Compare · Medications

Eucrisa vs Hydrocortisone

Eucrisa: A non-steroid ointment for mild to moderate eczema. It can be used on the face and in skin folds, and there is no limit on how long it can be used. Hydrocortisone: The mildest topical steroid, and the only one sold without a prescription. It is the usual starting point for the face, for skin folds and for young children.

Reviewed by Dr. Schwarz, Board-Certified Dermatologist
Representative medication packaging labelled Eucrisa, lying sideways on a white background.A plain white ointment tube lying on its side, labeled Hydrocortisone with a blue swoosh
Which one?At a glanceWhat it treatsDiagramsHow you take itResultsSide effectsSafetyCostWhen you stopQuestions

Which one is right for you?

Choose Eucrisa if…

Choose for mild to moderate eczema when you want a non-steroid you can use anywhere, for as long as needed.

  • Mild eczema on the face or folds
  • You want no time limit on use
  • Insurance covers it or savings apply

Choose Hydrocortisone if…

Choose as the first step for mild rashes on the face, folds or young children — the only steroid sold without a prescription.

  • A mild, itchy rash
  • The face, skin folds or a young child
  • You want to start over the counter
Often combined

Can you take them together?

A common pairing: hydrocortisone for short flares, Eucrisa for steroid-free maintenance between them.

At a glance

● Eucrisa
● Hydrocortisone
Type
Topical PDE4 inhibitor (crisaborole 2%)
Mild topical steroid (class 7)
What it does
Calms eczema inflammation without a steroid
Calms inflammation and itch
Best for
Mild to moderate eczema, including face and folds
Mild eczema, bites and rashes on the face, folds and children
Prescription
Yes
0.5–1% over the counter; 2.5% by prescription
Form
Ointment
Cream or ointment
How often
Twice daily
Twice daily
Course length
No time limit
1–2 weeks
Time to results
Up to 4 weeks
1–2 weeks
Main side effect
Burning or stinging where applied
Rarely any
Blood tests
None
None
Pregnancy
Check with your clinician
Check with your clinician
Cost
High; brand only
Low; generic and OTC

What it treats

Compare uses by strength of evidence. Evidence level describes confidence in a benefit, not its size.

Evidence level
Eucrisa
Hydrocortisone
Moderate evidenceSome supportive research
Extreme close-up of light skin in an active eczema flare, too close to tell which part of the body it is. Blotchy pink-red inflammation covers the whole frame with no clear edge, with small raised bumps, fine dry scale and a few fresh scratch marks.

Eczema

Reduces itch and redness.
Extreme close-up of light skin in an active eczema flare, too close to tell which part of the body it is. Blotchy pink-red inflammation covers the whole frame with no clear edge, with small raised bumps, fine dry scale and a few fresh scratch marks.

Eczema

Calms mild flares.
Insect Bites on light skin.

Insect Bites

Reduces itch and swelling.
The back of one hand and the wrist on pale skin. A bright pink, slightly swollen patch with tiny blisters covers the back of the hand and stops at a straight line across the wrist.

Contact Dermatitis

Calms mild rashes.
Limited evidenceEarly or small studies
—
Diaper Rash, close-up of representative skin findings.

Diaper Rash

Short use for inflamed rashes.
Little evidence
Two thick, sharply bordered plaques on a knee on fair light skin. They are salmon-pink to red with loose silvery-white scale on top.

Psoriasis

Not approved for psoriasis.
—
Not effective
Inflamed acne on light skin. The spots sit in a patch of pink, and the ring of redness around each one is easy to see. A few have a yellow-white head, and the skin between them is dry and flaking.

Acne

No role in acne.
Two thick, sharply bordered plaques on a knee on fair light skin. They are salmon-pink to red with loose silvery-white scale on top.

Psoriasis

Too mild for plaques.
Can make it worse
—
A round patch on a forearm on fair light skin, with a raised pink scaly border and a flatter, clearer middle.

Ringworm

Steroids let fungus spread.
AI-generated educational illustration of Perioral Dermatitis: 1. Perioral Dermatitis Header — Light Skin; Lighter skin. Not a clinical photograph.

Perioral Dermatitis

Steroids worsen it.
How it works

Eucrisa

Eucrisa. Crisaborole turns down inflammation inside skin. 1. Blocks PDE4: Inhibits an enzyme that breaks down cAMP. 2. Raises cAMP inside cells: Preserves a signal involved in regulating inflammation. 3. Helps inflamed skin settle: Eczema redness and itch can improve.
Open full-size diagram
Diagram explanation and sources

Blocks PDE4: Inhibits an enzyme that breaks down cAMP. Raises cAMP inside cells: Preserves a signal involved in regulating inflammation. Helps inflamed skin settle: Eczema redness and itch can improve.

