Pronunciation: HYE-droe-KOR-ti-sone
Brand names: Ala-Cort, Alkindi Sprinkle, Beta HC, Caldecort, Cortef, ... show all 9 brands Cortizone-10, Pandel, Proctocort, Vanicream HC
Dosage form: topical cream (0.5%, 1%, 2.5%), ointment (2.5%, 1%), lotion, gel, oral granule (0.5 mg; 1 mg; 2 mg; 5 mg), oral tablet (10 mg; 20 mg; 5 mg)
Drug class: Topical steroids

Medically reviewed by Melisa Puckey, BPharm. Last updated on Jul 4, 2024.

What is hydrocortisone?

Hydrocortisone cream is used to treat eczema, dermatitis, psoriasis, hemorrhoids, insect bites or stings, and other skin conditions to help relieve itchy or inflamed skin.  It is also available as hydrocortisone ointment, suppositories, gel, and lotion. Hydrocortisone is a steroid medicine that works by decreasing inflammation and reducing an overactive immune system.

Hydrocortisone cream and skin products should only be used on skin conditions that respond to steroids.

Hydrocortisone creams, suppositories, and other topical products may contain other active ingredients, including antibiotics neomycin and polymyxin B sulfate when used for inflamed, infected skin, or hydrocortisone with pramoxine for hemorrhoids.

Hydrocortisone, hydrocortisone butyrate, and hydrocortisone acetate are different medicines. Hydrocortisone butyrate 0.1% (Locoid) is stronger or more potent than hydrocortisone 2.5%, 1% and 0.5%.  Hydrocortisone acetate and hydrocortisone are both mild steroids.

Hydrocortisone ointment is used on very dry skin and creates a barrier to lock in moisture. This also helps the active ingredient penetrate the skin, so it is more potent than creams and lotions. Creams are easier to apply to the skin, are absorbed quickly, and help keep the skin moisturized. Lotions are lighter and easier to apply to large areas of the body, hairy areas, or weeping skin. Gels are often used on the scalp because they don’t leave the hair greasy.

Hydrocortisone tablets are used to treat asthma, allergic reactions, arthritis, inflammatory bowel diseases, adrenal insufficiency, lupus, certain cancers, and inflammatory conditions. It works to decrease inflammation, replace cortisol, or improve an overactive immune system.

Hydrocortisone side effects

Common hydrocortisone side effects (topical use)

Common hydrocortisone side effects are skin redness, itching, stinging, rash, redness or crusting around your hair follicles, burning, dryness, or other irritation of treated skin, itching, or irritation around your mouth, appearance and color changes in treated skin, signs of skin infection (swelling, redness, warmth, oozing), numbness, tingling, or burning pain.

Serious hydrocortisone side effects (topical use)

Get emergency medical help if you have signs of an allergic reaction: hives, difficult breathing, swelling of your face, lips, tongue, or throat.

Hydrocortisone side effects can occur if your skin absorbs topical steroid medicine. Tell your doctor if you have:

• swelling, weight gain (especially in your face or your upper back and torso);
• thinning skin, stretch marks, acne, increased facial hair;
• irregular menstrual periods, changes in sexual function, or
• memory problems, feeling irritable.

Hydrocortisone skin products can cause other serious side effects. Call your doctor at once if you have:

• worsening of your skin condition;
• pain, tenderness, headache;
• blurred vision, eye pain or redness, seeing halos around lights;
• high blood sugar--increased thirst, increased urination, dry mouth, fruity breath odor; or
• increased adrenal gland hormones--hunger, weight gain, swelling, skin discoloration, slow wound healing, sweating, acne, increased body hair, tiredness, mood changes, muscle weakness, missed menstrual periods, sexual changes.

Children can absorb larger amounts of hydrocortisone through the skin and may be more likely to have side effects.

Common hydrocortisone side effects (tablets)

Common hydrocortisone tablet side effects include fluid retention, alteration in glucose tolerance, elevation in blood pressure, behavioral and mood changes, increased appetite, and weight gain.

