What is the dosage and duration of hydrocortisone (hydrocortisone) for a patient with right arm swelling and itching?

Hydrocortisone Dosage for Right Arm Swelling and Itching

For right arm swelling and itching, apply 1% hydrocortisone cream twice daily for 7-10 days to the affected area using the fingertip unit method, with one fingertip unit covering approximately 2% of body surface area.

Dosage Recommendation

Hydrocortisone is an appropriate first-line treatment for localized skin inflammation presenting with swelling and itching. The recommended approach is:

• Strength: 1% hydrocortisone cream (low-potency topical corticosteroid)
• Frequency: Apply twice daily 1
• Duration: 7-10 days for acute symptoms
• Application method: Thin layer using the fingertip unit method

Application Technique

The fingertip unit (FTU) method ensures proper dosing:

• One FTU is the amount of cream squeezed from the tube from the tip of an adult index finger to the first crease
• One FTU covers approximately 2% of body surface area 1
• For an adult arm, approximately 3 FTUs would be needed to cover the entire surface

Treatment Algorithm

1. Initial treatment (Days 1-7):

   • Clean the affected area with mild soap and water
   • Pat dry gently
   • Apply 1% hydrocortisone cream twice daily (morning and evening)
   • Do not occlude the area unless specifically directed

2. Assessment after 7 days:

   • If symptoms have resolved → discontinue treatment
   • If partial improvement → continue for additional 3-5 days
   • If no improvement → seek medical reevaluation

3. For persistent symptoms beyond 10-14 days:

   • Discontinue hydrocortisone
   • Seek medical evaluation for alternative diagnosis or stronger treatment

Supportive Measures

In addition to hydrocortisone application:

• Apply cool compresses to reduce swelling and provide symptomatic relief 2
• Consider oral antihistamines if itching is severe, particularly at night
• Avoid scratching to prevent secondary infection
• Avoid potential irritants (harsh soaps, fragrances)

Important Considerations and Cautions

• Duration limits: Low-potency topical corticosteroids like 1% hydrocortisone have no specified time limit for use, but extended use should be avoided 1
• Adverse effects: Prolonged use can lead to skin atrophy, striae, and telangiectasias, especially in thin-skinned areas 3
• Monitoring: Watch for signs of skin thinning, increased redness, or worsening of symptoms
• Contraindications: Do not use if there are signs of infection, open wounds, or if previous allergic reaction to hydrocortisone

Special Situations

• If symptoms worsen: Discontinue use and seek medical attention
• For severe swelling with pain: Consider evaluation for other conditions like cellulitis or deep vein thrombosis
• For children: Use the same concentration (1%) but for shorter duration (5-7 days) and monitor closely

Hydrocortisone 1% cream is generally effective for mild to moderate inflammatory skin conditions and has a good safety profile when used appropriately for limited duration.