Can Diabetics Use Cortizone Cream? A Guide to Safe Application

October 10, 2025 •

4 min read

Approximately 30-70% of people with diabetes will experience a skin condition at some point in their lives [1.9.3]. A common question that arises is, can diabetics use cortizone cream for relief? While generally possible, it requires significant caution due to potential impacts on blood glucose.

Quick Summary

Individuals with diabetes can use cortisone cream, but must be aware of the risk of increased blood sugar. Safe use involves medical guidance, low-potency formulas, and careful monitoring.

Key Points

Blood Sugar Risk: Topical corticosteroids like cortisone can be absorbed into the bloodstream and raise blood glucose levels, a condition known as hyperglycemia [1.4.2, 1.3.1].
Consult a Doctor: People with diabetes should always consult a healthcare provider before using any cortisone cream to ensure it's safe for their specific situation [1.2.3, 1.2.5].
Absorption Factors: The risk of systemic absorption increases with high-potency creams, application over large areas, use on broken skin, and occlusive dressings [1.6.2].
Safe Usage Guidelines: If approved by a doctor, use the lowest effective dose for the shortest possible time and monitor blood sugar levels closely [1.4.2, 1.3.3].
Non-Steroidal Alternatives: For general dry and itchy skin, non-steroidal moisturizers and creams containing ingredients like pramoxine hydrochloride are often safer first-line treatments [1.8.2, 1.8.3].
Long-Term Risks: Prolonged use of topical steroids is associated with an increased risk of developing type 2 diabetes and side effects like skin thinning [1.4.4, 1.4.2].
Prevention is Key: Good blood glucose control and a consistent moisturizing routine can prevent many common diabetic skin problems from occurring [1.9.4].

The Link Between Diabetes and Skin Problems

People with diabetes are more susceptible to various skin issues, ranging from dryness and itching to more specific conditions like diabetic dermopathy [1.9.3, 1.9.4]. These problems often arise from high blood glucose levels, which can lead to poor circulation and nerve damage, impairing the body's ability to maintain healthy skin and fend off infections [1.9.4]. When skin becomes itchy, inflamed, or irritated, a common go-to remedy is an over-the-counter hydrocortisone or cortisone cream.

Cortisone creams are topical corticosteroids that work by reducing inflammation and suppressing the local immune response, providing relief from itching and rashes [1.10.4]. However, for a person with diabetes, the use of any steroid medication requires careful consideration.

How Corticosteroids Affect Blood Sugar

The primary concern with using steroids, including topical ones like cortisone, is their potential to raise blood glucose levels (hyperglycemia) [1.4.2]. Corticosteroids can antagonize the action of insulin and prompt the liver to release more glucose into the bloodstream [1.6.3, 1.3.3].

While oral or injected steroids have the most significant impact on blood sugar, topical steroids can also cause issues through systemic absorption—when the medication passes through the skin into the bloodstream [1.7.2, 1.6.5]. Although this is rare with low-potency creams used for short periods, the risk increases with several factors [1.4.1]:

High-Potency Formulas: Prescription-strength steroids are more likely to be absorbed systemically.
Large Application Area: Covering a large surface of the body increases the total amount of medication absorbed.
Broken or Thin Skin: Applying cream to damaged or delicate skin enhances absorption.
Long-Term Use: The cumulative dose over time is a significant risk factor [1.6.4].
Occlusive Dressings: Covering the treated area with a bandage or wrap can dramatically increase absorption [1.2.1].

There are documented cases where the use of a high-potency topical corticosteroid led to acute hyperglycemia, requiring a significant increase in insulin dosage to manage blood sugar levels [1.2.2]. Studies have also found a positive association between the use of topical corticosteroids and new-onset type 2 diabetes, with the risk increasing with the potency of the steroid used [1.4.3, 1.4.5].

Best Practices for Using Cortizone Cream with Diabetes

If you have diabetes and are considering using a cortisone cream, following these safety measures is crucial:

Consult Your Doctor: Before using any new medication, including over-the-counter cortisone cream, speak with your healthcare provider. They can assess the specific skin condition and recommend the most appropriate treatment [1.2.5].
Use the Lowest Potency Necessary: Start with the mildest effective formula, such as a 1% hydrocortisone cream, unless your doctor advises otherwise [1.5.3].
Apply Sparingly for a Short Duration: Use the smallest amount of cream needed to cover the affected area and for the shortest time possible to control symptoms [1.4.2]. Avoid long-term, continuous use.
Avoid Broken Skin: Do not apply cortisone to open cuts or wounds, as this increases systemic absorption [1.6.2]. Wash minor cuts with soap and water and cover them with sterile gauze [1.9.4].
Monitor Your Blood Sugar: Be extra vigilant about monitoring your blood glucose levels, especially when starting a new topical steroid. Report any sustained or unusual increases to your doctor [1.3.3]. The effect on blood sugar can appear within a day or two of starting treatment [1.10.2].

