When Should I Use Cortisone Cream? A Comprehensive Guide

October 8, 2025 •

5 min read

According to the American Academy of Family Physicians, topical corticosteroids, including cortisone cream (hydrocortisone), are an effective treatment for many dermatologic conditions involving inflammation and itching. Knowing exactly when should I use cortisone cream? is crucial for providing relief for common ailments like eczema, psoriasis, and insect bites while avoiding potential side effects.

Quick Summary

Cortisone cream (hydrocortisone) is a topical steroid that reduces inflammation, redness, and itching caused by various skin conditions. Safe and effective for short-term use, it requires understanding different potencies and proper application to avoid adverse effects.

Key Points

Identify the Right Condition: Use cortisone cream for inflammatory skin conditions like eczema, psoriasis, dermatitis, insect bites, and rashes, not for infections or fungal issues.
Choose the Right Potency: Over-the-counter (OTC) versions are for mild irritations and should only be used for short periods (up to one week), while higher potencies require a prescription for more severe conditions.
Apply Correctly: Apply a thin, even layer only to the affected area once or twice daily, and always wash your hands afterward.
Understand Application Duration: Limit continuous use, as prolonged application, especially with higher strengths, can lead to side effects like skin thinning and adrenal issues.
Know Where to Avoid Application: Never apply cortisone cream to the face, groin, underarms, or broken/infected skin without a doctor’s guidance due to increased absorption and side effect risk.
Consider Formulation: Select the right formulation (cream, ointment, lotion) based on the lesion characteristics, such as using an ointment for dry patches or a lotion for hairy areas.

Cortisone cream, or topical hydrocortisone, is a type of corticosteroid medication applied directly to the skin. It works by calming the body's immune response in the applied area, which helps to reduce inflammation, redness, and itching. This makes it a valuable tool in managing many inflammatory skin conditions, though it is not suitable for every skin issue. Understanding the correct usage, including potency, duration, and application, is essential for both effectiveness and safety.

What is Cortisone Cream?

Cortisone cream is a topical formulation of the corticosteroid hydrocortisone. Corticosteroids are a class of steroids, distinct from anabolic steroids, that are used to reduce inflammation. As a topical medication, very little of the active ingredient is absorbed systemically into the bloodstream, which minimizes the risk of body-wide side effects. The concentration of the active ingredient, hydrocortisone, determines the cream's potency, which can vary significantly between over-the-counter (OTC) and prescription products.

Conditions That Benefit from Cortisone Cream

Cortisone cream is effective for a variety of inflammatory skin conditions. These include:

Eczema (Atopic Dermatitis): It helps soothe flare-ups by reducing inflammation and the intense itching associated with eczema.
Psoriasis: For mild to moderate psoriasis, cortisone cream can help manage the plaques and scaling.
Contact Dermatitis: This includes allergic reactions to irritants like poison ivy, poison oak, and contact with cosmetics or jewelry.
Insect Bites and Stings: It provides fast relief from the itching and swelling caused by bug bites.
Heat Rash (Prickly Heat): It can calm the irritation and itching caused by sweat trapped under the skin.
Rashes: Many minor, unspecified skin rashes that are inflammatory in nature can be treated with a low-potency cortisone cream.
Seborrheic Dermatitis: It can help control the itching and scaling of dandruff and other oily skin conditions.

OTC vs. Prescription Strength: Choosing the Right Potency

The strength of cortisone cream is an important factor in its safe and effective use. Topical corticosteroids are classified into seven potency groups, with over-the-counter options being the mildest.

Low-Potency (OTC) Cortisone Cream

Available in concentrations up to 1% hydrocortisone, these products are for mild, minor skin irritations and are considered safe for short-term use. For many people, a 0.5% or 1% cream is sufficient for occasional use to manage common complaints like insect bites or mild rashes. OTC products should generally not be used for more than one week without consulting a doctor.

Medium- to High-Potency (Prescription) Cortisone Cream

Stronger cortisone creams, such as 2.5% hydrocortisone or other corticosteroids like triamcinolone, require a doctor's prescription. These are reserved for more severe or persistent conditions like certain cases of eczema or psoriasis that don't respond to milder treatments. The duration of use is strictly managed by a healthcare provider to prevent side effects.

How to Properly Apply Cortisone Cream

To use cortisone cream safely and effectively, follow these steps:

Wash and dry your hands and the affected skin area before application.
Apply a thin, even layer to the affected area only. A fingertip unit—the amount from the fingertip to the first crease—is enough to cover an area twice the size of an adult's palm.
Rub in gently until the cream disappears into the skin.
Wash your hands immediately after applying, unless you are treating the hands themselves.
Use sparingly and only for the duration recommended by the package or your doctor.

