Medication

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.
Dr. Schwarz, MD · Board-certified dermatologistLast reviewed September 8, 2026
A plain white ointment tube lying on its side, labeled Hydrocortisone with a blue swoosh

Start here

Hydrocortisone is the weakest steroid there is, and most people use too little of it for too long. Use enough, twice a day, until the rash is flat, then stop. A week of 1% that has not dented the rash usually means the wrong diagnosis, not another month of hydrocortisone. The damage I actually see comes from the opposite habit, a tube kept in a drawer and smeared on the face most days for months.

— Dr. Schwarz, Board Certified Dermatologist

Key Facts

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Also calledCortisol, hydrocortisone acetate, Cortizone-10, Cortaid, Hytone
Drug classTopical corticosteroid, the lowest potency class
Applied asCream, ointment, lotion, gel, spray or foam
Strengths sold0.5% and 1% over the counter, 2.5% by prescription
Typical courseA few days to two weeks at a time
Time to workItch settles in a day or two, the rash over about a week
Prescription onlyNo for 0.5% and 1%, yes for 2.5%

What It Is

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Hydrocortisone is a topical corticosteroid, the same molecule as cortisol, the hormone your adrenal glands make, which is why it is the gentlest of the group. In the United States topical steroids are ranked in seven potency classes, class 1 strongest and class 7 weakest. Hydrocortisone sits at the bottom. It is used for mild eczema, contact dermatitis, insect bites, mild seborrheic dermatitis and general itch. It treats inflammation. It does not treat infection and it does not cure what is underneath. Watch the name. Hydrocortisone butyrate and valerate are modified versions several classes stronger. A tube labeled hydrocortisone butyrate 0.1% is not a mild steroid.

How It Works

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A topical steroid crosses into skin cells and binds a receptor inside them. The receptor moves to the nucleus and turns down the genes that make inflammatory signals. Fewer signals means less redness, swelling and itch. Steroids also narrow small blood vessels, which is why treated skin briefly looks paler.

The percentage on the tube does not tell you how strong the product is. Potency comes from the molecule and the vehicle carrying it. Hydrocortisone 2.5% is still a weak steroid. Clobetasol 0.05% is the strongest one made. Comparing percentages across two different steroids tells you nothing.

The mechanism also explains why steroids make some rashes worse. Turning down local immune activity helps an immune-driven rash, and helps a fungal or bacterial one spread, because the redness that would have flagged it is suppressed while the organism keeps growing.

Here is where Hydrocortisone acts in the skin, and what the others do instead.

About Hydrocortisone
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Skin basics
BARRIEREPIDERMISDERMIS28 daysQUIETS THE IMMUNE SIGNALCROSSES EASILYSLOWS SKIN CELLS DOWN

The redness, swelling and itch are the immune system reacting, not the damage itself. Hydrocortisone turns that reaction down where it is happening, in the skin, which is why a rash settles within days. The mildest steroid, and the only one sold over the counter.

Hydrocortisone crosses the barrier well, and much better on thin skin — eyelids and folds — than on palms. That difference is why the same tube is mild in one place and too strong in another.

In a plaque, skin cells travel from the bottom of the epidermis to the surface in four to six days instead of a month, and pile up as scale. This slows them back down, so the plaque thins.

The outer film of dead cells and oil. It holds water in and keeps irritants out, and it is thinner than a sheet of paper. Almost every dry, itchy, stinging skin problem starts here.

The outer layer, and the only one anything in a jar reaches. It renews itself constantly: a cell made at the bottom takes about a month to reach the surface and flake off. Most of what a skincare product does, it does here.

The living layer underneath, holding the blood vessels, the nerves and the collagen. It is where lasting change happens and it is hard to reach: most of what is sold for the skin never gets this far.