Serious hydrocortisone side effects (tablets)

Serious hydrocortisone tablet side effects include adrenal crisis, immunosuppression and increased risk of infection, slow growth, Cushing's syndrome, decrease in bone mineral density, psychiatric side effects, ophthalmic adverse reactions, gastrointestinal adverse reactions, vaccinations and risk of Kaposi's sarcoma.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Warnings

Warnings for OTC topical products

Do not use it in the eyes, for diaper rash, or for external genital or feminine itching if you have a vaginal discharge. Do not use more than the recommended daily dosage unless directed by a doctor

Stop using this product and consult a doctor if your condition worsens or if symptoms persist for more than 7 days or clear up and occur again within a few days (do not continue to use this or any other hydrocortisone product for longer than 7 days, unless prescribed by a doctor).

Stop using this product and consult a doctor if bleeding occurs due to anal itching.

Prolonged use of topical corticosteroids may cause atrophy of the epidermis and subcutaneous tissue; these effects are most likely to occur (even with short-term use) in intertriginous (e.g., axilla, groin), flexor, and facial areas.

If a skin infection develops or is present, anti-infective therapy should be started. If it does not respond promptly, discontinue topical corticosteroid therapy until the infection has been controlled.

Warning for hydrocortisone tablets

Hydrocortisone Tablets may suppress the immune system and increase the risk of infection. Corticosteroid-associated infections can be mild but can be severe and, at times, fatal. The rate of infectious complications increases with increasing corticosteroid dosages.

Prolonged use of corticosteroids may cause eye side effects, including posterior subcapsular cataracts and glaucoma with possible damage to the optic nerves. It may also enhance the establishment of secondary ocular infections due to fungi or viruses.

Kaposi’s sarcoma has been reported to occur in patients receiving corticosteroid therapy, most often for chronic condition.

Average and large doses of hydrocortisone or cortisone can elevate blood pressure, cause salt and water retention, and increase potassium excretion. 

Vaccinations. Administration of live or live, attenuated vaccines is contraindicated in patients receiving immunosuppressive doses of corticosteroids. Killed or inactivated vaccines may be administered to patients receiving immunosuppressive doses of corticosteroids; however, the response to such vaccines may be diminished. Indicated immunization procedures may be undertaken in patients receiving nonimmunosuppressive doses of corticosteroids.

Before taking this medicine

Hydrocortisone topical 

You should not use hydrocortisone topical if you are allergic to it.

Tell your doctor if you have or have ever had:

• any type of skin infection;
• a skin reaction to any steroid medicine;
• cataract or glaucoma;
• thinning of the skin where you will apply hydrocortisone topical;
• problems with your adrenal gland; or
• liver disease.

Steroid medicines can increase the glucose (sugar) levels in your blood or urine. Tell your doctor if you have diabetes.

Pregnancy

Tell your healthcare provider if you are pregnant, plan to become pregnant or become pregnant as it is not known if hydrocortisone topical will harm an unborn baby.

Breastfeeding

Ask your healthcare provider if it is safe to breastfeed while using this medicine.

Hydrocortisone tablets

You should not use hydrocortisone if you are allergic to hydrocortisone or corticosteroids or if you have a systemic fungal infection.

Steroids can weaken your immune system, making it easier to get an infection or worsen an infection you already have. Tell your doctor about any illness or infection you had within the past several weeks.

Tell your doctor if you have ever had:

• heart disease, high blood pressure;
• tuberculosis;
• kidney disease;
• cirrhosis or other liver disease;
• a thyroid disorder;
• low bone mineral density (osteoporosis);
• stomach ulcers, ulcerative colitis, diverticulitis;
• diabetes;
• a colostomy or ileostomy;
• depression or mental illness;
• glaucoma or cataracts;
• herpes infection of the eyes; or
• a muscle disorder such as myasthenia gravis.

Long-term oral use of steroids may lead to bone loss (osteoporosis), especially if you smoke, do not exercise,  do not get enough vitamin D or calcium in your diet, or if you have a family history of osteoporosis.

Pregnancy

It is not known whether hydrocortisone tablets or capsules will harm an unborn baby. However, using this medicine during pregnancy may cause a hormone deficiency in the newborn. Tell your doctor if you are pregnant or plan to become pregnant.

Breastfeeding

Ask a doctor if it is safe to breastfeed while using this medicine.

How should I use hydrocortisone skin products?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Wash your hands before and after applying this medicine unless you are using it to treat a hand condition.

Do not take it by mouth. Topical medicine is for use only on the skin.

