Hydrocortisone creams, lotions, or ointments are topical (applied on the skin) medications containing hydrocortisone, a type of corticosteroid (1). The cream is used for relieving itching, redness, and swelling of the skin.
These creams are usually available over the counter. However, it is best to consult a pediatrician before using them for babies since medically unsupervised use of hydrocortisone has the potential to cause side effects.
Read this post to know more about the uses, dosage, cautions, benefits, side effects, and other common queries about using hydrocortisone creams for babies.
Is Hydrocortisone Cream Safe For Babies?
Mild doses of hydrocortisone creams used as per the doctor’s direction are unlikely to cause any side effects. The use of hydrocortisone without a doctor’s supervision may lead to undesired effects.
Possible side effects of hydrocortisone cream due to inappropriate use may include (2):
- Redness of the skin
- Possible spread of untreated infection from the affected area of skin to unaffected areas
- The skin may become thin after long-term use
- The skin may become lighter during treatment
- The skin may become dry and flaky
In some rare cases, topical steroid cream can get absorbed into the bloodstream, primarily through damaged skin (wounds) and may cause side effects. Adrenal gland suppression and high blood sugar are the side effects of steroids, and these may cause the following signs and symptoms (2).
- Stomach upset
- Muscle weakness
- Weight loss
- Sleepiness or drowsiness
- Rapid breathing
- Fruity odor of the breath
- Loss of appetite or increased hunger
Babies and young children may have slow growth due to the absorption of hydrocortisone into the bloodstream. In rare cases, anaphylaxis (allergic reactions) may occur, which needs to be treated in an emergency.
Note: Hydrocortisone cream may not have side effects in all babies, and not all side effects may be seen in a baby.
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Why Is Hydrocortisone Cream Used For Babies?
Application of hydrocortisone cream or ointment reduces swelling, erythema (redness), and pruritus (itching) caused by skin inflammation from various diseases and conditions.
Pediatricians may prescribe hydrocortisone creams for the following conditions weighing the benefits over risks (3).
- Contact dermatitis
- Insect bites or stings
- Diaper rash in extreme cases
- Heat rash in extreme cases
You may apply the cream as directed by the doctor for positive outcomes.
How Do You Use Hydrocortisone Cream On Babies?
You may follow the following tips for the right application of hydrocortisone cream on your baby’s skin (3).
- Wash or sanitize your hands before and after applying the cream.
- Squeeze out the required amount of cream on your finger.
- Gently apply a thin layer of the cream to the affected area.
- Gently and slowly rub the cream until it disappears and absorbs into the skin.
Observing the following precautions may help avoid side effects and other adverse effects.
- Do not use the cream on unaffected skin.
- Do not use more or less than the quantity prescribed by the doctor.
- Do not cover the affected area with a bandage after application unless directed by the doctor. If applying to the diaper area, do not cover it with a tight-fitting diaper. You may dress the baby in loose clothing.
- Do not apply the cream around the mouth or eyes unless directed by the doctor.
It is best to apply the cream at the same time each day, and not use it along with other medicated creams or skin products, like moisturizers. Maintain a gap of eight to 12 hours between applications if the baby has a dosage of twice a day. If you notice no improvement in a week or if the condition worsens, speak to the doctor.
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How Much Cream Should You Apply To Babies?
The amount of hydrocortisone cream needed may vary as per the type of skin condition, the severity of the condition, the affected area of the body, and your baby’s age. You may follow the pediatricians or pediatric dermatologists’ prescription for the dose and duration of treatment.
Pediatricians may prescribe the amount of cream in the fingertip unit, that is, the amount of cream that can be squeezed on your fingertip. Usually, one fingertip unit is recommended for a skin area double the size of the flat or palm of your hand.
