What is Hydrocortisone: Uses, Warnings & Interactions

Updated May 14, 2025  •  Published Dec 30, 2020

Hydrocortisone is a generic corticosteroid that treats inflammation. Topical hydrocortisone is widely available in over-the-counter formulations to treat minor skin problems like irritation, itch, and other issues. As a prescription drug, hydrocortisone is available in topical, oral, and rectal formulations to treat more serious medical conditions such as rheumatoid arthritis, psoriasis, or inflammatory bowel disease.

Hydrocortisone overview

BRAND NAMES:

  • Ala-Scalp, Alkindi Sprinkle (oral granules), Anusol HC, Cortizone-10, Cortef (tablet), Cortenema (enema), Hydroxym (Rx), Procto-Med HC (Rx), Scalpicin, Texacort (Rx), Alacort, Aloe Cort, Ana-Cool, Barmicil, CliniCalm, Dermacort, FixMySkin, Hydrocort. Hydroskin, Hydroxate Gel (Rx), Kera HC, Procto-Zone HC (Rx), Skin A Cool, Total Relief Shampoo

Generic Names:

  • Hydrocortisone

Uses:

  • Topical hydrocortisone relieves skin irritation, itchy skin, eczema, and other types of minor skin problems. Oral hydrocortisone treats adrenal gland insufficiency and inflammatory diseases or reactions of the skin, joints, blood, eyes, and digestive system. Hydrocortisone enemas are used for inflammatory bowel disease.

Therapeutic Classes:

  • Anti-Inflammatory, corticosteroid, glucocorticoid

Forms:

  • Cream, gel, ointment, lotion, spray, liquid, lip balm, shampoo, tablet, oral granules, rectal suspension (enema)

How it’s taken:

  • On the skin, by mouth, administered through the rectum

What is Hydrocortisone used for?

Nonprescription, topical hydrocortisone treats mild skin problems like irritation, itchiness, eczema, bug bites, and similar complaints. Prescription hydrocortisone treats a wide spectrum of inflammatory conditions, including autoimmune diseases, asthma, allergies, infections, arthritis, and similar medical conditions.

What form(s) does Hydrocortisone come in

  • Cream

    • 0.5%

    • 1%

    • 2% (Rx)

    • 2.5% (Rx)

  • Gel

    • 1%

    • 2% (Rx)

  • Liquid

    • 1%

    • 2.5% (Rx)

  • Ointment

    • 1%

  • Lotion

    • 1%

  • Spray

    • 1%

  • Lip balm

    • 0.5%

    • 1%

  • Shampoo

    • 1%

  • Tablet 

    • 5 mg

    • 10 mg

    • 20 mg

  • Oral granules

    • 0.5 mg

    • 1 mg

    • 2 mg

    • 5 mg

  • Rectal suspension (enema)

    • 100 mg/dose (60 mL)

What are common Hydrocortisone doses?

  • For minor skin irritation, itch, and swelling: Apply a thin layer or spray to the affected area two to four times daily

  • For itchy scalp: Shampoo once per day or apply hydrocortisone liquid to the scalp up to four times per day

  • For inflammatory conditions (Rx tablets): Doses will vary depending on the type and severity of the condition 

  • For adrenal insufficiency (Rx tablets):

    • In adults: 15–25 mg daily divided into two or three divided doses

    • In children: 8–10 mg/m^2 daily divided into two or three divided doses

  • For inflammatory bowel disease (Rx enema): One enema daily for 21 days or clinical remission, whichever comes first

Common Hydrocortisone prescriptions

  • Hydrocortisone
    59ml of 2.5% bottle

  • Hydrocortisone
    60ml of 100mg/60ml bottle

  • Hydrocortisone
    453.6gm of 1% jar

  • Hydrocortisone
    453.6gm of 2.5% jar

  • Hydrocortisone
    454gm of 1% jar

  • Hydrocortisone
    454gm of 2.5% jar

  • Hydrocortisone
    1.5gm of 1% packet

  • Hydrocortisone
    10mg tablet

  • Hydrocortisone
    20mg tablet

  • Hydrocortisone
    5mg tablet

  • Hydrocortisone
    28.35gm of 0.5% tube

  • Hydrocortisone
    28.35gm of 1% tube

  • Hydrocortisone
    28.35gm of 2.5% tube

  • Hydrocortisone
    28.4gm of 1% tube

  • Hydrocortisone
    28gm of 1% tube

  • Hydrocortisone
    28gm of 2.5% tube

  • Hydrocortisone
    30gm of 1% tube

  • Hydrocortisone
    30gm of 2.5% tube

  • Hydrocortisone
    20gm of 2.5% tube of cream

  • Hydrocortisone
    28.35gm of 0.5% tube of cream

  • Hydrocortisone
    28.35gm of 1% tube of cream

  • Hydrocortisone
    28.4gm of 1% tube of cream

  • Hydrocortisone
    28gm of 1% tube of cream

  • Hydrocortisone
    30gm of 2.5% tube of cream

  • Hydrocortisone
    20gm of 2.5% tube of ointment

  • Hydrocortisone
    28.35gm of 1% tube of ointment

  • Hydrocortisone
    28.4gm of 1% tube of ointment

  • Hydrocortisone
    28gm of 1% tube of ointment

  • Hydrocortisone
    30gm of 0.5% tube of ointment

  • Hydrocortisone
    30gm of 1% tube of ointment

How to take Hydrocortisone

  • Wash your hands with soap and water before and after applying topical hydrocortisone.

  • How to use hydrocortisone cream, gel, lotion, or liquid:

    • This medicine is for use on the skin only. Do not get it in your eyes, nose, or mouth. 

    • Follow the instructions on the medicine label if you are using this medicine without a prescription. Do not use more than four times a day.

    • For prescription hydrocortisone, follow the healthcare provider’s instructions. Doses will be applied two to four times per day.

    • Read and follow any patient instructions or package instructions included with the medicine.

    • Apply a thin layer of the medicine to the affected area. Rub it in gently.

    • Do not cover the treated area with a bandage unless directed by your healthcare provider. Do not cover the treated skin with tight-fitting diapers or plastic pants if you are using this medicine on a child's diaper area.

  • How to use hydrocortisone anti-itch scalp liquid:

    • Use the bottle to apply liquid to the affected area of the scalp.

    • Massage the liquid into the scalp.

    • Use up to four times a day as needed.

  • How to use hydrocortisone shampoo:

    • Wet the hair.

    • Apply shampoo.

    • Lather the hair.

    • Rinse.

  • How to use hydrocortisone aerosol spray:

    • Shake the aerosol can just before using. 

    • Hold the can 3 to 6 inches from the affected skin and spray for about 2 seconds. 

    • To apply to your face, spray into the palm of your hand and rub in gently.

    • Do not inhale this medicine or use it near heat or an open flame. Do not puncture, break, or burn the aerosol can.

  • How to take hydrocortisone tablets:

    • Follow the healthcare provider’s instructions. You may be instructed to take each day’s dose in the morning.

    • Take with a meal to minimize digestive system issues.

    • Take hydrocortisone tablets with a full glass of water.

    • Tablets can be crushed and mixed with liquid for easier dosing.

  • How to administer hydrocortisone granules:

    • Hydrocortisone granules come in the form of a capsule.

    • Open the capsule. The capsule should never be swallowed.

    • You can pour the capsule contents directly onto the person’s tongue, put the contents in a spoon and give it that way, or sprinkle the contents onto cold or room temperature soft food such as yogurt. 

    • When sprinkled on food, the dose must be taken within five minutes.

    • The person should immediately drink water, milk, or breast milk after a dose has been given.

  • How to administer a hydrocortisone enema:

    • Read and follow the patient instructions that come with this medicine. Talk to your healthcare provider or pharmacist if you have any questions. 

    • Make sure to mix the bottle well before administering a dose.

What to do if you miss a dose of Hydrocortisone

  • For over-the-counter topical hydrocortisone, apply a dose as soon as you can if needed. Do not apply more than four doses per day.

  • For prescription hydrocortisone, ask the healthcare provider or pharmacist what to do in case a dose is missed.

Hydrocortisone contraindications

  • This medicine is not right for everyone. 

  • Do not use it if you have had an allergic reaction to hydrocortisone.

  • Prescription hydrocortisone tablets and rectal suspension are never used in people with systemic fungal infections.

  • Prescription hydrocortisone rectal suspension is never used in anyone who has recently undergone a colon operation called an ileocolostomy.

Hydrocortisone warnings

  • Tell any healthcare provider who treats you that you are using this medicine.

  • Stop using over-the-counter hydrocortisone and call a healthcare provider if:

    • Symptoms do not improve after seven days

    • Symptoms come back

    • The condition worsens

    • You experience rectal bleeding

  • If over-the-counter hydrocortisone is swallowed, get medical help or call a poison control helpline.

  • For prescription hydrocortisone, tell the healthcare provider if you are pregnant, breastfeeding, or have:

    • A history of tuberculosis

    • Past or present hepatitis B infection

    • Past or present herpes infection of the eye

    • Other infections

    • Underactive thyroid

    • Liver cirrhosis

  • Prescription hydrocortisone can cause a number of very serious side effects including:

    • Adrenal gland problems

    • Electrolyte imbalances

    • Heart failure

    • High blood pressure

    • High blood sugar levels

    • Stomach ulcers

    • Pancreatitis

    • Tendon rupture

    • Compression fractures

    • Osteoporosis

    • Increased pressure in the head

    • Seizures

    • Impaired wound healing

    • Loss of muscle mass

    • Cataracts

    • Glaucoma

  • Do not stop taking hydrocortisone tablets until you talk to the healthcare provider. Prescription hydrocortisone may cause adrenal gland problems, requiring that the dose be gradually tapered.

  • Prescription hydrocortisone may cause you to get infections more easily.

  • Prescription hydrocortisone may delay growth in children. If you think your child is not growing properly while using this medicine, talk with your healthcare provider.

  • Do not use prescription topical hydrocortisone to treat a skin problem your healthcare provider has not examined.

  • Keep all forms of hydrocortisone securely out of the reach of children.

Hydrocortisone interactions

  • Over-the-counter hydrocortisone should not cause problems with other drugs.

  • Do not use any other hydrocortisone product if you’re using over-the-counter hydrocortisone.

  • Tell healthcare providers you are using OTC or prescription hydrocortisone. The drug may interfere with some blood tests.

  • For prescription hydrocortisone, tell the prescribing healthcare provider about all prescription drugs, over-the-counter medicines, and supplements you are using, particularly other corticosteroids.

Hydrocortisone side effects

Serious side effects

Talk to a healthcare provider if you notice any signs or symptoms of a possible serious side effect of topical hydrocortisone, including:

  • Burning, peeling, or crusting of the treated skin

  • Skin that’s getting thinner and bruises easily

  • Red, pus-filled bumps

  • Skin redness, pain, swelling, and warmth

  • Allergic reaction: Itching or hives, swelling in your face or hands, chest tightness, trouble breathing

Talk to a healthcare provider if you notice any signs or symptoms of a possible serious side effect of systemic hydrocortisone, including:

  • Rapid weight gain around your neck, upper back, breast, face, or waist

  • Dark freckles, skin color changes, coldness, weakness, tiredness, nausea, vomiting, weight loss

  • Blood in the stool, black and tarry stools, blood or blood clots in the vomit, abdominal pain

  • Muscle pain, weakness, muscle wasting

  • Vision changes

  • Sudden headache, vision changes

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing

Less serious side effects of topical hydrocortisone

  • Burning, itching, irritation, dryness

  • Poor healing of skin

Less serious side effects of oral hydrocortisone

  • Fever

  • Vomiting

  • Diarrhea

  • Infections

Sources:

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