Hydrocortisone topical cream side effects: A detailed guide

This article describes possible side effects of hydrocortisone topical cream. You can explore this overview article to learn more about hydrocortisone, including the drug’s uses, side effects, ways to save on cost, and more.

Hydrocortisone topical cream is a generic version of the brand-name drug Ala-Cort. Hydrocortisone also comes in several other forms, but these forms aren’t described in this article. To learn more about these forms, talk with your doctor.

More common side effects of hydrocortisone

Hydrocortisone topical cream may cause mild or serious side effects. Below are some of the more common side effects of this medication.

Commonly reported side effects of hydrocortisone topical cream include:

• burning
• dryness
• folliculitis (infection or inflammation of the hair follicles)
• irritation
• itching

Mild side effects of hydrocortisone

Hydrocortisone may cause certain mild side effects. Usually, mild side effects are temporary and can be easily managed. Tell your doctor or pharmacist if you have side effects that don’t go away or become bothersome.

Mild side effects of hydrocortisone topical cream that occurred in studies include:

• acne
• burning
• dryness
• folliculitis (infection or inflammation of the hair follicles)
• irritation
• itching
• unwanted hair growth
• mild allergic reaction*†

* To learn more about this side effect, see the “Side effects of hydrocortisone in detail” section below.

† An allergic reaction is possible with hydrocortisone topical cream. But it wasn’t reported in the drug’s studies.

Hydrocortisone topical cream may cause more mild side effects than those listed above. For details, see the drug’s prescribing information.

Serious side effects of hydrocortisone

Hydrocortisone may cause certain serious side effects. If you have any serious side effects from hydrocortisone topical cream, call your doctor right away. But if you think you’re having a medical emergency or your side effects feel life threatening, take immediate action. Call 911 or a local emergency number, or go to the nearest emergency room.

After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Visit MedWatch’s website if you’d like to notify the FDA about a side effect you’ve had with hydrocortisone.

Serious side effects of hydrocortisone topical cream that occurred in studies include:

• adrenal insufficiency*
• blockage of the sweat glands, which causes a rash
• Cushing syndrome*
• increased blood sugar levels
• increased risk of skin infection
• permanent skin changes, such as stretch marks or loss of skin color
• skin thinning or breakdown
• slowed growth in children*
• severe allergic reaction*†

* To learn more about these side effects, see the “Side effects of hydrocortisone in detail” section below.

† An allergic reaction is possible with hydrocortisone topical cream. But it wasn’t reported in the drug’s studies.

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Common questions about side effects of hydrocortisone

Here are answers to some common questions about side effects of hydrocortisone topical cream. If you have other questions, talk with your doctor or pharmacist.

How do side effects of hydrocortisone topical cream compare with those seen with hydrocortisone oral tablet?

In general, the side effects of hydrocortisone topical cream are fewer and less serious than those seen with the oral tablet. The reason for this is the way you use the two different dosage forms. You apply the topical cream on your skin. With short-term use, your skin does not absorb a lot of the drug. So most of the side effects are limited to the site where you apply it.

On the other hand, you take the oral tablet by mouth. When you swallow a drug, your body absorbs it, and it circulates throughout your body. So the oral tablet can have side effects that affect all parts of your body. Examples of some serious side effects that can happen with the oral tablet include thinning bones and high blood pressure. These side effects usually aren’t a problem with the topical cream unless you use it for a long time or over large areas of your body.

You can learn more about the side effects of hydrocortisone oral tablet by talking with your doctor or pharmacist.

Does hydrocortisone cause long-term side effects?

Yes, in some cases hydrocortisone topical cream may cause long-term side effects. These can occur if you take the drug for a long time or last for a while after you’ve stopped taking the drug.

Examples of long-term side effects reported with hydrocortisone topical cream include:

• adrenal insufficiency (when the adrenal glands do not make enough cortisol)*
• blockage of the sweat glands, which causes a rash
• Cushing syndrome (high levels of cortisol)*
• increased blood sugar levels
• increased risk of skin infection
• permanent skin changes, such as stretch marks or loss of skin color
• skin thinning or breakdown
• slowed growth in children*
• unwanted hair growth

* To learn more about these side effects, see the “Side effects of hydrocortisone in detail” section below.

Talk with your doctor to learn more about these side effects and how to manage them. Ask your doctor for more information about how long these side effects of hydrocortisone may last.

Side effects of hydrocortisone in detail

Below you’ll find details on some of the side effects of hydrocortisone topical cream.

Cushing syndrome

In studies, Cushing syndrome (high levels of cortisol) was seen in people using hydrocortisone topical cream. This side effect may be serious.

Cushing syndrome can happen when your skin absorbs a lot of hydrocortisone. This causes high levels of hydrocortisone in your blood. Hydrocortisone acts like the hormone cortisol. A hormone is a chemical substance that carries messages in the body. Cortisol is the hormone that helps your body respond to stress. So high levels of hydrocortisone can cause the same symptoms that would be seen in someone with too much cortisol. These symptoms can include:

• fatty hump between the shoulders
• mood swings
• round, full face
• skin problems
• weight gain, especially around the belly

Certain factors can increase the risk of Cushing syndrome with hydrocortisone topical cream. These include:

• applying it over large areas
• placing a dressing over the area that seals out air and water
• using it for a long time

Ways to manage

If you experience symptoms of Cushing syndrome, tell your doctor right away. They’ll likely recommend slowly taking a break from treatment, applying it less often, or using a different topical corticosteroid.