Apply a thin layer of hydrocortisone cream, ointment, lotion, or gel to the affected skin and rub it in gently. Do not apply this medicine over a large skin area unless your doctor has told you to.

Apply rectal creams and ointments externally to the anal area; some commercially available creams also may be applied externally to the anogenital areas.

For scalp conditions, part the hair and apply a small amount of lotion or solution directly to the affected area; rub gently into the scalp. Maintain usual hair care, but do not wash out the lotion immediately after application. Alternatively, for scalp dermatoses, apply aerosol to dry scalp after shampooing.

Do not cover treated skin with a bandage unless your doctor tells you to.

For hydrocortisone lotion and spray shake well just before each use.

If you are treating the diaper area, do not use plastic pants or tight-fitting diapers.

You may need medical tests to be sure this medicine is not causing harmful effects.

You may need blood or urine tests while using this medicine.

Stop using OTC hydrocortisone skin products and call your doctor if your symptoms do not improve after using this medicine for 7 days, or if your symptoms get worse or get better, and then come back in a few days.

Store at room temperature, away from moisture and heat. Do not freeze. Keep the bottle tightly closed when not in use.

How should I take hydrocortisone tablets or capsules?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Take with food if hydrocortisone upsets your stomach.

Do not swallow an Alkindi Sprinkle capsule whole. Open the capsule and pour the medicine granules onto the tongue before swallowing. You may also mix the granules with soft food such as yogurt or applesauce (not with liquid). Swallow the mixture right away without chewing.

Drink water right after taking the Alkindi Sprinkle granule mixture. If giving this medicine to a baby, give infant formula or breast milk.

If you have trouble sleeping, you may need to take this medicine early in the day. Follow your doctor's dosing instructions very carefully.

Your dose needs may change if you have a serious illness, fever or infection, surgery or a medical emergency. Tell your doctor about any such situation that affects you.

Your doctor will need to check your progress on a regular basis.

You should not stop taking hydrocortisone suddenly. Follow your doctor's instructions about tapering your dose.

Store at room temperature away from moisture, heat, and light.

Wear a medical alert tag or carry an ID card to let others know you use steroid medication.

What happens if I miss a dose?

Skin products: Apply the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not apply two doses at one time.

Tablets or capsules: Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222 if anyone has accidentally swallowed the medicine.

Skin products: High doses or long-term use of hydrocortisone topical can lead to thinning skin, easy bruising, changes in body fat (especially in your face, neck, back, and waist), increased acne or facial hair, menstrual problems, impotence, or loss of interest in sex.

Hydrocortisone tablets or capsules:

High doses or long-term use of steroid medicine can lead to thinning skin, easy bruising, changes in body fat (especially in your face, neck, back, and waist), increased acne or facial hair, menstrual problems, impotence, or loss of interest in sex.

What should I avoid while using hydrocortisone?

Skin products

• Do not use hydrocortisone topical to treat any skin condition that has not been checked by your doctor.
• Avoid applying hydrocortisone topical to the skin of your face, underarms, or groin area unless your doctor has told you to.
• Avoid using other medications on the areas you treat with hydrocortisone skin products unless your doctor tells you to.
• Do not get hydrocortisone topical in your eyes. If contact does occur, rinse with water.

Hydrocortisone oral products

• Avoid receiving a "live" vaccine. The vaccine may not work as well while you are using hydrocortisone. 
• Avoid being near people who are sick or have infections. Call your doctor for preventive treatment if you are exposed to chickenpox or measles. These conditions can be serious or even fatal in people who are using hydrocortisone.

What other drugs will affect hydrocortisone?

Skin products

Medicine used on the skin is not likely to be affected by other drugs you use, but many drugs can interact. Tell your doctor about all your current medicines, including prescription and over-the-counter medicines, vitamins, and herbal products.

Hydrocortisone oral products

Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.

Tell your doctor about all your current medicines. Many drugs can affect hydrocortisone tablets and capsules, especially:

• birth control pills or hormone replacement therapy;
• heart medication;
• insulin or oral diabetes medicine;
• medicine to treat an infection;
• seizure medication;
• a blood thinner such as warfarin (Coumadin, Jantoven); or
• NSAIDs (nonsteroidal anti-inflammatory drugs)--aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

This list is not complete and many other drugs may affect hydrocortisone. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer