Hydrocortisone is a steroid that you can apply to the skin to help relieve eczema flare-ups. While you can buy mild-strength formulas over the counter, stronger formulas usually require a prescription.

Topical hydrocortisone in cream, ointment, lotion, or gel forms can help relieve swelling, itching, and skin discoloration from eczema. You can apply it directly to irritated skin.

Pharmacies generally sell hydrocortisone over the counter for mild eczema. But if your eczema is moderate to severe, you may need a prescription formula.

Keep reading to learn how hydrocortisone cream works to relieve eczema, who can use it, the possible side effects, and what to try if it doesn’t work for you.

Hydrocortisone is a corticosteroid medication. Corticosteroid medications reduce inflammation in the body.

While some corticosteroids are taken orally or infused, hydrocortisone is a topical product. That means it’s applied to the skin.

The topical form helps reduce skin swelling, itching, and discoloration. It can help relieve rashes and treat chronic skin conditions such as eczema. You typically use it along with other products that help hydrate the skin.

It’s available in creams, lotions, ointments, gels, and solutions. The medication is available in different strengths ranging from .1 to 2.5%. You can purchase over-the-counter hydrocortisone creams up to 1% strength at pharmacies. But more potent forms require a subscription.

Hydrocortisone isn’t the only topical steroid. A doctor may recommend hydrocortisone or another steroid cream based on:

  • a person’s age
  • the location of the eczema flare-up
  • how much of the body a person needs to apply the cream to
  • other factors

Hydrocortisone cream is a common eczema treatment. It can reduce itching and swelling during eczema flare-ups.

The strength you need can depend on the severity of your flare-ups and how your skin responds to hydrocortisone. You might need to try a few strengths before you find one that helps manage your symptoms.

While hydrocortisone alone helps reduce inflammation, it doesn’t treat skin dryness or flaking, though these may improve as you treat the inflammation. Dermatologists typically recommend using it along with an emollient, a type of topical product that helps moisturize and protect the skin.

Read about the types of eczema and treatments for each.

Pediatricians may prescribe mild-strength hydrocortisone cream for babies with moderate eczema if using other treatments, including emollients specifically designed for infants, hasn’t worked. However, it’s best to talk with your child’s pediatrician before using any new medication, including over-the-counter hydrocortisone products.

They may recommend trying other eczema management strategies first, such as:

  • identifying and avoiding possible eczema triggers
  • avoiding possible irritants, including scented bath and skin products and scented laundry detergents
  • ruling out other possible causes of their symptoms, including skin infections and allergies
  • a moisturizing routine for dry skin

Read more about eczema creams and eczema washes for babies.

You’ll use the same general steps to apply hydrocortisone whether it’s a cream, ointment, lotion, or gel. Read the instructions that come with your specific product before your first use.

If your hydrocortisone cream is a prescription, you might have specific instructions to follow from a pharmacist or your doctor. Hydrocortisone should be used once or twice daily unless a doctor has advised you to use it more often.

Some products work best when applied to damp or wet skin. A healthcare professional may advise you to apply it after bathing.

The general instructions for hydrocortisone use are the same for adults and children. It’s important to:

  • wash and dry your hands before use
  • apply a thin layer of hydrocortisone to any irritated areas.
  • rub in until it’s disappeared into your skin while being careful not to rub too hard
  • apply to all affected areas
  • not get hydrocortisone in open cuts or sores
  • wash and dry your hands after using
  • wait at least 10 minutes before applying other skin care products, including emollients

A healthcare professional may also recommend applying a bandage after applying a hydrocortisone product, as it can increase the amount of the medication that’s absorbed.

There are possible side effects of hydrocortisone. Most symptoms are minor and contained to the skin area treated with hydrocortisone. Side effects are significantly more likely when hydrocortisone is used for longer than 4 weeks or when a stronger formulation is used over a large part of the body. Common side effects include:

Less common side effects

Systemic side effects, or those that affect body systems, are not common with topical hydrocortisone.

Steroids taken orally or infused are more likely to cause adverse system side effects than hydrocortisone applied topically. However, if you use a strong formulation of hydrocortisone for a long time on thin areas of skin or on a large surface area of the body, you can potentially develop systemic side effects.

They may include:

  • glaucoma
  • hypertension, or high blood pressure
  • hyperglycemia, or high blood sugar
  • suppression of the parts of your body responsible for producing cortisol, the stress hormone
  • Cushing syndrome, which results from high levels of cortisol

Hydrocortisone is often one of the first treatments that doctors recommend to manage eczema flare-ups.

For many people, hydrocortisone is effective and relieves symptoms. However, it isn’t meant for daily use except for a short time to manage an eczema flare.

Part of managing eczema involves preventing flare-ups by identifying and avoiding your eczema triggers. Keeping your skin clean and moisturized can also help prevent flare-ups.

Your doctor might prescribe different medications if your flare-ups are severe or don’t respond to hydrocortisone. They can include:

  • higher strength topical steroids
  • other topical medications, including calcineurin inhibitors, topical Janus kinase (JAK) inhibitors, and roflumilast (Zoryve)
  • immune-suppressing medications
  • immune-suppressing injections
  • phototherapy
  • dupilumab (Dupixent)

The right option can depend on how severe your eczema is and how your body responds to various treatments.

Learn more about treating severe eczema.

Hydrocortisone is a common eczema treatment. It’s available in both over-the-counter and prescription strengths. It can reduce the itching, skin discoloration, and swelling of eczema flare-ups.

There are some risks and side effects to using hydrocortisone. While most side effects are minor and contained to the skin, there are some serious risks associated with hydrocortisone use. The risk increases the longer hydrocortisone is used or the larger the body surface area where you use it.

A medical professional can prescribe you an alternative if you experience side effects or if hydrocortisone isn’t effective for your eczema.