What It Treats

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Eczema
Eczema
Strong evidence
The one steroid you can buy without a prescription, and the only step in this routine that treats rather than protects. A thin layer twice a day on the itchy patches, for up to two weeks at a time. Mild enough for the face and the eyelids for a few days, and too mild for skin that has gone thick and leathery.
Contact Dermatitis
Contact Dermatitis
Strong evidence
The mildest topical steroid, and enough for a small patch on the body once the contact has stopped. Use it twice a day for one to two weeks rather than dabbing it on now and then. It is often too weak for the hands or feet, and on the face or eyelids it should be short-term and worth asking about first.
Molluscum Contagiosum
Molluscum Contagiosum
Moderate evidence
For the dry itchy eczema-like patch that develops around the bumps in about a third of children — not for the bumps themselves. Treating it properly matters, because the itch drives the scratching and the scratching is what spreads the infection. Use it on the skin between and around the bumps, thinly and for a short course. Strong steroid creams applied over the bumps calm the redness and can help the virus stay longer.
Seborrheic Dermatitis
Seborrheic Dermatitis
Moderate evidence
A mild steroid cream that settles the stinging and redness on the face within a few days, which no antifungal does that quickly. Use it for a week or two to break a flare, not as the ongoing plan — the skin beside the nose and on the eyelids thins with repeated use. Something anti-yeast has to run underneath it.
Dry Skin (Xerosis)
Dry Skin (Xerosis)
Moderate evidence
A few days of over-the-counter steroid cream can break the itch-scratch cycle when dry skin has turned red and itchy and moisturizer alone is not holding it. Use it twice a day for no more than a week, on the itchy patches only, with the moisturizer continuing around it. If you need it repeatedly, that is a reason to be seen rather than to keep buying it.

Not the Best For

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Keratosis Pilaris
Keratosis Pilaris
Limited evidence
A mild steroid cream used in short courses when the red halo around the bumps is the main complaint, not the roughness. It calms the inflammation for a while and does nothing to the plugs. It is not a long-term answer, because weeks of steroid on thin skin like the cheeks causes its own problems.
Ingrown Hairs
Limited evidence
A low-strength steroid cream calms a badly inflamed patch quickly and takes the soreness out of it. It is a short course of days, prescribed for a specific flare, not something to keep using. Facial and neck skin thins with repeated steroid use, and it does nothing about the hair that caused the bump.
Scabies
Scabies
Limited evidence
Mild steroid cream helps the itch, but only after scabies has been diagnosed and treated. Used before that on an undiagnosed itchy rash it flattens the rash enough to make scabies much harder to recognize while the mites carry on spreading — sometimes called scabies incognito. If you have been using it, say so at your appointment.
Psoriasis
Psoriasis
Limited evidence
The mildest steroid you can buy, and it is honestly too weak for a thick plaque on an elbow or knee. Where it does help is thin skin — the face, the eyelids and the body folds — used for short stretches. If nothing has changed after two weeks, the answer is a stronger prescription rather than more of this.
Sunburn
Sunburn
Limited evidence
One percent hydrocortisone can take the edge off a small, sore area for a few days. Use it on unbroken skin only, never on blisters or open areas, and not over large parts of the body. It is a mild help rather than a fix, and if the burn is big enough that you want to cover it all, that is a burn worth having looked at.
Folliculitis
Weak evidence
It is the obvious thing to reach for because the bumps itch, and it is usually the wrong one. Steroid cream quietens the itch for a few days while the infection in the follicles carries on underneath, and the rash that comes back is often more widespread. It also changes how things look, which makes the diagnosis harder afterward. Cool compresses and a medicated wash are the safer starting point.
Close-up of small pink bumps and flaky skin clustered on the chin below the lower lip
Perioral Dermatitis
Never use
The most common self-treatment for this rash and the most common cause of it. It looks like it is working within two days, and the rash comes back worse when it stops, which pulls people into using it again. Even the mildest over-the-counter strength does this. If you are using one now, that is the thing to stop first, with your doctor's help if it was prescribed.
Ringworm
Never use
It takes the itch away for a few days, and that is exactly the problem. Steroid cream damps down the immune reaction that was holding the fungus at the edge, so the infection spreads while the rash looks better. What returns is bigger, shapeless and harder to recognize. Do not put it on an undiagnosed rash.
Jock Itch
Never use
On its own it is the wrong treatment. It takes the itch away in a day and suppresses the response that was holding the fungus in check, so the rash spreads and loses the clear edge that makes it recognizable. The same goes for combination steroid-antifungal creams. If the itch is genuinely unbearable, ask a doctor, who may add a mild steroid for a few days alongside a real antifungal as a deliberate short-term decision.
Athlete's Foot
Athlete's Foot
Never use
A steroid cream calms the itch, so it feels like it is helping, while the fungus spreads underneath with less to show for it. The rash it leaves is harder to recognize and harder to treat, and it makes a later scraping unreliable. Do not put a steroid on an undiagnosed foot rash.
Ringworm, jock itch and athlete's foot
Makes it worse
It calms the redness while the fungus carries on spreading underneath. That blurs the picture and delays the treatment that would actually clear it.
A reaction while the trigger is still there
Doesn't work
Contact dermatitis clears steadily once the nickel, plant or fragrance behind it is out of the picture. Hydrocortisone alone will not hold it if the contact continues.
Keeping seborrheic dermatitis away
Doesn't work
Redness and flaking around the nose and brows improve on it, but the condition returns without an antifungal cream or a medicated shampoo holding it.
Doesn't work
A rash that has not changed in two weeks | Check the diagnosis, not the dose: A mild rash should be gone or nearly gone by two weeks. If it is unchanged, the diagnosis or the strength needs revisiting rather than the course being extended.

