Which is better, hydrocortisone cream or ointment?

October 9, 2025 •

4 min read

While both deliver the same active ingredient, hydrocortisone cream and ointment have different formulations for distinct skin needs. The primary distinction lies in their oil-to-water ratio, affecting their texture, absorption, and overall efficacy for a particular condition.

Quick Summary

The best choice between hydrocortisone cream and ointment depends on the skin condition being treated. Cream is ideal for moist, weeping skin, while the more potent ointment is better for dry, thick, or flaky patches needing intense moisture.

Key Points

Formulation is key: The best choice between hydrocortisone cream and ointment depends on the skin condition being treated, with cream for moist skin and ointment for dry skin.
Ointments are more potent: For the same concentration, hydrocortisone ointments are generally stronger because their greasy, occlusive nature enhances skin absorption.
Creams are for moist rashes: Creams are water-based and have a mild drying effect, making them ideal for weeping, moist rashes, and applying to hairy areas.
Ointments are for dry skin: The high oil content of ointments provides superior moisturization and forms a protective barrier, best suited for dry, scaly patches like severe eczema.
Consider the application area: Creams are better for sensitive areas like skin folds to avoid maceration, while ointments can be too greasy for some areas and clothing.
Check for preservatives: Creams often contain preservatives that can cause irritation, while ointments are less likely to contain them, making them a gentler option for some sensitive skin.

The question of which is better, hydrocortisone cream or ointment, does not have a single answer; the most effective formulation depends entirely on the condition of the skin being treated. Hydrocortisone, a mild corticosteroid, works to reduce inflammation, redness, and itching, but its effect is significantly influenced by the vehicle (cream or ointment) that carries it. Choosing the right one is crucial for optimal results and patient comfort.

Understanding the Core Differences

The fundamental difference between a hydrocortisone cream and ointment is their composition. These variations directly impact their texture, absorption rate, and suitability for various skin types and conditions.

Hydrocortisone Cream: This is a semi-solid emulsion consisting of equal parts oil and water. Its water-based nature makes it lighter and non-greasy, allowing for quicker absorption into the skin. Creams are cosmetically more appealing to many and are easier to apply over larger or hairier areas. They also have a mild drying effect due to the water content, which can be beneficial for certain skin conditions.
Hydrocortisone Ointment: An ointment is an oil-based semisolid, typically containing 80% oil and 20% water. It has a thicker, greasier texture that does not rub in easily and remains on the skin's surface longer. The greasy consistency forms a protective, occlusive barrier that helps trap moisture, making it ideal for very dry skin.

Potency and Skin Absorption

Ointments are generally more potent than creams with the same concentration of hydrocortisone. This increased potency is not due to a different amount of the active ingredient but rather the ointment's occlusive nature. The protective, greasy layer of an ointment enhances the skin's absorption of the medication, allowing it to penetrate more deeply and work more effectively on thicker, drier skin. Creams, while still effective, are less occlusive and therefore deliver a less intense dose of the medication to the skin.

When to Choose Hydrocortisone Cream

Selecting the right formulation is a matter of matching the medication to the specific skin symptoms. A hydrocortisone cream is the better choice for certain conditions and application areas due to its unique properties.

For moist, weeping, or oozing rashes: The drying effect of the water content in a cream is beneficial for skin lesions that are weeping or producing fluid, such as some types of eczema or poison ivy rashes.
For skin folds (intertriginous areas): In areas where skin touches skin, like the groin, armpits, or between the fingers, ointments can trap moisture and increase the risk of maceration (skin softening) and folliculitis. A cream is a safer, more appropriate choice for these sensitive regions.
For hairy areas and the scalp: The lighter, less greasy texture of a cream makes it easier and more comfortable to apply to areas with hair without clumping or leaving a residue.
For patient preference: Many people find the less-greasy texture of creams more cosmetically appealing and are therefore more likely to use them consistently, which is a key factor in treatment success.

When to Choose Hydrocortisone Ointment

While creams have their place, ointments are the preferred option for other types of skin irritations, particularly those involving dryness and thickness.

