Hydrocortisone for Facial Eczema: Usage and Side Effects | MyEczemaTeam

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Hydrocortisone for Facial Eczema: Usage and Side Effects

Medically reviewed by Jazmin N. McSwain, PharmD, BCPS
Posted on September 11, 2023

If you’re living with facial eczema, you’re no stranger to the discoloration, dryness, itching, and swelling that can make life uncomfortable and frustrating. It’s not just that it’s visible to everyone — your facial skin’s sensitivity means even mild inflammation can bring discomfort and itchiness.

Hydrocortisone is a treatment option for facial eczema. But with so many different types of hydrocortisone, it can be hard to know which products you should use. After reading this article, you should feel more confident about speaking to your dermatologist about the different types of hydrocortisone that are available, how to use it, and the side effects.

What Is Hydrocortisone?

Hydrocortisone is an anti-inflammatory medication that can help treat skin conditions that cause itching, discoloration, and swelling. It belongs to a group of medications called corticosteroids (steroids). When it’s applied to the skin, it’s known as a topical steroid. Steroids can be used to temporarily relieve itching associated with many different conditions, such as:

  • Atopic dermatitis — The most common form of eczema
  • Seborrheic dermatitis — A type of eczema that causes greasy scales and itchy, flaky patches on the skin and scalp
  • Psoriasis — A skin disease that causes a rash with itchy, scaly patches
  • Insect bites
  • Poison ivy
  • Contact dermatitis — Itchy rash caused by direct contact with a substance or allergen

Hydrocortisone decreases inflammation in the area of the skin where it’s applied. It works by calming your body’s immune response, which helps ease pain, itching, and inflammation.

Types of Hydrocortisone Products

You can find hydrocortisone in many different products available with and without a prescription. Some common brand names of over-the-counter (OTC) topical hydrocortisone products include:

  • Aquaphor Itch Relief
  • Cortaid
  • Cortizone-10
  • Cetacort
  • Gelmicin

Many other OTC products are available for eczema on the face. Check the active ingredients on the drug facts label of the product to see if it contains hydrocortisone. If you’re not sure whether you can use a product on your face or other part of your body, talk to your doctor or pharmacist.

You and your dermatologist may pick a product based on the strength or type of formulation. Talk to your dermatology provider about the best product for your skin.

Strength

The strength of a topical hydrocortisone product refers to the amount of hydrocortisone it contains, measured as a percentage of its ingredients. Strength is different from potency, which refers to the anti-inflammatory effect of the drug.

Hydrocortisone 1 percent is the strongest type of OTC topical steroid available in the United States. This is considered a low-potency topical steroid (not as strong as others) because it has a relatively lower anti-inflammatory effect.

Other types of topical hydrocortisone and other strengths are more potent and require a prescription, including:

  • Hydrocortisone 2.5 percent cream, lotion, ointment, or solution
  • Hydrocortisone valerate 0.2 percent cream or ointment
  • Hydrocortisone butyrate 0.1 percent cream, lotion, ointment, or solution
  • Hydrocortisone probutate 0.1 percent cream

Hydrocortisone Formulation

Hydrocortisone is available as a cream, lotion, ointment, or solution. Hydrocortisone’s anti-inflammatory properties make it a go-to treatment for soothing the discomfort and discoloration caused by facial eczema. It brings your skin back to its normal healthy state.

Creams are a popular formulation of hydrocortisone and can be used on most areas of your skin. They are a mixture of water and oils. Creams can provide moisture while also being absorbed into the skin without leaving a residue. However, creams often contain preservatives that could cause irritation or an allergic reaction in some people with eczema.

Lotions are usually less greasy than creams. Lotions can be a good choice for areas with hair because they are easily absorbed and don’t leave a residue.

Ointments are usually thick and greasy. Because most ointments don’t need a preservative, they may be a good choice if your skin is sensitive to preservatives. However, you’ll want to avoid using ointments in areas of the skin with hair because it can cause skin problems like folliculitis (inflammation of a hair follicle) and miliaria (inflammation of a sweat gland).