Forms

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Hydrocortisone comes as a cream, ointment, lotion, gel, spray and foam. The drug is the same. The vehicle changes how much gets absorbed, how it feels, and how much it stings.

Ointments are greasy, hold moisture in, and deliver more drug than the same strength cream. They suit dry, thickened or cracked skin. Creams are lighter and easier, the usual everyday choice. Lotions, gels, sprays and foams suit hairy areas and the scalp, though the alcohol in some stings broken skin.

Hydrocortisone is also sold mixed with antifungals and anti-itch additives. Ask a pharmacist before picking a combination off the shelf, because the second ingredient is doing something you may not need.

Strengths

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Every strength here sits in the weakest potency class. Going from 1% to 2.5% is a small step, not the jump to a different steroid.

WeakestStrongest
0.5%1%2.5%
The lowest
0.5%
Over the counter. Fine for mild itch, often not enough for an eczema flare.
The standard over-the-counter strength
1%
What most people mean by hydrocortisone, and the strength studied for mild eczema. Start here.
Prescription
2.5%
Modestly stronger. Used when 1% is not enough but a mid-potency steroid is not wanted, often on the face or in skin folds.

Basics

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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.

Sample Routine

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Here is where Hydrocortisone sits in a day, and what goes around it. Pick what you are treating and what your skin is like, and the rest of the routine changes to suit.

What to Expect

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First few minutes | Applying it
A thin layer on the affected skin. The mildest steroid strength, which is why it is sold over the counter.
Days 1 to 2 | Itch 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 | Clearing
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 | Judge it here
A mild rash should be gone or nearly gone. Contact dermatitis clears steadily once the trigger is gone.
Weeks 2 to 4 | Mild seborrheic dermatitis
Redness and flaking around the nose and brows improve.
After stopping | Marks stay behind
Brown or gray patches where the rash was are pigment change, not scarring. They fade over weeks to months.

What to Avoid

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  • Using it on a rash nobody has looked at Steroids blur ringworm and yeast rashes and let them spread. That is how a simple problem becomes stubborn.
  • Covering it unless you were told to Plastic wrap, a tight bandage or a diaper all count. Occlusion pushes far more drug in and turns a mild steroid strong.
  • Weeks of daily use on thin skin The face, eyelids, groin and armpits are thinnest and absorb most. Short courses are fine there. Months are not.
  • Using it as a moisturizer A steroid does not repair the skin barrier. A plain emollient does, and that is the daily job.
  • Using someone else's prescription tube Potency is not obvious from the label, and someone else's strong steroid used on the face is how the worst thinning happens.
  • Acne, rosacea and perioral dermatitis A steroid settles all three for a few days, then makes them worse.

