Hydrocortisone Prescription for Skin Allergy
For mild skin allergies, the typical prescription for hydrocortisone is a 1% or 2.5% cream or ointment applied twice daily for 2-3 weeks to affected areas, with appropriate potency selection based on the treatment area (lower potency for face/genitals, higher potency for body). 1, 2
Formulation and Strength Selection
- Hydrocortisone is available as a 1% cream for over-the-counter use, classified as a low potency (Class 6-7) topical corticosteroid 3
- For prescription use, hydrocortisone is typically available in 1% and 2.5% formulations 4
- Low potency formulations (hydrocortisone 1-2.5%) are recommended for face, intertriginous areas, and children 2
- For body areas with thicker skin, higher potency corticosteroids may be needed for adequate response 1, 2
Application Instructions
- Apply a thin layer to affected areas twice daily (morning and evening) 1
- Use the fingertip unit method for proper dosing: one fingertip unit (amount from fingertip to first finger crease) covers approximately 2% body surface area 4
- Apply after bathing when possible, as slightly damp skin may enhance absorption 2
- For weeping/acute eczema, use cream formulations; for dry/chronic eczema, use ointment formulations 2
Duration of Treatment
- For mild skin allergies, hydrocortisone can be used for 2-3 weeks 1, 2
- There is no specified time limit for low-potency topical corticosteroid use, but regular reassessment is recommended 4
- After initial treatment period, gradual tapering is advised rather than abrupt discontinuation to prevent rebound flares 2
Additional Recommendations
- Always use hydrocortisone with regular emollients (applied at different times) to enhance efficacy and reduce steroid requirements 2
- For pruritus (itching), combine with oral antihistamines such as cetirizine/loratidine 10 mg daily or hydroxyzine 10-25 mg QID 1
- For areas covering <10% body surface area (BSA) with mild symptoms, continue using hydrocortisone while adding oral antihistamines 1
Precautions and Monitoring
- Monitor for signs of skin thinning, telangiectasia, and striae, especially with prolonged use 2
- The risk of adverse effects increases with prolonged use, large application area, higher potency, occlusion, and application to areas with thinner skin 2, 4
- Consider allergy to hydrocortisone itself if condition worsens after application (occurs in approximately 4.8% of patients with suspected allergic contact dermatitis) 5
- For moderate to severe cases (covering >10% BSA), consider referral to dermatology 1