Members of MyEczemaTeam often keep hydrocortisone cream handy for eczema flare-ups. “A week or so ago, I tried using bleach on a mop. I ended up getting a skin reaction, but it’s healing on its own. I used some hydrocortisone cream on the burns,” said one member.

“Weather causes my ears to itch and flare up — I have hydrocortisone that’s helping today,” shared another.

Hydrocortisone is a synthetic form of cortisol, a natural hormone produced by the adrenal glands. It falls under the category of topical corticosteroids, which reduce inflammation and itching associated with skin conditions like eczema. When applied to the affected skin, hydrocortisone suppresses overactive immune responses in the area to alleviate the symptoms of eczema, such as skin irritation, itchy skin, and swelling.

Over-the-Counter vs. Prescription Strength

Hydrocortisone products come in different strengths based on the concentration of medication. The lower the percentage, the milder the formula. More powerful treatments have higher percentages — but also more potential side effects.

Lower-potency hydrocortisone creams usually contain 0.5 percent to 1 percent hydrocortisone. These types of products are available over the counter (OTC). Mild cases of eczema or sensitive areas, such as the face and groin, may be better suited for weaker OTC products.

Higher-strength hydrocortisone products go up to 2.5 percent concentration. These require a prescription from a health care professional.

Different Forms of Hydrocortisone Products

You can find hydrocortisone in various forms, each with its advantages and considerations:

• Creams — Hydrocortisone creams work for most types of eczema, including weepy or wet skin. Creams have a light texture, making them easy to apply and absorb into the skin.
• Foams — Foams with hydrocortisone are good for hairy areas, like the scalp or areas with facial hair.
• Gels — Gels dry quickly and leave minimal residue behind, so you won’t worry about the medication getting onto something else, like clothing or furniture.
• Lotions — Hydrocortisone lotions are more liquid than creams, making them ideal for covering large affected areas or hairy patches of skin.
• Ointments — Hydrocortisone ointments are thicker than creams, creating a protective barrier on the skin. They are particularly useful for treating dry and thickened skin areas.
• Sprays — Hydrocortisone sprays are a convenient way to apply the medication on hard-to-reach areas or when direct contact with the skin is challenging.

For hairy areas, you can also consider medicated shampoo with hydrocortisone. The absorption of hydrocortisone may vary by the type of formulation, but not significantly. Putting bandages over areas treated with hydrocortisone increases absorption, so you shouldn’t wrap or cover the area unless specifically advised otherwise by your health care provider. Your doctor can help you choose the best product based on the condition of your skin, cost, and your personal preferences.

Other Ingredients in Hydrocortisone Products

In addition to hydrocortisone, many products for eczema also contain other ingredients that people find beneficial. “Hydrocortisone with aloe vera can be helpful with inflammation and adding moisture to those dry areas,” shared a MyEczemaTeam member.

These ingredients may enhance hydrocortisone’s effectiveness and provide additional benefits for the skin. Some common add-ins include:

• Aloe vera — Known for its soothing properties, aloe vera can help reduce inflammation, making it a promising complement to hydrocortisone's effects.
• Chamomile — Chamomile offers some demonstrated benefits for eczema and allergy-related symptoms.
• Colloidal oatmeal — Often used in creams and lotions, colloidal oatmeal forms a protective layer on the skin, helping to retain moisture and reduce itching.
• Vitamin E — A potent antioxidant, vitamin E is a popular ingredient in skin care products with potential beneficial effects.

One MyEczemaTeam member said, “I have been using coconut oil and hydrocortisone for the itch. It’s been working great for my 10-year-old.”

Before trying any of these add-ins, it’s important to know whether or not they may worsen your eczema or cause an allergic reaction. Consider speaking with your health care provider before trying one. Additionally, always check the ingredients list on your skin care products to see if it contains anything you know your skin reacts poorly to.

Precautions and Possible Side Effects

When using hydrocortisone products, it's crucial to follow the instructions provided by your dermatologist or indicated on the packaging. Avoid higher-potency products on sensitive areas of skin or for extended periods to reduce your risk of side effects.

Some of the most common side effects of hydrocortisone include:

• Acne
• Burning
• Discoloration
• Dry skin
• Itching

Serious reactions like crusting or peeling of treated skin, pus-filled bumps near the hair follicles, skin infections, or allergic reactions require medical attention. In addition, topical steroids are meant for short-term flares, so doctors usually prescribe them once a day for one to two weeks or less.

Apply hydrocortisone in a thin layer to the treatment area using clean hands, then wash your hands after applying a topical steroid (unless the treatment is meant for your hands).

Although you can buy hydrocortisone over the counter, you should talk to your dermatologist before using it. They may suggest a patch test to watch for skin reactions before applying it to a larger area.

Avoid using the product beyond the recommended time, as doing so may make treatment less effective. Also, using too much steroid cream can be dangerous, leading to skin thinning and stretch marks. In areas where the skin is already thin, hydrocortisone may do more harm than good. “I’m 61 and can’t use any steroid on my thinning face,” shared a MyEczemaTeam member.

When your skin symptoms are under control and you’re ready to stop using hydrocortisone, ask your doctor about tapering off to avoid potential rebound effects.

Everyone’s skin is different, but the right hydrocortisone product can be a helpful tool for controlling eczema symptoms, so work with your dermatology provider to identify the best solution for you.

Talk With Others Who Understand

On MyEczemaTeam, the social network for people with eczema and their loved ones, more than 48,000 members from around the world come together to ask questions, offer support and advice, and connect with others who understand life with eczema.

How does topical hydrocortisone fit into your eczema treatment plan? Have you noticed any serious side effects or skin problems after using topical steroids? Share your experience in the comments below or start a discussion on your Activities page.