For dry, flaky, or scaly patches: The occlusive and lubricating properties of an ointment are highly effective for conditions like severe eczema and psoriasis, where the skin is extremely dry and thickened. It provides deep moisturization while delivering the medication.
For enhanced potency and penetration: When treating very dry or tough skin, the enhanced absorption provided by an ointment means a higher amount of the steroid penetrates the skin, leading to a stronger therapeutic effect.
For sensitive skin reactions: Creams often contain preservatives to prevent microbial growth in their water content. These preservatives can sometimes cause stinging, irritation, or allergic reactions. Ointments, which contain fewer or no preservatives, may be better for individuals with sensitive skin.
For maximum barrier protection: The thick layer of an ointment provides an excellent barrier to protect irritated skin from external factors, aiding in the healing process.

Comparison Table: Cream vs. Ointment


Feature	Hydrocortisone Cream	Hydrocortisone Ointment
Composition	Equal parts oil and water	High oil content (~80%)
Texture	Lighter, smoother, non-greasy	Thicker, greasier, heavy
Absorption	Absorbs quickly into the skin	Absorbs slowly, remains on surface
Potency	Generally less potent (at same strength)	Generally more potent (at same strength)
Best For	Moist/weeping rashes, skin folds, hairy areas	Dry/flaky skin, thick patches, maximum potency
Drawbacks	May contain irritating preservatives, less hydrating	Greasy feel, harder to spread, can stain clothes

Important Safety Considerations

Regardless of the formulation, it is crucial to use hydrocortisone safely and correctly. Always follow the instructions provided by a healthcare professional or on the packaging.

Avoid prolonged use, especially on the face, as it can lead to skin thinning and other side effects.
Do not apply to infected or broken skin unless advised by a doctor, as it can mask or worsen an underlying infection.
Over-the-counter (OTC) hydrocortisone should typically be used for no longer than seven days.
Consult a healthcare provider for use on children under 2, pregnant individuals, or for sensitive body parts.

Conclusion: Making the Right Choice

There is no single "better" option between hydrocortisone cream and ointment; the best choice is the one that is most appropriate for the specific skin condition being treated. For dry, scaly, or thickened skin patches, an ointment provides superior occlusive and penetrating benefits. For moist, weeping rashes or areas where a less-greasy application is preferred, a cream is the ideal solution. When in doubt, consult a pharmacist or doctor to help determine the correct formulation. Consistent and appropriate use of the right product is the key to effectively managing skin irritation.

For more detailed information on eczema and its treatments, you can visit the National Eczema Association.

Frequently Asked Questions

The more effective choice depends on the cause of the itch. For dry, flaky skin, the more potent and moisturizing ointment is likely to provide better relief. For a weeping, moist rash, the cream may be more suitable.

You should use a hydrocortisone ointment for very dry, thick, or scaly skin conditions like severe eczema or psoriasis. The ointment’s greasy base provides more potent medication delivery and a protective, moisturizing barrier.

Hydrocortisone ointment should generally not be used on the face unless specifically prescribed and monitored by a doctor. The skin on the face is thinner and more sensitive, and prolonged use can cause skin thinning and other adverse effects.

For a moist, weeping poison ivy rash, a hydrocortisone cream is often a good choice because of its drying effect. However, for severe or widespread rashes, OTC options may not be sufficient, and a doctor should be consulted.

Yes, it is possible to use both formulations depending on the location and nature of your skin condition, but not on the same spot at the same time. For example, you might use an ointment on a dry, thick patch of eczema and a cream on a weeping area.

Ointments are less likely to contain preservatives that can cause irritation, but their occlusive nature can potentially cause folliculitis or maceration in skin folds. Creams may cause stinging or burning in some individuals due to their preservative content.

Over-the-counter hydrocortisone products (typically 1%) should not be used for more than seven days unless directed by a doctor. If your symptoms do not improve within this timeframe, or if they worsen, you should see a healthcare professional.