Is cortisone good for eczema?

Eczema

Is this your child’s symptom?

  • An itchy rash that your doctor told you was eczema
  • Eczema is a chronic skin disease
  • Recurrent flare-ups of severe itching occur
  • The medical name for eczema is atopic dermatitis

Symptoms of Eczema

  • The main symptom is itching. If it doesn’t itch, it’s not eczema.
  • With flare-ups (itching attacks), the rash becomes red or even raw and weepy.
  • Onset: Average onset at 3 months old. Range: 1-6 months old. Usually begins by 2 years old.
  • Location: Classic eczema starts on the cheeks at 1 to 6 months of age. It can spread to the rest of the face. In infants, the outer surfaces of the arms and legs also become involved.
  • In older children, eczema is found in the joint creases. The elbows, wrists, and knees are the most common places.
  • The rash is usually the same on both sides of the body.

Cause of Eczema

  • A type of dry, sensitive skin that children inherit.
  • Flare-ups are from skin contact with soap, shampoo, pollen or other irritating substances.
  • About 30% of babies with severe eczema also have food allergies. The most common is cow’s milk.
  • Over 10% of children have eczema. It’s the most common skin condition of the first 10 years.

Triggers of Eczema Flare-Ups

  • Soaps. Never use bubble bath. It can cause a major flare-up.
  • Pollens. Keep your child from lying on the grass during grass pollen season.
  • Animals. Avoid any animals that make the rash worse.
  • Foods. If certain foods cause severe itching (flares), avoid them.
  • Wool. Avoid wool fibers and clothes made of other scratchy, rough materials.
  • Dry Air. Use a humidifier if the air in your home is dry.
  • Herpes Virus Infection (Serious). Keep your child away from anyone with fever blisters (cold sores). The herpes virus can cause a serious skin infection in children with eczema.
  • Eczema is not caused by laundry soap you use to wash clothing.

Itching Scale

  • Mild: doesn’t interfere with normal activities
  • Moderate: interferes with child care or school, sleep, or other normal activities
  • Severe: constant itching that can’t be controlled

Food Allergy and Eczema Flare-Ups

  • Food allergies are a factor in 30% of young children with severe eczema. This factor is mainly seen in babies.
  • The main allergic foods are cow’s milk and eggs.
  • The main symptoms are increased skin redness and itching. Some parents report these symptoms start during or soon after the feeding.
  • The eczema becomes easier to control if you avoid the allergic food.

Diagnosing Food Allergy and Eczema Flare-Ups

  • Your child’s doctor may suggest the steps listed below:
  • Remove the suspected food or foods from your child’s diet for 2 weeks. The eczema should greatly improve.
  • Then give your child that food when the eczema is under good control. This is called a “challenge.”
  • If the food is causing flare-ups, the eczema should become itchy and red. The flare-up should occur quickly within 2 hours of eating the food.
  • If this occurs, avoid giving this food to your child. Talk to your child’s doctor about the need for any food substitutes.
  • If the eczema does not flare-up, your child isn’t allergic to that food.

When to Call for Eczema

Call 911 Now

  • You think your child has a life-threatening emergency

Call Doctor or Seek Care Now

  • Age less than 12 weeks old with fever. Caution: do NOT give your baby any fever medicine before being seen.
  • Looks infected (spreading redness, pus, soft oozing scabs) and fever
  • Many small blisters or punched-out sores occur
  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent

Call Doctor Within 24 Hours

  • Eczema is very painful to touch
  • Looks infected but no fever
  • Itching is severe after using steroid cream for more than 48 hours
  • You think your child needs to be seen, but the problem is not urgent

Call Doctor During Office Hours

  • Itching flare-ups occur often
  • Eczema diagnosis was never confirmed by a doctor
  • You have other questions or concerns

Self Care at Home

  • Eczema with no other problems
  • Questions about prevention of eczema flare-ups

Seattle Children’s Urgent Care Locations

If your child’s illness or injury is life-threatening, call 911.

