Hydrocortisone Topical (patient information)

Why this medication is prescribed

Hydrocortisone is available with or without a prescription. Low-strength preparations (0.5% or 1%) are used without a prescription for the temporary relief of (1) minor skin irritations, itching, and rashes caused by eczema, insect bites, poison ivy, poison oak, poison sumac, soaps, detergents, cosmetics, and jewelry; (2) itchy anal and rectal areas; and (3) itching and irritation of the scalp. It is also used to relieve the discomfort of mouth sores.

Hydrocortisone may be prescribed by your doctor to relieve the itching, redness, dryness, crusting, scaling, inflammation, and discomfort of various skin conditions; the inflammation of ulcerative colitis or proctitis; or the swelling and discomfort of hemorrhoids and other rectal problems.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

How should this medication be used

Hydrocortisone comes as ointment, cream, lotion, liquid, gel, medicated cloth towelette, and spray for use on the skin; foam, suppositories, cream, ointment, and enema for rectal use; and paste for use in the mouth.

Hydrocortisone is usually used one to four times a day for skin problems.

For mouth sores, it usually is applied two or three times a day after meals and at bedtime. If mouth sores do not begin to heal within 7 days, call your doctor.

For colitis, hydrocortisone usually is used every night or twice a day (every morning and night) for 2 or 3 weeks. Although colitis symptoms may improve within 3-5 days, 2-3 months of regular enema use may be required. Call your doctor if your colitis symptoms do not improve within 3 weeks.

For proctitis, hydrocortisone usually is used one or two times a day for 2-3weeks, then if necessary every other day until your condition improves. Proctitis symptoms may improve within 5-7 days.

For hemorrhoids, hydrocortisone usually is used twice a day (every morning and night) for 2-6 days.

Follow the directions on the label carefully, and ask your doctor or pharmacist to explain any part that you do not understand. Use hydrocortisone exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

If you obtained hydrocortisone without a prescription and your condition does not improve within 7 days, stop using it and call your doctor.

Call your doctor if any area treated with hydrocortisone gets worse or if redness, swelling, or oozing of pus develops.

To use hydrocortisone ointment, cream, lotion, liquid, or gel on your skin, wash or soak the affected area thoroughly before applying the medication, unless it irritates your skin. Then apply sparingly in a thin film and rub it in gently.

To use the lotion, liquid, or gel on your scalp, part your hair, apply a small amount of the medicine on the affected area, and rub it in gently. Protect the area from washing and rubbing until the medication dries. You may wash your hair as usual but not right after applying the medicine.

To apply the aerosol spray, shake well and spray on the affected area holding the container about 3-6 inches away. Spray for about 2 seconds to cover an area the size of your hand. Take care not to inhale the vapors. If you are spraying near your face, cover your eyes.

Avoid prolonged use on the face, in the genital and rectal areas, and in skin creases and armpits unless directed to do so by your doctor.

If you are using hydrocortisone on your face, keep it out of your eyes.

If you are using hydrocortisone on a child=s diaper area, do not use tight-fitting diapers or plastic pants. Such use may increase side effects.

Do not apply cosmetics or other skin preparations on the treated area without talking to your doctor.

If your doctor tells you to wrap or bandage the treated area, follow these instructions:

1. Soak the area in water or wash it well.
2. While the skin is moist, gently rub the medication into the affected areas.
3. Cover the area with plastic wrap (such as Saran Wrap or Handi-Wrap). The plastic may be held in place with a gauze or elastic bandage or adhesive tape on the normal skin beside the treated area. (Instead of using plastic wrap, plastic gloves may be used for the hands, plastic bags for the feet, or a shower cap for the scalp.)
4. Carefully seal the edges of the plastic to make sure the wrap adheres closely to the skin. If the affected area is moist, you can leave the edges of the plastic wrap partly unsealed or puncture the wrap to allow excess moisture to escape.
5. Leave the plastic wrap in place as long as directed by your doctor. Usually plastic wraps are left in place no more than 12 hours each day.
6. Cleanse the skin and reapply the medication each time a new plastic wrapping is applied.

Apply the rectal cream or ointment externally to the anal area. Some nonprescription creams may be applied to the genital and anal areas; read the label of the product you are using carefully.

The hydrocortisone enema comes with directions that you should follow carefully. Lie on your left side while using the enema and for 30 minutes afterward. Try to hold the enema in for at least 1 hour and preferably all night.

The rectal foam also comes with directions that you should follow carefully. A special applicator is provided and always should be used to apply the foam. Do not insert any part of the container into your rectum. After using the applicator, take it apart and clean it thoroughly with warm water.