When to Avoid Cortisone Cream

Despite its benefits, cortisone cream is not for every skin problem. Always consult a healthcare professional before use, especially in these cases:

Skin Infections: Cortisone cream can suppress the skin's immune response, potentially worsening bacterial, fungal, or viral infections like impetigo, ringworm, athlete's foot, or shingles.
On the Face: The skin on the face is thinner and more sensitive. Unless specifically prescribed by a doctor, avoid using cortisone cream here, as prolonged use can cause thinning skin, acne, or rosacea.
Broken or Damaged Skin: Do not apply to open wounds, cuts, scrapes, or severe burns.
Sensitive Areas: Avoid application on the genitals, armpits, or around the eyes unless a doctor specifically advises it.
Diaper Rash: For babies, avoid using cortisone cream under tight-fitting diapers, as the occlusion increases absorption and side effect risk.
Long-Term Use: Using potent creams for extended periods or mild creams for longer than recommended can lead to side effects like skin thinning, stretch marks, and adrenal gland issues.

Comparison of Cortisone Cream Formulations


Feature	Cream	Ointment	Lotion	Gel/Solution
Use Case	Versatile; good for most conditions, including weeping or moist eczema.	Best for dry, thick, or scaly lesions like psoriasis and chronic eczema.	Good for large areas or hairy skin, as it's less greasy.	Ideal for the scalp and areas with dense hair; non-greasy.
Potency	Generally less potent than ointments of the same concentration.	More occlusive, so it increases steroid absorption and potency.	Least occlusive and often the least potent vehicle.	Penetrates quickly, good for hairy areas.
Texture	White, semi-solid, absorbed easily.	Greasy, petroleum-based, provides moisture barrier.	Liquid-based, thin, spreads easily.	Clear, quick-drying, non-greasy.
Advantages	Cosmically appealing, good compliance.	Maximum hydration and penetration for very dry skin.	Easy to apply to large or hairy areas; cooling effect.	Does not leave a residue on hair.
Disadvantages	May contain preservatives causing irritation.	Greasy, can feel unpleasant; may cause folliculitis in hairy areas.	Least potent option; can contain alcohol that stings.	Can cause stinging if skin is broken.

Potential Side Effects and Safety Precautions

While cortisone cream is safe when used correctly, misuse can lead to side effects. The risk increases with higher potency, longer duration, or application on sensitive skin.

Common Side Effects:

Burning, stinging, dryness, or irritation at the application site.
Acne-like breakouts.
Mild changes in skin color.

Serious Side Effects (more likely with prolonged, high-potency use):

Skin Thinning (Atrophy): The most common side effect of long-term use, causing delicate, easily bruised skin.
Stretch Marks (Striae): Can develop from skin thinning.
Adrenal Gland Issues: In rare cases of excessive, prolonged use, systemic absorption can suppress the adrenal glands.
Topical Steroid Withdrawal (TSW): After prolonged use, stopping the cream can cause a rebound flare-up with severe redness and burning.

For more in-depth information, you can consult the guidance from the American Academy of Family Physicians on Topical Corticosteroids.

Conclusion: Safe and Effective Use

When should you use cortisone cream? For minor, short-term inflammatory conditions like bug bites or mild eczema flare-ups, over-the-counter cortisone cream is a quick and effective solution. For more persistent or severe issues, a higher-potency prescription may be necessary under a doctor's supervision. Key takeaways include using the lowest effective strength for the shortest duration possible, being mindful of application areas, and avoiding use on infections or broken skin. By following these guidelines, you can safely harness the anti-inflammatory properties of cortisone cream to soothe irritated skin and find relief.

Frequently Asked Questions

You should not use cortisone cream on your face unless specifically instructed by a doctor. The facial skin is more delicate and absorbs steroids more readily, increasing the risk of side effects like skin thinning, acne, or rosacea.

For over-the-counter cortisone creams, do not use for more than seven days without consulting a doctor. For prescription strengths, follow your doctor's instructions, as the duration varies based on the condition and potency.

Cortisone cream is a generic term often used to refer to hydrocortisone cream. Hydrocortisone is the active ingredient in most topical products sold over the counter and by prescription to reduce skin inflammation.

Ointments are generally considered more potent than creams of the same strength because they are more occlusive, which helps the active ingredient penetrate the skin better. The choice depends on the skin condition, with ointments better for dry, scaly skin and creams better for weeping rashes.

No, cortisone cream is not an appropriate treatment for acne and can actually worsen breakouts or cause a skin reaction that mimics acne. There are other specific medications for treating acne.

If your symptoms do not improve after one week of using an OTC cortisone cream, or if they worsen at any point, stop use and consult a doctor. A healthcare provider can provide an accurate diagnosis and recommend the appropriate treatment.

Long-term or excessive use of cortisone cream can cause side effects such as thinning of the skin, stretch marks, easy bruising, and changes in skin pigmentation. In very rare cases, excessive use over large body areas can lead to systemic effects.

No, cortisone cream should not be used for fungal infections like ringworm or athlete's foot. It can mask symptoms and cause the infection to spread and worsen. An antifungal medication is required for these conditions.