Care Advice

Treatment for Eczema

  1. What You Should Know About Eczema:
    • Eczema is a chronic skin disease. So, you need to learn how to control it.
    • Itching attacks (flare-ups) are to be expected.
    • The goal is to treat all flare-ups quickly. Reason: To prevent skin damage.
    • Here is some care advice that should help.
  2. Treatment is Based on Severity of Eczema:
    • Mild Eczema. Just need to use a moisturizing cream and to avoid flare-up triggers.
    • Moderate Eczema. Also need to use a steroid cream and bedtime allergy medicine.
    • Severe Eczema. Also may need antibiotics for a skin infection caused by Staph bacteria. This infection starts in open skin from severe itching.
  3. Moisturizing Cream or Ointment for Dry Skin:
    • All children with eczema have dry sensitive skin.
    • The skin needs a moisturizing cream (such as Eucerin) Apply once or twice daily.
    • Apply the cream after a 5 or 10-minute bath. To trap moisture in the skin, apply the cream while skin is still damp. Do this within 3 minutes of leaving the bath or shower.
    • The steroid cream should be applied to any itchy spots first. Then use the moisturizing cream as the top layer.
    • While most parents prefer creams, moisturizing ointments are sometimes needed in the winter. An example is Vaseline.
    • Caution: Never stop the moisturizing cream. Reason: The rash will come back.
  4. Steroid Cream or Ointment for Itching:
    • Itchy skin is the main symptom of eczema.
    • Steroid creams or ointments are essential for controlling red, itchy skin.
    • Apply steroid creams only to itchy or red spots (not to the normal skin).
    • Most children have 2 types of steroid creams. (1) A mild steroid cream is used to treat any pink spots or mild itching. This is often 1% hydrocortisone cream (such as Cortaid). No prescription is needed. (2) Another stronger steroid cream is needed to treat any spots with severe itching. This is a prescription steroid cream such as Synalar. Never apply this stronger cream to the face.
    • Apply these creams as directed or 2 times per day.
    • After the rash quiets down, apply it once per day. After 1 good week just use moisturizing cream.
  5. Bathing – Avoid Soaps:
    • Give one bath a day for 10 minutes in lukewarm water. Reason: Water-soaked skin feels less itchy. Follow the bath with a moisturizing cream (such as Eucerin) to all the skin.
    • Avoid all soaps. Reason: Eczema is very sensitive to soaps, especially bubble bath. There is no safe soap for young children with eczema. They can be cleaned using warm water.
  6. Allergy Medicine for Itching at Bedtime:
    • Many children with eczema need an allergy medicine by mouth at bedtime.
    • Reason: Scratching in bed can cause severe skin breakdown. It may also interfere with falling sleep.
    • Give the med your child’s doctor wanted you to use for itching.
    • If none was suggested, you can try Benadryl at bedtime. No prescription is needed.
    • Caution: Do not use if age is under 1 year. Reason: Benadryl is a sedative. Give your doctor a call for advice.
  7. Itching Attack – Shower to Remove Irritants:
    • Playing in the grass, being around animals, or swimming can cause increased itching.
    • For itching from these causes, give your child a quick shampoo and shower.
  8. Itching Attack – Treatment:
    • At the first sign of any itching, use the steroid cream. Put it on the areas that itch. If unsure, apply 1% hydrocortisone cream (such as Cortaid). No prescription is needed.
    • Keep your child’s fingernails cut short and smooth.
    • Ask older children to try not to itch, but never punish for itching.
    • For constant itching in young children, cover the hands with socks or gloves. Use for a day or until the itching is brought under control. Provide extra cuddling during this time.
  9. Return to School:
    • Eczema cannot be spread to others.
    • Children with eczema do not need to miss any child care or school.
  10. What to Expect:
    • Eczema is a chronic condition. Around the teen years, about half get over their eczema.
    • Many children who have severe eczema as babies develop asthma and nasal allergies.
  11. Call Your Doctor If:
    • Itching is not under control after 2 days of steroid cream
    • Rash looks infected (spreading redness, yellow scabs or pus)
    • You think your child needs to be seen
    • Your child becomes worse