To insert a rectal suppository, follow these steps:

1. Remove the wrapper. If the suppository is too soft to insert, chill it in the refrigerator for 30 minutes or run cold water over it before removing the foil wrapper.
2. Dip the tip of the suppository in water.
3. Lie down on your left side and raise your right knee to your chest. (A left-handed person should lie on the right side and raise the left knee.)
4. Using your finger, insert the suppository into the rectum (about 1/2 to 1 inch in infants and children and 1 inch in adults). Hold it in place for a few moments.
5. Remain lying down for 15 minutes. Then, stand up, wash your hands thoroughly, and resume your normal activities.

Note that some hydrocortisone suppositories may stain fabric, so take any precautions needed.

Special precautions

Before using hydrocortisone:

• tell your doctor and pharmacist if you are allergic to hydrocortisone or any other drugs.
• tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially cancer chemotherapy agents, other topical medications, and vitamins.
• tell your doctor if you have an infection or have ever had diabetes, glaucoma, a circulation disorder, or an immune disorder.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using hydrocortisone, call your doctor immediately.
• remember not to use hydrocortisone on children less than 2 years of age without talking to a doctor.

What to do if you forget a dose

Apply the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not apply a double dose to make up for a missed one.

Side effects

Minor side effects

Hydrocortisone may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• drying or cracking of the skin
• acne
• itching
• burning
• change in skin color

Severe side effects

If you experience any of the following symptoms, call your doctor immediately:

• severe skin rash
• difficulty breathing or swallowing
• wheezing
• skin infection (redness, swelling, or oozing of pus)

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/MedWatch/report.htm] or by phone [1-800-332-1088].

Storage conditions needed for this medication

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it according to the package instructions. Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

Other information

Keep all appointments with your doctor.

Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.

Brand names

• Ala-Cort®
• Ala-Scalpt®
• Anucort-HC®
• Anu-Med® HC
• Anusert® HC-1
• Anusol-HC®
• Anusol-HC®-1
• Aquanil HC®
• Caldecort® Anti-Itch
• Cetacort®
• CortaGel® Extra Strength
• Cortaid® FastStick® Maximum Strength
• Cortaid® Intensive Therapy
• Cortaid® Maximum Strength
• Cortaid® Sensitive Skin Formula
• Cortaid® Spray Maximum Strength
• Cortenema®
• Corticaine®
• Cortifoam®
• Cortizone for Kids®
• Cortizone®-5
• Cortizone-10®
• Cortizone-10® External Anal Itch Relief Creme®
• Cortizone-10® Scalp Itch Formula Liquid
• Dermacort®
• Dermarest® DriCort®
• DermiCort®
• Dermtex® HC
• Dermtex® HC Spray
• Gynecort® 10
• Hemorrhoidal®-HC
• Hemril-HC® Uniserts®
• HydroSKIN®
• Hytone®
• LactiCare®-HC
• Lanacort® 10
• Locoid®
• Massengill® Medicated Soft Cloth Towelette®
• Nupercainal® Hydrocortisone Anti-Itch Cream
• Nutracort®
• Orabase® HCA
• Pandel®
• Penecort®
• Preparation H® Hydrocortisone
• Proctocort®
• ProctoCream®-HC
• Sarnol® HC
• Scalp-Aid®
• Scalpcort® Maximum Strength
• Texacort®
• Westcort®

Brand names of combination products

• Analpram-HC® containing Hydrocortisone Acetate and Pramoxine Hydrochloride
• Carmol® HC containing Hydrocortisone Acetate and Urea
• Cortisporin® containing Hydrocortisone, Bacitracin Zinc, Neomycin Sulfate, and Polymyxin B Sulfate
• Enzone® containing Hydrocortisone Acetate and Pramoxine Hydrochloride
• Epifoam® containing Hydrocortisone Acetate and Pramoxine Hydrochloride
• Lazersporin-C® containing Hydrocortisone, Neosporin Sulfate, and Polymyxin B Sulfate
• Mantadil® containing Hydrocortisone Acetate and Chlorcyclizine Hydrochloride
• Pramosone® containing Hydrocortisone Acetate and Pramoxine Hydrochloride
• proctoFoam®-HC containing Hydrocortisone Acetate and Pramoxine Hydrochloride
• Zone-A® Cream containing Hydrocortisone Acetate and Pramoxine Hydrochloride
• Zone-A® Forte Lotion containing Hydrocortisone Acetate and Pramoxine Hydrochloride
• Zone-A® Lotion containing Hydrocortisone Acetate and Pramoxine Hydrochloride