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Alternatives To Hydrocortisone Cream For Babies
If your baby has side effects to even low to moderate potency topical hydrocortisone, pediatricians may suggest alternatives to treat the skin condition. These may include:
- Anti-allergic medications
- Skin moisturizing creams, ointments, or lotions
- Regular baths using baby shampoos, however avoid prolonged periods in water
- Application of breast milk can be considered for diaper rash
- Regular baths using baby shampoos
Keeping your baby’s skin clean and dry is the best way to prevent many skin conditions, such as diaper rash and contact dermatitis. If your baby has sensitive skin, try to use hypoallergenic baby products and always seek advice from the pediatrician when you notice skin rash in babies. Never delay the care until more skin area is affected.
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Facts About Steroid Creams
The following facts may help you to know more about the topical hydrocortisone medications (2).
- Hydrocortisone belongs to the class of medicines called corticosteroids, which is different from anabolic steroids used for muscle enhancement.
- Most hydrocortisone creams are mild.
- Hydrocortisone butyrate (Locoid) is a potent medication that is only available on prescription.
- Hydrocortisone creams are available in different dosage forms such as 0.1%, 0.5%, 1%, 2.5%, etc. 0.1% hydrocortisone cream contains 1mg hydrocortisone in each gram of cream, while 2.5 % hydrocortisone cream contains 2.5mg of hydrocortisone in each gram.
- Hydrocortisone creams plus antimicrobials (antifungal or antibacterial) are often available for treating skin inflammation due to skin infections.
- Ointments are preferred for dry and flaky skin conditions, and lotions help cover large areas of skin and scalp. The cream form is best recommended for moist skin areas.
- Dermacort, Zenoxone, Lanacort, Mildison Lipocream 1%, and Dioderm are a few examples of hydrocortisone cream brands.
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Frequently Asked Questions
1. When will the hydrocortisone cream start showing results?
You may see results in three to seven days after commencing application. Even though the baby’s skin inflammation gets better, apply the cream for as long as directed by the doctor. If the baby’s condition worsens or there is no improvement after a week of use, contact your doctor (3).
2. What will happen if you forget to apply the hydrocortisone cream?
It is normal to miss a dose of medication during your busy schedule. If you forget to apply the ointment or cream on a prescribed time, you may follow the below recommendations to avoid excess use (3).
- If you apply only once a day in the evening or morning, you may use the cream as soon as you remember. You need to maintain a minimum of eight hours gap between the applications.
- If you miss a twice-a-day dose, you may apply until there is a minimum four-hour gap between the next dose. If not, skip the missed dose and continue with the regular dose.
Never bother a sleeping baby to apply a missed dose of ointment or cream. You may do it when they wake up, or if there is not enough time gap, continue with regular dosage timings.
3. What will happen if you apply hydrocortisone cream in excess?
A little more than the normal dosage may not harm your baby’s skin. However, do not consistently apply more than the prescribed quantity. Seek medical help if the baby has skin irritation or any other reactions.
4. Can other creams be applied along with the hydrocortisone?
You should not apply other creams, lotions, or ointments at the same time with hydrocortisone. Wait at least ten minutes after the application of hydrocortisone to apply your baby’s moisturizers or emollient. It is ideal to apply different products at different times to avoid cross-reactions (3).
There is no restriction on the intake of paracetamol or ibuprofen along with topical hydrocortisone application unless restricted by the pediatrician. You may check with the pharmacists or doctors before taking any other medications, including herbal and complementary products, with hydrocortisone.
5. Does hydrocortisone cream help treat diaper rash?
Mild hydrocortisone creams can be used for treating nappy rash. However, keeping the skin clean and dry is the best way to avoid diaper rash in babies (4). You may seek help from a pediatrician to identify if your baby has a fungal or bacterial skin infection in the diaper area. In such cases, oral antibiotics, topical antibiotics, or antifungal creams could be needed.
Hydrocortisone creams, ointments, or lotions may help treat various skin conditions in babies. However, the exact dosage and the form may vary depending on the age and skin type. Self-treatment with topical corticosteroids may increase the risk of side effects. It is essential to seek a pediatrician’s advice before using it. You may also go in for a follow-up and use it as per prescription to have desired effects.
2. Hydrocortisone skin creams; National Health Service
3. Hydrocortisone (topical) for eczema; Medicines for Children
4. Nappy Rash; All Wales Medicines Strategy Group; National Health Service