Available Strengths of Hydrocortisone Ointment
Hydrocortisone ointment is available in 1% and 2.5% strengths, with 1% being the most common over-the-counter formulation and 2.5% typically requiring a prescription.
Classification and Potency
Hydrocortisone ointment falls into the lowest potency categories in the topical corticosteroid classification system:
- Class 7 (Lowest potency): Hydrocortisone 1% cream/ointment 1
- Class 5-6 (Low potency): Hydrocortisone 2.5% cream/ointment 1
This classification is important as it guides appropriate clinical use based on:
- Treatment location
- Condition severity
- Patient age
- Duration of therapy
Formulations and Availability
- 1% hydrocortisone ointment: Available over-the-counter 2
- 2.5% hydrocortisone ointment: Generally requires a prescription
- Hydrocortisone valerate 0.2% ointment: A prescription-strength derivative with intermediate potency 3
- Hydrocortisone buteprate 0.1% cream: Another prescription-strength derivative 4
Clinical Applications
Hydrocortisone ointment is indicated for:
- Mild inflammatory skin conditions: Atopic dermatitis, contact dermatitis
- Pruritus: 1% hydrocortisone ointment has demonstrated 68% reduction in pruritus ani compared to placebo 5
- Facial applications: Class V/VI corticosteroids (including hydrocortisone 2.5%) are recommended by the American Academy of Dermatology for facial applications 1
Application Guidelines
- Dosing frequency: Apply once or twice daily 6
- Duration: No specified time limit for low-potency topical corticosteroid use, unlike higher potency products 6
- Measurement: Use the "fingertip unit" method - amount that covers from the tip of the index finger to the first crease, covering approximately 2% of body surface area 1, 6
Special Considerations
- Pediatric use: The lowest potency and shortest duration possible should be used in children 1
- Facial/genital use: Lower potency formulations (1%) are preferred for these sensitive areas 1
- Pregnancy/lactation: Topical corticosteroids can work safely and effectively in patients who are pregnant or lactating 6
Potential Adverse Effects
- Skin atrophy: Risk increases with prolonged use, higher potency, and application to thin-skinned areas
- Other local effects: Telangiectasia, striae, rosacea, purpura
- Contact hypersensitivity: Occurs in 2-5% of patients 1
Hydrocortisone ointment, particularly the 1% strength, represents one of the safest topical corticosteroid options when used appropriately, with minimal risk of adverse effects compared to higher potency alternatives.