Adrenal insufficiency

In studies, adrenal insufficiency was seen in people using hydrocortisone topical cream. This side effect may be serious.

With adrenal insufficiency, your adrenal glands do not make enough cortisol. Cortisol is a hormone that helps your body respond to stress. (A hormone is a chemical substance that carries messages in the body.) Adrenal insufficiency can happen if your skin absorbs a lot of hydrocortisone. This causes high levels of hydrocortisone in your blood. High levels of hydrocortisone cause your adrenal glands to shut down and stop making cortisol. As long as you are using hydrocortisone, you may not have any symptoms of adrenal insufficiency because the hydrocortisone is acting like cortisol. But if you stop using hydrocortisone suddenly, symptoms can develop.

Symptoms may include:

• fatigue (low energy)
• loss of appetite
• muscle weakness
• nausea or vomiting
• weight loss

Certain factors can increase the risk of adrenal insufficiency with hydrocortisone topical cream. These include:

• applying it over large areas
• placing a dressing over the area that seals out air and water
• using it for a long time

Ways to manage

If you’ll be using hydrocortisone topical cream in any of the ways listed above, your doctor may order a test to check your adrenal gland function from time to time. If there’s a problem, your doctor may recommend slowly taking a break from treatment, applying it less often, or using a different topical corticosteroid. If you experience symptoms of adrenal insufficiency after you stop hydrocortisone, tell your doctor right away.

Slowed growth in children

In studies, slowed growth was seen in children using hydrocortisone topical cream. This side effect may be serious.

Children absorb more hydrocortisone topical cream than adults. This puts them at higher risk of side effects that affect the whole body, including adrenal insufficiency and Cushing syndrome. If children develop adrenal insufficiency, it can affect their growth. Symptoms may include not growing as tall as they should and not gaining the usual amount of weight.

Certain factors can increase the risk of slowed growth in children with hydrocortisone topical cream. These include:

• applying it over large areas
• placing a dressing over the area that seals out air and water
• using it for a long time

Ways to manage

If a child needs to use hydrocortisone topical cream, doctors usually prescribe the smallest amount that effectively treats the condition. They also try to limit it to short-term use. If you have concerns about slowed growth in a child, tell your doctor. They’ll likely recommend monitoring their growth and development closely.

Allergic reaction

For some people, hydrocortisone topical cream can cause an allergic reaction.

Symptoms can be mild or serious, and they may include:

• itchiness
• skin rash
• swelling under the skin, usually affecting eyelids, lips, hands, or feet
• swelling of the mouth, tongue, or throat, which can make it hard to breathe
• flushing (temporary warmth, redness, or deepening of skin color)

Ways to manage

For mild allergic reaction symptoms, such as a mild rash, call your doctor right away. They may recommend treatments to help manage your symptoms. They’ll also let you know whether you should keep taking the medication.

For severe allergic reaction symptoms, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms require immediate medical care because they can become life threatening. If you’ve had a serious allergic reaction to hydrocortisone topical cream, your doctor may recommend taking a different medication instead.

Warnings for hydrocortisone

Below are some factors you may want to discuss with your doctor before taking hydrocortisone topical cream.

Warnings

It may not be safe for you to take hydrocortisone topical cream if you have specific health conditions. These are sometimes called drug-condition interactions. Other things may also affect whether hydrocortisone topical cream is a safe treatment option for you.

Before taking hydrocortisone topical cream, tell your doctor about your health and medications you take. Things to consider include:

• Cushing syndrome
• diabetes
• past allergic reaction to hydrocortisone

Hydrocortisone and pregnancy

It’s not known whether hydrocortisone topical cream should be used during pregnancy. If you’re planning a pregnancy or can become pregnant, talk with your doctor before using this medication.

Hydrocortisone and breastfeeding

It’s not known whether hydrocortisone topical cream should be used while breastfeeding. If you’re breastfeeding or planning to do so, talk with your doctor before using this medication.

Hydrocortisone and alcohol

Hydrocortisone topical cream is not known to interact with alcohol.

If you drink alcohol, talk with your doctor about whether it’s safe to consume it during your treatment with hydrocortisone topical cream.

What to ask your doctor

This article describes common and serious side effects of hydrocortisone topical cream. If your doctor prescribes this medication, they can discuss possible side effects with you. Let your doctor know if you have concerns or questions about treatment with this medication.

Here’s a list of some possible questions you may want to ask your doctor:

• How should I apply hydrocortisone topical cream?
• How long will I need to use hydrocortisone topical cream?
• How do the side effects of hydrocortisone topical cream compare with other topical steroids?
• What can I do to prevent side effects with hydrocortisone topical cream?
• Do other forms of topical hydrocortisone cause the same side effects?

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.