Monitoring

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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.

If You Stop

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Short courses are stopped outright. No taper, no withdrawal from a week of hydrocortisone. What does happen is relapse. Eczema, seborrheic dermatitis and psoriasis are ongoing conditions, so the rash returns if nothing is holding it. That is the condition coming back, not the cream causing it, which is why a maintenance plan matters more than the steroid's strength. Topical steroid withdrawal is a separate, much less common problem, seen after months or years of near-daily use on the face or genital skin. It looks like burning, stinging and bright redness spreading beyond where the cream went, flaring badly on stopping. It is not a reason to avoid a week of treatment for a rash that needs it. If you have used a steroid daily for months, plan stopping with a clinician rather than quitting abruptly.

Cost

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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.

Ask Your Doctor

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If you are pregnant or breastfeeding
Ask the doctor managing your pregnancy before starting or continuing, including where on the body. If breastfeeding, keep it off the nipple area before a feed.
If the rash has not improved
After about a week, it may not be eczema. Ringworm and yeast rashes get worse with a steroid.
If the skin is weeping or crusted
Weeping, crusting, a golden-yellow color or spreading warmth suggests infection, which needs treating first.
If you are treating a child
Especially under two. Children absorb more for their size, and diaper areas are effectively occluded.
If you need it for more than a week or two
The face, eyelids and genital skin need a plan, not repeat purchases.
If the skin becomes thin or shiny
Easy bruising or small blood vessels appearing mean the same. Stop and get it looked at.
If pale patches appear on treated skin
Steroids can lighten skin, and it shows more on deeper skin tones. It usually recovers slowly, but get it assessed.
If you get swelling, hives or wheezing
Any change in breathing needs emergency care.

How It Compares

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DesonideDiagram: how Desonide works in the skin
Desonide 0.05%
Different job
One step up in potency and still mild enough for the face and for children. Prescription only, so it is the usual next move when hydrocortisone is not enough.
Triamcinolone AcetonideDiagram: how Triamcinolone Acetonide works in the skin
Triamcinolone acetonide 0.1%
Different job
Mid-potency, and much more effective on body eczema and thicker rashes. Not a face or skin-fold treatment for more than a very short course.
Emollients and moisturizers
Different job
They do not clear a flare, but they reduce how often flares happen and how much steroid is needed overall. The two are partners, not alternatives.
Tacrolimus and pimecrolimus
The same
These calm the same kind of inflammation without causing thinning, which makes them useful on eyelids and folds for long-term control. They burn or sting for the first week or two and cost more.
CrisaboroleDiagram: how Crisaborole (Eucrisa) works in the skin
Crisaborole
The same
A non-steroid option for mild to moderate eczema. Gentler on thin skin, commonly stings on application, and more expensive.
Antifungal creams
Different job
For the rashes they treat, which is the point. If the problem is ringworm or a yeast rash in a fold, a steroid is the wrong drug and an antifungal is the right one.

Myths

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  • "All steroid creams thin your skin." Thinning depends on dose, potency, site and time — strong steroids for long stretches on thin skin, not a week of 1% on an arm. Early thinning usually recovers over months. Stretch marks do not.
  • "The percentage tells you how strong it is." It does not. Potency comes from the molecule and the vehicle. Hydrocortisone 2.5% is among the weakest steroids made; clobetasol 0.05% is the strongest.
  • "Over the counter means safe anywhere, for as long as I like." Being sold without a prescription tells you about potency, not site or duration. Months of daily use on eyelids or in the groin still causes damage.
  • "Hydrocortisone cures eczema." It clears a flare. Eczema is ongoing, and what keeps it quiet between flares is regular moisturizer and avoiding triggers.
  • "Use as little as possible." Undertreating is the more common mistake. A rash treated properly for a short time needs less steroid overall than one smoldering for months.

Questions Patients Ask

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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.

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.

Is 1% strong?

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

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.

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.

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.

References

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