If you’re living with facial eczema, you know how the discoloration, dryness, itching, and swelling can make life uncomfortable. It’s not just about appearance — the skin on your face is more sensitive, so even mild inflammation can bring major discomfort.

Hydrocortisone is one treatment option for facial eczema. But with several types available, it can be hard to know which one to use. This article can help you feel more confident when talking with your dermatologist. Together, you can explore the types of hydrocortisone, how to use them, and what side effects to watch for.

What Is Hydrocortisone?

As an anti-inflammatory medication, hydrocortisone can help treat skin conditions that cause itching, discoloration, and swelling. Hydrocortisone belongs to a group of medications called corticosteroids (steroids).

Topical steroids — those applied to the skin — are used to temporarily relieve itching caused by 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 itchy, scaly patches
• Insect bites
• Poison ivy
• Contact dermatitis — An itchy rash caused by touching a substance or allergen

Hydrocortisone works by calming your body’s immune response. This helps reduce inflammation, itching, and pain where it’s applied.

Types of Hydrocortisone Products

You can find hydrocortisone in many forms, both over the counter (OTC) and by prescription. Common OTC brand names include:

• Aquaphor Itch Relief Ointment
• Aveeno 1% Hydrocortisone Anti-Itch Cream
• Cortaid
• Cortizone-10

Many other OTC products can be used for facial eczema. Check the active ingredients listed on the drug facts label to see if a product contains hydrocortisone. If you’re not sure whether a product is safe to use on your face or another part of your body, ask your doctor or pharmacist.

Talk with your dermatologist (skin doctor) about the best product for your skin. You and your doctor may choose a product based on its strength or type of formulation.

Strength

The strength of a hydrocortisone product refers to the amount of hydrocortisone it contains, measured as a percentage of its ingredients. Strength is different from potency, which describes how strongly the drug reduces inflammation.

Hydrocortisone 1 percent is the strongest OTC topical steroid available in the United States. It’s considered low potency, meaning it has a relatively lower anti-inflammatory effect.

Prescription hydrocortisone products may have higher strengths and be more potent. For example, hydrocortisone 2.5 percent is available only by prescription. Prescription-strength forms include hydrocortisone valerate, hydrocortisone butyrate, and hydrocortisone probutate.

Hydrocortisone Formulation

Hydrocortisone comes as creams, lotions, ointments, and solutions. All forms can help reduce itching, inflammation, and discoloration caused by facial eczema.

Creams, a mixture of water and oil, are the most popular formulation. They moisturize well and absorb into the skin. However, creams often contain preservatives that could irritate eczema-prone skin or cause allergic reactions in some people.

Lotions are lighter and less greasy than creams. They can be a good choice for areas with body hair because they absorb quickly and don’t leave a residue.

Ointments are thick and greasy and may leave a residue. They usually don’t contain preservatives, which makes them a good option for sensitive skin. However, they can clog hair follicles and sweat glands, especially on hairy areas, and may lead to skin issues like folliculitis (inflamed hair follicles) or miliaria (blocked sweat glands).

Solutions are the thinnest forms and work well on hairy areas. However, they 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. Avoid areas with eczema around your eyes unless your healthcare provider says otherwise. If the medication gets in your eyes, immediately rinse them with cool water.

Use topical hydrocortisone only as directed by your dermatologist or as instructed on the product label — don’t apply more or less. Wash your hands before and after applying the medication.

Only use hydrocortisone on your face under a healthcare provider’s supervision. Facial skin is especially sensitive and can absorb medications more easily than other areas do. You’ll usually apply a thin layer to the affected area one to four times daily, gently rubbing it in. Try to apply it around the same time each day.

Your dermatologist may advise you to use it just once a day — often at night, after washing your face.

How Much Medication Should You Use?

It can be hard to know how much of a product to use. Dermatologists use a simple guide called the fingertip unit — the amount of medication squeezed from the tip of your finger to the first crease.

Half a fingertip unit usually covers an area the size of your hand. To cover your entire face and neck, use about two and a half fingertip units.

How Long Should You Use Hydrocortisone?

Use hydrocortisone only as long as your healthcare provider recommends. Let your doctor know if your eczema isn’t improving — they may suggest stopping or changing your treatment. “More is definitely not better when it comes to steroid creams,” one MyEczemaTeam member noted.

If you use a topical corticosteroid too long or too often, it won’t work as well. Overuse may also increase your risk of side effects, such as:

• Skin thinning
• Changes in skin color
• Unwanted hair growth

To avoid side effects, your doctor may recommend short bursts of treatment, perhaps one or two weeks at a time.

If your doctor prescribed hydrocortisone, check in with them if your eczema hasn’t improved after two weeks. If you’re using an OTC hydrocortisone product and it hasn’t helped after one week, talk with your doctor before continuing.

Tips for Using Hydrocortisone on Facial Eczema

Work closely with your doctor or dermatologist when using hydrocortisone on your face. These tips can help you use the medication safely and effectively:

• Read the label carefully before using the product.
• Follow your doctor’s instructions exactly.
• Don’t use hydrocortisone on your face for more than three months unless your doctor tells you to.
• Avoid your eyes and mouth while applying the product.
• Rub your skin gently while applying the product.
• Use a reminder or timer to help you apply it at the same time every day.

What Are the Risks of Hydrocortisone for Facial Eczema?

The skin on your face is very sensitive, making it more likely to react to hydrocortisone.

Like other eczema treatments, corticosteroids 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

Long-term use may cause more serious side effects, such as:

• Thinner or more fragile skin
• Easy bruising
• Enlarged blood vessels
• Increased hair growth
• Stretch marks

Rarely, long-term use or high doses of hydrocortisone can lead to systemic (whole-body) side effects, such as adrenal suppression (low hormone production from the adrenal glands). Using topical steroids near your eyes can also increase the risk of cataracts or glaucoma.

Before Using Hydrocortisone for Facial Eczema

Talk with your dermatologist before using hydrocortisone on your face. Even though many products are sold without a prescription, they can still cause side effects or make your eczema worse.

Your dermatologist may suggest testing a product to make sure it’s safe for your skin. Apply a small amount to the same small spot of skin twice a day for seven to 10 days. If your skin doesn’t become discolored, itchy, or swollen, the product is likely safe to use.

With your healthcare provider’s guidance, hydrocortisone may be a helpful part of your eczema care plan — especially when used carefully and for the right amount of time.

Talk With Others Who Understand

On MyEczemaTeam, the social network for people with eczema and their loved ones, 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 develop any side effects? Share your experience in the comments below, or start a conversation by posting on your Activities page.