Comparison of Treatments for Diabetic Itch


Feature	Cortisone Creams (Topical Steroids)	Non-Steroidal & Moisturizing Options
Mechanism	Reduce inflammation by suppressing the local immune response [1.10.4].	Hydrate the skin, restore the skin barrier, or provide topical pain relief [1.8.2, 1.8.3].
Primary Use	Inflammatory rashes, eczema, insect bites, allergic reactions [1.8.4].	General dryness, diabetic dermopathy, preventing cracks and fissures [1.9.2, 1.8.2].
Blood Sugar Risk	Can increase blood sugar if absorbed systemically, especially with high-potency, long-term use [1.4.2, 1.6.5].	No direct risk to blood sugar levels.
Other Side Effects	Skin thinning (atrophy), changes in pigmentation, excessive hair growth with prolonged use [1.4.2].	Generally well-tolerated; potential for skin irritation based on ingredients.
Examples	Hydrocortisone 1% (e.g., Cortizone-10), prescription-strength steroids (e.g., fluocinonide) [1.2.2, 1.8.4].	CeraVe Diabetics' Dry Skin Relief, Vaseline, lotions with pramoxine hydrochloride (e.g., Sarna) or calcineurin inhibitors (prescription) [1.8.1, 1.8.3, 1.5.4].

Alternatives to Cortisone Cream

For many common diabetic skin issues, non-steroidal options are safer and should be the first line of defense.

Moisturizers: High-quality, fragrance-free moisturizers are essential. Look for ingredients like ceramides, urea, and glycerin to combat the dry skin often associated with diabetes [1.8.1, 1.9.4].
Topical Anesthetics: Products containing pramoxine hydrochloride can effectively relieve itching without the use of steroids [1.8.3].
Calcineurin Inhibitors: For conditions like eczema, prescription medications such as tacrolimus or pimecrolimus can reduce inflammation without the side effects of steroids [1.5.4].
Proper Skin Hygiene: Avoid very hot showers or baths, use mild soaps, and pat skin dry gently. Applying moisturizer immediately after bathing helps lock in moisture [1.9.4].

For specific conditions like diabetic dermopathy (harmless brown patches on the shins), there is no required treatment, though keeping blood sugar well-managed is key. Moisturizers can help improve the skin's appearance [1.9.2].

Conclusion

So, can diabetics use cortizone cream? The answer is yes, but with significant caution and always under the guidance of a healthcare professional. While low-strength creams used sparingly for a short time are unlikely to cause problems, the potential risk of raising blood sugar is real, particularly with higher-potency or long-term use [1.6.3, 1.6.1].

Prioritizing excellent blood glucose management and a daily skincare routine with high-quality moisturizers can prevent many skin issues from developing in the first place [1.9.4]. If itching and inflammation persist, discuss all your options—both steroidal and non-steroidal—with your doctor to create a treatment plan that is both safe and effective for you. For more information on managing diabetes and skin health, a great resource is the American Diabetes Association.

https://diabetes.org/about-diabetes/complications/skin-complications

Frequently Asked Questions

Yes, it is possible. Although rare, hydrocortisone cream can be absorbed through the skin and enter the bloodstream, which can lead to high blood glucose (hyperglycemia), especially with long-term use, high-potency formulas, or application on large areas of skin [1.4.2, 1.7.2].

The effect of steroids on blood glucose can occur within a day or two after starting the medication. For topical applications, this depends on the rate of systemic absorption [1.10.2, 1.10.4].

Safe alternatives include high-quality, fragrance-free moisturizers with ingredients like ceramides and urea, as well as non-steroidal anti-itch creams containing pramoxine hydrochloride. For inflammatory conditions, a doctor might prescribe calcineurin inhibitors [1.8.1, 1.8.3, 1.5.4].

Yes, it is highly recommended to monitor your blood glucose levels more closely when you start using a topical steroid, even an over-the-counter one. This helps you and your doctor detect any potential increase in your blood sugar levels early [1.3.3].

Yes, the potency of the steroid is a major factor. Higher-potency topical corticosteroids carry a greater risk of systemic absorption and, consequently, a greater risk of affecting your blood sugar levels and causing other side effects [1.6.2, 1.4.5].

You should be extremely cautious and consult your doctor. The skin on the feet can be prone to cracks and sores in people with diabetes, which can increase medication absorption. Your doctor or a podiatrist can give you the safest advice [1.9.4].

Symptoms of hyperglycemia include increased thirst and urination, blurry vision, and nausea. If you experience these symptoms while using a cortisone cream, check your blood glucose and contact your healthcare provider [1.4.2].