A solution is the thinnest formulation containing hydrocortisone. It can be used in areas with hair but may be drying and cause stinging.

How Should You Use Hydrocortisone on Your Face?

You should only apply topical hydrocortisone externally — don’t put it in your mouth, nose, or eyes. If you get any medication in your eyes, immediately rinse them with cool water. Don’t apply topical hydrocortisone more or less often than instructed. Make sure to wash your hands before and after applying the medication.

Use hydrocortisone exactly as your dermatologist instructs, and follow the directions on the medication label. You will usually apply a thin layer to the affected area one to four times daily and rub gently. You should apply it around the same time each day.

When you use hydrocortisone on your face, your dermatologist may advise you to use it just once a day, so it may be best to apply it at night after washing your face.

How Much Medication Should You Use?

It can be difficult to know how much medication you need to apply to the affected area of skin. Dermatologists have developed the fingertip unit measurement to help you figure out how much medication you need. One fingertip unit is the amount of medication squeezed from your fingertip to the first crease of your finger.

A good rule of thumb is to use half of a fingertip unit to cover an area the size of your hand. To cover your entire face and neck, you should need about two and a half fingertip units of medication.

How Long Should You Use Hydrocortisone?

You should use hydrocortisone only as long as instructed by your doctor or dermatologist. If you don’t see any improvement, you shouldn’t just keep using it. As one MyEczemaTeam member noted, “More is definitely not better when it comes to steroid creams.”

If you use a topical corticosteroid like hydrocortisone too long or too often, it won’t work as well. Additionally, if you use it for too long, you may increase your risk of side effects (e.g. skin-color changes, unwanted hair growth). To avoid side effects, your doctor may instruct you to use hydrocortisone in short bursts of one or two weeks at a time.

If your doctor prescribed hydrocortisone, you should contact them if you don’t see any improvement in your eczema flare after two weeks. If you haven’t spoken to your doctor yet and have been using an OTC hydrocortisone product, contact them if you don’t see any improvement after one week.

What Are the Risks of Hydrocortisone for Facial Eczema?

The skin on your face is very sensitive and can be more susceptible to the side effects of hydrocortisone.

Like other eczema treatments, hydrocortisone can cause side effects. Possible side effects of hydrocortisone include:

  • Dryness
  • Cracked skin
  • Acne
  • Burning, itching, or stinging
  • Changes in your skin color
  • Skin irritation
  • Skin infection

With long-term use of hydrocortisone, you may notice more serious side effects, such as:

  • Skin that appears thinner or more fragile
  • Easy bruising
  • Blood vessels that appear larger
  • Increased hair growth
  • Stretch marks

Before Using Hydrocortisone for Facial Eczema

If you have eczema on your face, talk to your dermatologist about finding the right treatment for your eczema. Even though many hydrocortisone products are available without a prescription, you might experience side effects that make your condition worse. To be safe, your dermatologist may want to make sure you don’t react to the ingredients in a hydrocortisone product by doing a patch test on other areas of your skin.

Talk With Others Who Understand

MyEczemaTeam is the social network for people with eczema and their loved ones. On MyEczemaTeam, more than 48,000 members come together to ask questions, give advice, and share their stories with others who understand life with eczema.

Have you used hydrocortisone to treat your facial eczema? Did you have any side effects? Share your experience in the comments below, or start a conversation by posting on your Activities page.

Posted on September 11, 2023
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Jazmin N. McSwain, PharmD, BCPS completed pharmacy school at the University of South Florida College of Pharmacy and residency training at Bay Pines Veterans Affairs. Learn more about her here.
Amanda Jacot, PharmD earned a Bachelor of Science in biology from the University of Texas at Austin in 2009 and a Doctor of Pharmacy from the University of Texas College of Pharmacy in 2014. Learn more about her here.

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