Prevention of Eczema Flare-Ups

  1. Tips to Help Prevent Flare-Ups:
    • Some flare-ups of eczema cannot be explained. But others are triggered by things that can be avoided.
    • Avoid chlorine in swimming pools and spas, harsh chemicals, and soaps.
    • Never use bubble bath. It can cause a major flare.
    • Keep your child off the grass during grass pollen season.
    • Avoid any animals that make the rash worse.
    • If certain foods cause severe itching (flares), avoid them.
    • Wear clothes made of cotton or cotton blends as much as possible. Avoid wool fibers and clothes made of other scratchy, rough materials. They make eczema worse.
    • Try to avoid excess heat, excess cold and dry air (use a humidifier). Avoid over-dressing. Heat can make the rash worse.
    • Caution: Keep your child away from anyone with fever blisters (cold sores). The herpes virus can cause a serious skin infection in children with eczema.
  2. Call Your Doctor If:
    • You have other questions or concerns

And remember, contact your doctor if your child develops any of the ‘Call Your Doctor’ symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Last Reviewed: 02/01/2020

Last Revised: 03/14/2019

Copyright 2000-2019 Schmitt Pediatric Guidelines LLC.

Eczema: Management and Treatment

How is eczema treated?

Treatment of eczema depends on the symptoms (for example, dry skin is treated differently than oozing blisters) and the factors that trigger or worsen symptoms. No one treatment is best for all people. The goal of treatment is to reduce itching and discomfort and to prevent infection and additional flare-ups.

Treatment options include:

  • Prevention: Preventing flare-ups is the best way to manage eczema. For that reason, it is important to try to identify and avoid symptom triggers, such as certain detergents or food allergens, and to moisturize the skin.
  • Skin care: Keeping your skin moist is important, because itching increases when the skin is dry. Use a moisturizing cream or ointment. Lotions are less effective. It is important to keep skin moisturized by applying creams or ointments several times a day — including after bathing/showering while skin is still damp — to keep your skin moist. Use mild soaps and products that are free of perfumes, dyes, and alcohol. Look for products that are “fragrance-free,” “hypoallergenic,” and “for sensitive skin.” New products containing “ceramide” actually replace some of the “glue” that is missing in the skin of eczema patients and are the most effective moisturizers.
  • Medications: Over-the-counter creams and ointments containing the steroid cortisone — such as hydrocortisone (Cortisone 10®) and hydrocortisone acetate (Cort-Aid®) — may be used to help control the itching, swelling, and redness associated with eczema. Stronger, prescription-strength steroid creams are also available. Steroid pills and shots may be used in the short term to get control of severe eczema, but long-term use of these is not recommended because of the possible side effects, which include high blood pressure, weight gain, and thinning of the skin.

Newer medications, called topical immunomodulators (TIMs), are showing progress in treating patients with moderate to severe eczema, particularly those patients who do not respond to traditional treatment. TIMs — such as tacrolimus (Protopic®) and pimecrolimus (Elidel) — work by modulating (changing) the body’s immune response to allergens. TIMs also have fewer side effects than steroids. The most common side effect reported with tacrolimus is a temporary stinging or burning sensation that generally improves after a few days of use.

Other medications that might be used for patients with eczema include antibiotics if the skin becomes infected, and antihistamines to help control itching. Some patients with severe eczema may require oral immunomodulatory or immunosuppressant medications to control their skin disease.

  • Phototherapy: The ultraviolet light waves found in sunlight have been shown to help certain skin disorders, including eczema. Phototherapy uses ultraviolet light, usually ultraviolet B (UVB), from special lamps to treat people who have severe eczema.

What complications are associated with eczema?

