Can steroid ointment raise blood pressure?

October 9, 2025 •

3 min read

While topical steroid ointments are common and safe for short-term use, systemic side effects can occur, including an increase in blood pressure. This happens when a significant amount of the medication is absorbed through the skin and enters the bloodstream.

Quick Summary

The risk of high blood pressure from steroid ointments is rare and primarily linked to high-potency products, extensive application, or prolonged use. Absorption into the bloodstream can cause systemic side effects, requiring careful monitoring, especially in at-risk individuals.

Key Points

Rare but Possible: Steroid ointment can raise blood pressure, but this is a rare systemic side effect, not a common one.
Absorption is Key: This occurs when a significant amount of the steroid is absorbed through the skin into the bloodstream, a process called systemic absorption.
Risk Factors Matter: High potency, prolonged use, extensive application areas, and occlusive dressings increase the risk of systemic absorption and side effects.
Vulnerable Populations: Children and individuals with pre-existing hypertension or heart conditions are more susceptible to this risk.
Safe Usage is Essential: To minimize risk, use the lowest effective dose, follow your doctor's instructions strictly, and monitor your blood pressure if you are using a high-potency steroid for a long time.

Understanding the Link Between Steroid Ointment and Blood Pressure

For most individuals using a steroid ointment as prescribed—that is, for short periods on limited areas of the skin—the risk of it affecting blood pressure is extremely low. However, the active ingredient in these ointments, a corticosteroid, can be absorbed through the skin and enter the bloodstream, leading to systemic effects. While topical application is designed to be a localized treatment, certain conditions can increase the likelihood of systemic absorption and, in rare cases, lead to elevated blood pressure.

Steroids can raise blood pressure through mineralocorticoid effects, causing salt and water retention and increasing fluid volume. This is more common with oral steroids, but can occur with sufficient topical absorption. Steroids may also increase sensitivity to hormones that raise blood pressure.

The Mechanism: How Systemic Absorption Can Occur

Systemic absorption is influenced by several factors:

Key factors that enhance systemic absorption include:

Higher potency: Stronger steroids are more likely to be absorbed.
Duration of use: Longer use increases the total absorbed dose.
Large body surface area: Applying over a large area, especially in children, increases risk.
Occlusive dressings: Covering the area with bandages increases absorption.
Site of application: Areas with thinner skin absorb more.
Damaged or inflamed skin: Increases absorption rates.
Age: Children and infants are more vulnerable due to thinner skin and higher surface area to weight ratio.

Factors That Increase the Risk of Elevated Blood Pressure

Certain patient factors can increase the risk of hypertension from topical steroid use. Discuss your medical history with your healthcare provider.

Pre-existing hypertension: Can worsen with steroid-induced fluid retention.
Kidney or heart problems: May make individuals less able to manage fluid and electrolyte imbalances caused by steroids.
Other steroid use: Combining topical steroids with other forms increases overall systemic exposure and risk.

Comparing Topical Steroids vs. Oral Steroids


Feature	Topical Steroids (Ointments, Creams)	Oral Steroids (Tablets, Syrups)
Absorption	Localized effect, minimal systemic absorption with proper use.	Absorbed directly into bloodstream, systemic effect.
Potency	Ranges from mild to super-high.	Typically higher potency and uniform systemic dose.
Side Effects	Primarily local, systemic effects like hypertension are rare.	Higher risk of systemic side effects, including hypertension.
Use Case	Treats localized skin conditions.	Treats widespread or severe inflammatory conditions.

How to Safely Use Steroid Ointments

Follow your dermatologist's instructions to minimize risk:

Follow directions strictly: Use only as prescribed for the recommended duration.
Use the lowest effective dose: A healthcare provider will prescribe the lowest potency necessary.
Limit application area: Apply only to the affected area.
Avoid occlusion: Do not cover the area with bandages unless instructed by a doctor.
Monitor blood pressure: Regular checks are essential if using potent steroids long-term or with a history of hypertension.
Recognize symptoms of systemic absorption: Watch for swelling, unusual tiredness, increased thirst, or frequent urination.
Do not stop abruptly: A doctor may advise tapering after extended use.

Conclusion

The risk of steroid ointment raising blood pressure is rare and linked to specific factors like high potency, prolonged use, and extensive application. Safe use under medical guidance, avoiding overuse, and adhering to the treatment plan are crucial for minimizing this risk. Individuals with pre-existing conditions should discuss them with their healthcare provider.

For more clinical information, consult resources from organizations like the American Academy of Family Physicians (AAFP).

Note: This article is for informational purposes only and does not constitute medical advice. Consult a healthcare professional for diagnosis and treatment.

Frequently Asked Questions

It is very unlikely for normal, short-term use of steroid ointment to cause high blood pressure. The risk is considered rare and is primarily associated with misuse, such as applying high-potency steroids over a large body area for an extended period.

Since high blood pressure from topical steroids is a systemic effect, signs can include swelling in the ankles or feet due to fluid retention, headaches, or unusual weakness. You should also watch for other systemic signs like weight gain or increased thirst.

The risk of hydrocortisone cream causing elevated blood pressure is minimal due to its low potency. It would require extensive, long-term application over a large surface area to cause noticeable systemic effects, but caution is still advised for those with a history of hypertension.

Factors increasing absorption include using a high-potency steroid, applying it to large or thin-skinned areas (like the face), covering the area with a dressing (occlusion), and applying it to inflamed or damaged skin.

Yes, oral steroids carry a significantly higher risk of systemic side effects, including high blood pressure, compared to topical steroids. This is because oral medication is fully absorbed into the body's system, whereas topical absorption is minimal under normal use.

You should contact your doctor immediately. Do not stop using the steroid abruptly without medical advice, as this could cause other complications. Your doctor will assess your blood pressure and may adjust your treatment plan.

Use the lowest effective potency for the shortest duration possible, apply it only to the affected area as directed, and avoid occlusive dressings unless specifically told to do so by your doctor.