used sparingly to treat rash around the genitals, it should never be used in the vagina. Any preparation formulated for hemorrhoid treatment (such as Anusol-HC) should be used on the hemorrhoid only and not internally.
• When hydrocortisone cream can be used to treat seborrheic dermatitis of the scalp, it doesn't actually treat dandruff. Dandruff is typically treated with medicated shampoos that contain either salicylic acid, selenium sulfide, or zinc pyrithione.
• Hydrocortisone cream can make certain skin conditions worse, including impetigo and rosacea. Speak to your doctor if you have any of these conditions.

Hydrocortisone cream may be used on children but exercise caution, particularly in younger children. Speak with your pediatrician before using hydrocortisone cream on babies or toddlers, whether to treat eczema or diaper rash. There may alternative products that are gentler and work just as well.

Hydrocortisone cream is typically applied to the affected area of skin from two to four times per day. Apply the cream thinly, rubbing it in until fully absorbed. Treatment can last anywhere from a few days to a few weeks until the rash and itchiness have resolved. Use typically should not exceed four weeks.

Lower-potency versions (such as 0.5% or 1%) can be applied to the face for shorter periods of time, although any area around the eyes should be strictly avoided. Wash your hands thoroughly after use.

If using a moisturizer along with the hydrocortisone cream, apply the moisturizer first and let it absorb for 10 to 15 minutes before using the hydrocortisone.

Long-term use of any topical steroid on the face, particularly high-potency preparations, should also be avoided as this can cause irreversible skin damage. Repeated use around the eyes or on the eyelids has been known to cause glaucoma.

While side effects are rare if a hydrocortisone product is used as directed, they can happen. Stop the medication and contact your doctor if any of these occur:

• Irregular heartbeats (arrhythmia)
• Blurred vision or seeing "halos" around lights
• Insomnia
• Puffy face
• Blistering
• Worsening of the skin condition

Hydrocortisone cream can be very effective in treating mild skin inflammation but should never be used as a cure-all. Because it worked well, for example, in clearing up your rash, don't presume that you can use it just as effectively on diaper rash or any other skin condition your family may have.

Always read the manufacturer's insert leaflet to determine if it's the appropriate treatment and how the product should be used. If in doubt, speak with your pharmacist or doctor.