  • Scratching or rubbing itchy areas can break the skin, allowing bacteria to enter and cause infection.
  • Scars can form when the skin is damaged from continued scratching.
  • Very itchy eczema can disturb sleep.
  • Some people with eczema avoid social activities because they are uncomfortable and/or self-conscious.
  • In persons with darker skin, inflammation from eczema may leave dark marks that linger for months.

Can eczema be cured?

Currently, there is no cure for eczema. However, proper treatment and good skin care can often control or minimize symptoms.

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Hydrocortisone

Medical Editor: John P. Cunha, DO, FACOEP

Last reviewed on RxList 1/14/2019

Hydrocortisone (hydrocortisone) Cream 2.5% is a topical (for the skin) steroid used to treat inflammation of the skin caused by a number of conditions such as allergic reactions, eczema, or psoriasis. Hydrocortisone is available in generic form. Common side effects of Hydrocortisone Cream include

  • skin redness/burning/itching/peeling,
  • thinning of your skin,
  • blistering skin,
  • stretch marks,
  • nausea,
  • heartburn,
  • headache,
  • dizziness,
  • menstrual period changes,
  • trouble sleeping (insomnia),
  • increased sweating, or
  • acne.

Tell your doctor if you have any serious side effects of Hydrocortisone Cream including blurred vision, or seeing halos around lights, uneven heartbeats, weight gain, puffiness in your face, or feeling tired.

Dose and administration: Apply hydrocortisone cream to the affected area as a thin film 2 to 4 times daily depending on the severity of the condition. It is not likely other drugs you take orally or inject will have an effect on topically applied hydrocortisone. But many drugs can interact with each other. Tell your doctor all prescription and over-the-counter medications and supplements you use. During pregnancy, hydrocortisone should be used only when prescribed. Infants born to mothers who have been using this medication for an extended period of time may have hormone problems. Tell your doctor if you notice symptoms such as persistent nausea/vomiting, severe diarrhea, or weakness in your newborn. This medication passes into breast milk. However, this drug is unlikely to harm a nursing infant. Consult your doctor before breast-feeding.

Our Hydrocortisone (hydrocortisone) Cream 2.5% Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Using Topical Cortisone to Treat Eczema

To calm the itch and inflammation of most types of eczema, the first product for eczema treatment you’ll likely reach for is an over-the-counter cortisone.

While severe cases of eczema require prescription-strength products, mild cases of atopic dermatitis or eczema that result from contact with an irritating ingredient or allergen may need only careful skin care and a low-dose cortisone cream.

Guidelines for Topical Eczema Treatment

With so many formulas and strengths available, choosing the right cortisone cream or lotion may be nearly as puzzling as finding out what causes your itch.

A topical eczema treatment is any product that you apply to your skin. The American Association of Dermatology (AAD) says topical cortisones, or corticosteroids, are the most widely used product to manage top eczema symptoms — inflammation, redness, and itchiness.

Also known as glucocorticoids or simply steroids, hydrocortisone products are not related to illegal and unsafe anabolic steroids.

Corticosteroids are substances similar to hormones your body makes naturally. However, you still need to use these eczema treatments sparingly.

On drugstore shelves, hydrocortisone, a mild glucocorticoid, is the ingredient you’re most likely to see on product packages; there are many different brands available. Over-the-counter hydrocortisone comes in different strengths, usually 0.5 and 1 percent. There are also stronger versions your doctor may prescribe.

The idea is to use the lowest concentration needed to treat your eczema symptom to minimize possible side effects. Usually it takes only two or three days of this eczema treatment to calm inflammation. In general, over-the-counter products are meant for mild cases of eczema that are red and itchy but do not ooze, have scales, or crusted patches.

Hydrocortisone is also available in different formulations:

  • A spray works well on hard-to-reach areas like the scalp and will keep hair from becoming greasy.
  • Lotions easily cover large parts of the body.
  • A light cream is often best for the face.
  • An ointment provides the most effective barrier, but may feel and look too greasy for daytime use — you might want to limit it to nighttime.

