From the Research
Topical hydrocortisone is generally not effective for treating hyperpigmentation and is not recommended for this purpose. While hydrocortisone is useful for reducing inflammation in skin conditions like eczema or contact dermatitis, it does not directly address the underlying mechanisms of hyperpigmentation, which involve excess melanin production in the skin. In fact, prolonged use of topical corticosteroids can sometimes worsen hyperpigmentation or cause other side effects like skin thinning, telangiectasia (visible blood vessels), or even steroid-induced acne.
For hyperpigmentation treatment, more appropriate options include:
- Topical ingredients specifically designed to reduce pigmentation, such as hydroquinone (2-4%) 1
- Retinoids, which have been shown to be effective in treating hyperpigmentation 2, 3
- Azelaic acid, vitamin C, niacinamide, or alpha hydroxy acids, which work by either inhibiting melanin production, increasing cell turnover, or providing antioxidant effects 2, 4, 3 Additionally, strict sun protection with broad-spectrum sunscreen (SPF 30+) is essential for preventing further darkening of hyperpigmented areas and allowing existing spots to fade over time 2, 5, 4.
It's worth noting that the most recent and highest quality study 1 supports the use of hydroquinone as an effective treatment for hyperpigmentation, and other studies 2, 5, 4 also recommend the use of retinoids, azelaic acid, and other topical ingredients for treating hyperpigmentation. Therefore, topical hydrocortisone should not be used as a first-line treatment for hyperpigmentation, and instead, patients should be advised to use evidence-based treatments that target the underlying mechanisms of hyperpigmentation.