From the Guidelines
Hydrocortisone is a mild topical corticosteroid that differs from other topical corticosteroids primarily in its potency, safety profile, and accessibility. It is classified as a low-potency steroid (typically available as 0.5% or 1% formulations), making it less effective for severe inflammatory conditions but safer for long-term use, sensitive areas, and pediatric patients compared to more potent options like betamethasone or clobetasol 1. Some key points to consider when differentiating hydrocortisone from other topical corticosteroids include:
- Potency: Hydrocortisone is considered a low-potency steroid, which is less effective for severe conditions but safer for long-term use and sensitive areas 1.
- Safety profile: Hydrocortisone has a lower risk of side effects such as skin thinning, striae, and hypothalamic-pituitary-adrenal axis suppression compared to more potent corticosteroids 1.
- Accessibility: Hydrocortisone is widely available over-the-counter in many countries, usually in 0.5-1% strengths, while higher-potency corticosteroids require prescriptions 1.
- Mechanism of action: Hydrocortisone works by binding to glucocorticoid receptors to reduce inflammation, but its molecular structure results in less receptor binding affinity than more potent steroids, explaining its milder effects and better safety profile 1. Overall, hydrocortisone is a common first-line treatment for mild skin conditions like insect bites, minor irritation, or mild eczema due to its safety profile and accessibility.
From the Research
Topical Hydrocortisone vs Other Topical Corticosteroids
- Topical hydrocortisone is a type of topical corticosteroid, and its differences from other topical corticosteroids are mainly related to its potency and formulation 2.
- Topical corticosteroids are classified by strength, and the risk of adverse effects increases with prolonged use, large area of application, higher potency, occlusion, and application to areas of thinner skin such as the face and genitals 3.
- The choice of a topical corticosteroid, including hydrocortisone, depends on the context, such as the type of dermatitis being treated and its localization, and must respect "Good clinical practice" guidelines to select the best benefit/risk ratio 2.
- There is no specific information available that directly compares topical hydrocortisone to all other topical corticosteroids, but studies have compared different potencies of topical corticosteroids, including hydrocortisone, in terms of their effectiveness and safety 4, 5, 6.
Potency and Formulation
- Topical hydrocortisone is considered a mild to moderate potency topical corticosteroid, whereas other topical corticosteroids can range from mild to very potent 4.
- The formulation of topical hydrocortisone can vary, including ointments, creams, lotions, and solutions, which can affect its potency and absorption 3.
- The potency and formulation of topical corticosteroids, including hydrocortisone, can influence their effectiveness and safety, with stronger potencies and certain formulations associated with a higher risk of adverse effects 4, 5, 6.
Clinical Use
- Topical hydrocortisone is commonly used to treat inflammatory skin conditions, such as eczema and dermatitis, and its use is often guided by clinical practice guidelines 3, 4, 5, 6.
- The use of topical hydrocortisone and other topical corticosteroids requires careful consideration of the potential benefits and risks, including the risk of adverse effects, such as skin thinning and systemic absorption 3, 4, 5, 6.