PDE4 inhibition and increased intracellular cAMP are established. The exact link to clinical improvement is not fully defined; this is a simplified overview, not every downstream pathway.

Source 1

Hydrocortisone

Hydrocortisone. Calms itchy, inflamed skin. 1. Activates steroid receptors: Binds receptors inside skin and immune cells. 2. Turns down inflammatory signals: Changes gene activity to reduce inflammatory messengers. 3. Eases redness and itch: Swelling and irritation settle as inflammation falls.
Open full-size diagram
Diagram explanation and sources

Activates steroid receptors: Binds receptors inside skin and immune cells. Turns down inflammatory signals: Changes gene activity to reduce inflammatory messengers. Eases redness and itch: Swelling and irritation settle as inflammation falls.

Simplified glucocorticoid receptor-mediated effects in steroid-responsive skin inflammation. Full effects also involve other pathways. No claim of antimicrobial action or cure; formulation and potency affect clinical use.

Source 1 · Source 2 · Source 3

How you take it

Treatment plan

When to Apply: A thin layer twice a day on the inflamed areas, on clean dry skin. Moisturizer goes everywhere, including over the top once it has settled.

How to Start: Twice daily from day one, on the flaring areas only, not over the whole body as a preventive. If the stinging is hard to tolerate, moisturize first and use the ointment straight from the fridge. The stinging usually fades within the first week.

If It Irritates: Burning or stinging for a few minutes after applying is the commonest effect, and usually not an allergy. It settles as the skin heals. Redness spreading beyond where you applied it, or stinging that gets worse rather than better after two weeks, should be reviewed.

If It's Not Working: There is one strength, so there is nothing to increase. Four weeks of proper twice-daily use is a fair trial. After that: a different non-steroid, a short steroid course to break the flare, or a look at what else is driving the rash.

When to Apply: Twice a day, on the rash only, on clean dry skin. A thin film that makes the skin look shiny is enough. One fingertip unit, the amount along the last joint of an adult index finger, covers about two adult palms. Moisturizer can go on a few minutes before or after.

How to Start: Twice daily from day one, until the rash is flat rather than merely better. Usually three to seven days. Two weeks is the outer limit for one stretch without seeing a clinician, less on the face.

If It Irritates: Stinging on application is usually the base, not the steroid, and is more likely on broken skin or from an alcohol-containing gel or spray. An ointment often settles it. Itch or redness that worsens over days can mean an allergy to something in the product, which does happen with steroids.

If It Is Not Working: Stop after about a week and reassess. A rash that does not respond to hydrocortisone is often not eczema. Ringworm, a yeast rash in a fold and psoriasis all look plausible and all need something different.

Monitoring

No blood tests and no routine monitoring. Very little reaches the bloodstream, and what does is broken down quickly, so nothing accumulates.

Monitoring is a review at about four weeks to decide whether it is working. Long term, this is a drug people can stay on: no maximum duration, no limit on the area treated, no rest period. That is the practical difference between it and a topical steroid.

The one thing worth watching is whether it is quietly standing in for treatment that would actually control the disease. Eczema that keeps escaping it needs a different plan, not more months of the same ointment.

No blood tests are needed for ordinary short courses in a healthy adult. Monitoring means looking at the skin: did the rash clear, has the skin gone thin or shiny, have small blood vessels appeared, are stretch marks forming in the folds.

Children absorb proportionally more because they have more skin surface for their size, so a doctor watches how much is used and over how large an area. Anyone applying a steroid to large areas most days for months should be under review rather than repeating over-the-counter purchases.

Hydrocortisone is not a drug to stay on continuously. Where a condition needs ongoing control, the plan is short bursts for flares, emollients doing the daily work, or a switch to a treatment designed for maintenance.

When you’ll see results

Approximate windows, not promises.

● Eucrisa
● Hydrocortisone
First few minutes

First few minutesApplying it: A thin layer twice a day. Stinging or warmth for a few minutes is common, worst in week one.

First few minutesApplying it: A thin layer on the affected skin. The mildest steroid strength, which is why it is sold over the counter.

Days 1 to 7

Days 1 to 7Adjusting: Stinging is at its worst now. Itch eases before the rash looks different.

Week 2

Week 2Settling: Redness and scaling fade. Most of the stinging has gone.

Week 4

Week 4Judge it here: The point the trials measured. A meaningful share of people reach clear or almost clear skin; a meaningful share do not. No change by four weeks means more time will not help.

Ongoing

OngoingFace, eyelids and folds: Its strongest case. Use it on and off as needed: no cumulative limit, no rest period, none of the thinning that limits steroids on thin skin.

Days 1 to 2

Days 1 to 2Itch first: Itching and stinging ease before the rash looks different, the earliest sign it is working. Insect bites and minor irritation settle in a day or two, and that is the whole course.

