Hydrocortisone for Acne: How It Works, How to Use It, Side Effects and More

• Hydrocortisone belongs to a class of drugs that help to lower inflammation in the body.
• Hydrocortisone is not an acne treatment, but it can help soothe breakouts
• Using hydrocortisone for extended periods can be harmful

What Is Hydrocortisone?

Hydrocortisone is a corticosteroid (a subgroup of steroid hormones) that is typically used to relieve inflammation and itchiness. It is also used to reduce the immune system’s activities, for the treatment of autoimmune and many other types of diseases. 

Low-strength hydrocortisone is available over the counter as both an oral drug and a topical medication. Topical hydrocortisone relieves skin inflammation and itchiness that manifest as symptoms of a skin condition. It is mostly available as a cream or lotion, but can also come in gel or ointment forms.

Topical hydrocortisone is formulated in different concentrations. The most common that can be purchased over-the-counter are hydrocortisone 1% and 2.5%. Hydrocortisone creams in strengths of not more than 2.5% are considered to be mild and are the least potent type of corticosteroids.

Sometimes, topical hydrocortisone is also formulated with antibiotics. 

How Hydrocortisone Works to Treat Acne

Hydrocortisone creams and lotions are not intended to be a treatment for acne. However, it can reduce the inflammation typically present in many types of acne. Essentially, it can shrink the size of your pimples and blemishes and reduce their redness. Hydrocortisone cream does this by narrowing the blood vessels in your skin’s inner layer. It also works on your DNA—making your body increase its expression of anti-inflammatory genes while decreasing the expression of pro-inflammatory genes. 

It is acceptable to use hydrocortisone for acne blemishes for short periods. You should, however, be aware that it is merely a temporary fix and it does not address any of the underlying causes of your acne,

What forms of acne can hydrocortisone treat?

Hydrocortisone does not treat any type of acne. It has no antibacterial properties and, as such, cannot kill any acne-causing bacteria; neither does it help regulate the skin’s oil production.  Hydrocortisone does not help shed dead skin cells or clear clogged pores. It also does not have any effect on acne that’s caused or triggered by hormones, stress, or dietary habits.

Using hydrocortisone for acne can only help decrease inflammation and soothe breakouts. 

Hydrocortisone for acne scars

Topical hydrocortisone has no effect on acne scars. There’s some limited evidence that when corticosteroids like hydrocortisone are injected into the skin, they can help treat acne scars. This is, however, a procedure that should only be performed by your dermatologist or doctor. 

How to Use Hydrocortisone for Acne

You can use hydrocortisone for acne when you are experiencing inflammatory symptoms like redness and swelling. It is advisable to think of hydrocortisone as an occasional treatment for flare-ups.

How to use:

1. Wash your hands thoroughly.
2. Using your fingertips, apply a thin layer of hydrocortisone cream onto your skin
3. Like you would with a spot treatment, be sure to only apply it on areas where you are experiencing inflammation or itching.
4. Be careful that it does not get into your eyes, nose, or mouth.
5. Complete your skin care routine

If you are using it for multiple days, apply it around the same time every day. You can apply hydrocortisone cream once or twice daily.

Hydrocortisone cream should not be used as a first-line treatment for pimples, nor should it be used in concentrations higher than 2.5% without your dermatologist’s supervision. 

How long should you use it? 

Hydrocortisone can be used for up to 3 months. However, to avoid side effects,  if you are using it on your face or neck, you should use it for the least amount of time possible. 

You ideally should not use hydrocortisone for acne for longer than two weeks at a stretch, except your dermatologist/doctor otherwise directs you. Prolonged use of hydrocortisone of the skin, especially on the face where the skin is particularly thin, comes with a host of adverse effects. 

Results 

After applying hydrocortisone cream, you should expect to see less redness and swelling, and an overall decrease in the size of your pimples and blemishes.

Your skin can develop a tolerance for hydrocortisone— making it ineffective at reducing your acne inflammation over time. 

Side Effects and Interactions

Side effects

If you decide to use hydrocortisone for acne, you should be extra careful not to use it for long periods. This is because it can worsen the acne you’re trying to get rid of and even cause new breakouts and zits. 

Asides from acne, other common and well-documented side effects of prolonged use of topical hydrocortisone include skin atrophy (skin thinning), purpura (blood spots), striae (stretch marks), rosacea and perioral dermatitis. Other less common side effects are excessive hair growth, skin color changes or loss, and delayed wound healing.

More importantly, topical hydrocortisone can be absorbed into the body in large enough concentrations to disrupt some of your organs’ functions. Consequently, you can also experience systemic side effects from over-using hydrocortisone creams. Glaucoma, Cushing syndrome, hypertension, and high blood sugar are all conditions that can develop from using high concentrations of hydrocortisone cream, especially in areas where the skin is very thin. 

Facial skin tends to be particularly thin—necessitating cautiousness if using hydrocortisone for facial acne. Systemic side effects are, however, significantly less likely to occur than skin-level, local side effects. 

If you start to experience any of these side effects at all, it is advisable to discontinue the usage and consult a dermatologist. Steroid-induced skin thinning usually reverses itself after you stop using hydrocortisone cream, but may take weeks or months.

Interactions

Hydrocortisone interacts with hundreds of drugs and substances, so you should check with your doctor first.

Alternatives

Instead of using hydrocortisone for acne primarily, you should use other medications and ingredients actually intended for treating pimples.

Some of the most effective topical acne medications are: 

Benzoyl peroxide

This topical medication targets acne-causing bacteria directly—making it a better choice for acne treatment than hydrocortisone. Benzoyl peroxide fills your pores with oxygen, and Propionibacterium acnes (the bacteria that cause inflammatory acne breakouts) cannot survive or thrive in oxygen-rich environments.

Benzoyl peroxide is one of the most frequently used acne treatments and has been proven to be safe in concentrations of up to 10%. Benzoyl peroxide can be bought as a medication on its own. You can also find it as an active ingredient in many skin care products like cleansers and masks. You may experience side effects like redness, dryness, and itchiness. The higher the concentration of benzoyl peroxide you use and the more sensitive your skin, the more likely you are to experience these side effects.

Salicylic acid

Salicylic acid is an ingredient found in many facial cleansers, moisturizers, and liquid-saturated pads. It does not kill acne-causing bacteria, but it does help to clean out and unclog pores— preventing breakouts and the worsening of already existing zits. Salicylic acid is preferable to hydrocortisone for cane because it targets one of the root causes of acne. Salicylic acid is typically well-tolerated, and most people only experience mild skin irritation, if anything at all.

Antibiotics

Topical antibiotics, in the form of creams and ointments, are effective at treating inflammatory acne. Topical antibiotics don’t always work, though, as some strains of Propionibacteria acnes are now resistant to antibiotics. Like the others, antibiotics are a better alternative to hydrocortisone because it attacks a root cause of acne.

Most of these alternatives to hydrocortisone for acne can be used in combination with each other. Even so, it is essential to check with your dermatologist before attempting to combine them.

Takeaway

Hydrocortisone cream is not an acne treatment, but you may use it to reduce redness, itchiness, and swelling of breakouts. Avoid the prolonged use of hydrocodone for acne as it can cause a myriad of skin and systemic problems.

Many hydrocortisone products do not require a prescription and are accessible over the counter.