Maximize Your Topical Eczema Treatment

Following package directions and guidelines from your doctor or pharmacist will bring the best results. In general, apply a cortisone cream or lotion in a light film twice a day.

When possible, use hydrocortisone on freshly washed skin and gently rub it in. According to the AAD, one way to enhance its effects is to first soak in a warm bath for 20 minutes, then apply it; this technique helps skin hold in some of the moisture from the bath and promotes better penetration of the topical.

Limit your use of OTC topicals to two weeks at a time. You should start seeing results in just a few days. But, if you’re trying a topical on your own and don’t see any results within a week, call your doctor.

To prevent eye problems like cataracts and glaucoma, be sure to avoid applying any topical corticosteroids near your eyes. Always practice proper skin care.

Warnings About Topical Eczema Treatment

The greater its strength, the more potent the corticosteroid, and the more care you need to take when using one.

Cautions. Ask your doctor or pharmacist about possible negative interactions with any medications you’re already taking or using, particularly any other topicals. If you are or could be pregnant or have a medical condition such as diabetes, a disorder of the circulatory or immune system, or an infection, don’t use even the mildest topical hydrocortisone before clearing it with your doctor.

Also, these products are not intended for children under 2 unless your pediatrician makes them part of an eczema treatment plan; children with eczema need a specialized skin care program to control their flares.

Side Effects. With careful use, low-strength topicals shouldn’t cause side effects. Problems like thinning skin, spider veins, and stretch marks, or glaucoma and cataracts, are more likely from high-strength prescription products used over long periods of time. However, to minimize any negative reaction, don’t overuse even over-the-counter products. This will also prevent you from developing a tolerance to them, which means you get less of a response when you do use them.

If your condition doesn’t clear in a few days to a week, call your doctor. Also call if your eczema gets worse — you see deeper redness, cracks in your skin, or oozing — and stop using the topical. Some people are allergic to cortisone; signs may include serious breathing problems and a severe rash; in extreme cases, call 911.

Although topical hydrocortisones are widely available, the best practice is to use them under a doctor’s guidance. Depending on how serious the skin condition is, eczema treatment may include very short courses of stronger topicals alternating, as needed, with low-strength varieties. Working with a doctor or dermatologist will determine the best program for your skin condition — with the fewest side effects.

Hydrocortisone 1% In Absorbase Side Effects

Generic Name: hydrocortisone topical

Medically reviewed by Drugs.com. Last updated on Feb 19, 2019.

  • Side Effects
  • Dosage
  • Interactions
  • Pregnancy
  • Breastfeeding
  • More

Note: This document contains side effect information about hydrocortisone topical. Some of the dosage forms listed on this page may not apply to the brand name Hydrocortisone 1% In Absorbase.

For the Consumer

Applies to hydrocortisone topical: topical application cream, topical application gel/jelly, topical application liquid, topical application lotion, topical application ointment, topical application solution, topical application spray

Other dosage forms:

  • topical application cream, topical application lotion, topical application ointment, topical application solution
  • topical application cream
  • topical application cream, topical application ointment

Along with its needed effects, hydrocortisone topical (the active ingredient contained in Hydrocortisone 1% In Absorbase) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking hydrocortisone topical:

Incidence not known

  • Blistering, burning, crusting, dryness, or flaking of the skin
  • irritation
  • itching, scaling, severe redness, soreness, or swelling of the skin
  • redness and scaling around the mouth
  • thinning of the skin with easy bruising, especially when used on the face or where the skin folds together (e.g. between the fingers)
  • thinning, weakness, or wasting away of the skin

Some side effects of hydrocortisone topical may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known

  • Acne or pimples
  • burning and itching of the skin with pinhead-sized red blisters
  • burning, itching, and pain in hairy areas, or pus at the root of the hair
  • increased hair growth on the forehead, back, arms, and legs
  • lightening of normal skin color
  • lightening of treated areas of dark skin
  • reddish purple lines on the arms, face, legs, trunk, or groin
  • softening of the skin

For Healthcare Professionals

Applies to hydrocortisone topical: compounding powder, rectal cream with applicator, rectal foam, rectal ointment, rectal solution, rectal suppository, topical cream, topical gel, topical kit, topical lotion, topical ointment, topical pad, topical paste, topical solution, topical spray, topical stick

General

The most commonly reported side effects were burning, itching, irritation, dryness, and folliculitis.