Days 3 to 7

Days 3 to 7Clearing: Redness fades and the skin flattens. A mild eczema flare settles here; cracked skin takes longer than skin that was only red. Weeping or crusting should be settling, not spreading.

Weeks 1 to 2

Weeks 1 to 2Judge it here: A mild rash should be gone or nearly gone. Contact dermatitis clears steadily once the trigger is gone.

Weeks 2 to 4

Weeks 2 to 4Mild seborrheic dermatitis: Redness and flaking around the nose and brows improve.

After stopping

After stoppingMarks stay behind: Brown or gray patches where the rash was are pigment change, not scarring. They fade over weeks to months.

Side effects

Sorted by what to do about them.

Eucrisa

Hydrocortisone

Common
Common
  • Burning or stinging where applied
Common
  • Rarely any at this strength
Tell your doctor
Tell your doctor
  • Stinging that doesn't settle
Tell your doctor
  • A rash that spreads or changes (possible fungus)
  • Spots around the mouth
Stop and get care
Stop and get care
  • Hives, swelling or trouble breathing
Stop and get care
  • Spreading rash with fever

Safety and who should avoid it

Pregnancy
Use care
Little absorbed but data limited; ask your clinician.
Use care
Ask the doctor managing your pregnancy.
Breastfeeding
Use care
Keep it off the nipple.
Use care
Keep it off the nipple before a feed.
Children
3 months and older
Approved from 3 months.
Use care
Under 2 only on medical advice.
Monitoring
None
Judge at 4 weeks.
None
See a doctor if no better in 1 week.
Key interactions
None known
—
None known
—
Other cautions
Use care
Stinging is more common on broken skin.
Avoid
Ringworm, perioral dermatitis, rosacea, infected skin.

Cost and getting it

Getting it and cost

Cost is the obstacle here, not safety. It has been brand-name with no stocked generic for most of its life, and the cash price for a large tube is high. Generic availability changes, so ask the pharmacy.

Prior authorization is common. Plans usually want a topical steroid first, sometimes a calcineurin inhibitor too, which is cheaper as a generic. A savings card exists for people with commercial insurance, with terms that change often.

Tube size matters more than with most creams, because it goes on twice a day over an area. A small tube covering a child's whole body lasts days. Ask for the size that matches the area treated.

Hydrocortisone is cheap. Store-brand 1% cream is the same drug at the same strength as the branded tube, usually for much less. Anti-itch versions with added ingredients cost more without treating the inflammation any better.

Prescription 2.5% is generic and also cheap, though the visit costs more than the tube. Ointments and creams are the cheapest vehicles. Foams and sprays cost more.

When you stop

Comes back?
Eczema can return; it can be restarted any time.
Eczema can flare again; moisturizer helps hold it.
Taper needed?
No.
No for short courses.
After the last dose
No rebound and no skin thinning.
See a doctor if the rash returns quickly.

Common questions

Eucrisa:Why does it sting?

Probably the drug itself acting on inflamed skin, not the base. It is the commonest complaint, worst in the first days, and fades within a week.

Eucrisa:Can I use it on my eyelids?

Thin skin is where it makes the most sense and it is used there, but not in the eye itself. Keep it off the lid margin.

Eucrisa:Is it as good as a steroid cream?

No, it is milder. Its advantage is delicate skin and long stretches without the thinning that limits steroids.

Eucrisa:How long can I use it for?

There is no set limit. On during flares, off in between, for as long as it helps.

Eucrisa:Can children use it?

It is licensed from three months of age.

Eucrisa:Does it work for anything other than eczema?

Licensed for atopic dermatitis. Doctors sometimes use it off-label for other inflammatory rashes, where the evidence is thinner.

Hydrocortisone:How long can I use hydrocortisone?

About a week at a time on the body for an over-the-counter tube, less on the face. A rash that needs it longer than two weeks is a reason to be seen, not to buy more.

Hydrocortisone:Can I use it on my face?

For a few days, yes, and it is the mildest option there. Facial skin is thin and absorbs well, so weeks of daily use causes thinning, redness and small bumps around the mouth.

Hydrocortisone:Is 1% strong?

No. It is the bottom of the potency ladder. If a week of it has not worked, question the diagnosis.

Hydrocortisone:Will it thin my skin?

A short course on the body will not. Thinning comes from stronger steroids over long periods, especially on the face, eyelids, groin and armpits. Early changes usually recover over months. Stretch marks are permanent.

Hydrocortisone:Can it lighten my skin?

It can. Pale patches on treated skin show up more on deeper skin tones, and usually fade slowly after stopping. Untreated inflammation also leaves light and dark marks, so avoiding treatment is not a way around it.

Hydrocortisone:Can I use it on a fungal rash or on my child's diaper rash?

Not on its own. A steroid makes ringworm and yeast harder to recognize while they keep spreading. Diaper areas are covered, so absorption is higher, worth having a child's rash there looked at.

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