Cardiovascular

Frequency not reported: Bradycardia, cardiac arrest, cardiac arrhythmias, cardiac enlargement, circulatory collapse, congestive heart failure, fat embolism, hypertension, hypertrophic cardiomyopathy in premature infants, myocardial rupture following recent myocardial infarction, syncope, tachycardia, thromboembolism, thrombophlebitis, vasculitis

Endocrine

Frequency not reported: HPA axis suppression, decreased carbohydrate and glucose tolerance, development of cushingoid state, glycosuria, hirsutism, hypertrichosis, increased requirements for insulin or oral hypoglycemic agents in diabetes, manifestations of latent diabetes mellitus, menstrual irregularities, secondary adrenocortical and pituitary unresponsiveness (particularly in times of stress, as in trauma, surgery, or illness), suppression of growth in pediatric patients

Immunologic

Frequency not reported: Decreased resistance to infection, concomitant skin infections

Ocular

Frequency not reported: Exophthalmos, glaucoma, increased intraocular pressure, posterior subcapsular cataracts, rare instances of blindness associated with periocular injections

Psychiatric

Frequency not reported: Depression, emotional instability, euphoria, insomnia, mood swings, personality changes, psychic disorders

Local

Frequency not reported: Burning, itching, irritation, dryness, folliculitis

Gastrointestinal

Frequency not reported: Abdominal distention, nausea, pancreatitis, peptic ulcer with possible perforation and hemorrhage, perforation of the small and large intestine (particularly in patients with inflammatory bowel disease), ulcerative esophagitis

Musculoskeletal

Frequency not reported: Aseptic necrosis of femoral and humeral heads, Charcot-like arthropathy, loss of muscle mass, muscle weakness, osteoporosis, pathologic fracture of long bones, steroid myopathy, tendon rupture, vertebral compression fractures

Hypersensitivity

Frequency not reported: Anaphylactoid reaction, anaphylaxis, angioedema

Respiratory

Frequency not reported: Pulmonary edema

Dermatologic

Frequency not reported: Acne, allergic dermatitis, cutaneous and subcutaneous atrophy, dry scaly skin, ecchymoses and petechiae, edema, erythema, hyperpigmentation, hypopigmentation, impaired wound healing, increased sweating, rash, sterile abscess, striae, suppressed reactions to skin tests, thin fragile skin, thinning scalp hair, urticaria, miliaria, telangiectasia

Metabolic

Frequency not reported: Fluid retention, hypokalemic alkalosis, potassium loss, sodium retention, negative nitrogen balance due to protein catabolism, increased appetite, weight gain

Hepatic

Frequency not reported: Elevation in serum liver enzyme levels (usually reversible upon discontinuation), hepatomegaly

Nervous system

Frequency not reported: Convulsions, headache, increased intracranial pressure with papilledema (pseudotumor cerebri) usually following discontinuation of treatment, neuritis, neuropathy, vertigo

Other

Frequency not reported: Abnormal fat deposits, hiccups, increased or decreased motility and number of spermatozoa, malaise

1. Cerner Multum, Inc. “UK Summary of Product Characteristics.” O 0

2. Cerner Multum, Inc. “Australian Product Information.” O 0

3. “Product Information. Pandel (hydrocortisone topical).” Savage Laboratories, Melville, NY.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.

Medical Disclaimer

More about Hydrocortisone 1% In Absorbase (hydrocortisone topical)

  • During Pregnancy or Breastfeeding
  • Dosage Information
  • Drug Interactions
  • 2 Reviews
  • Drug class: topical steroids
  • FDA Alerts (1)

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