Is Hydrocortisone Safe To Use For Seborrheic Dermatitis?

Managing seborrheic dermatitis can be challenging. Your skin care regimen might include various treatments, and hydrocortisone cream is often mentioned as a potential option. In fact, it’s one of the first treatments doctors prescribe.

Hydrocortisone can improve your symptoms almost overnight but is it safe to use?

Hydrocortisone is a topical steroid that can reduce inflammation and is used to treat a variety of skin conditions including eczema, seborrheic dermatitis and undiagnosed rashes. While it can be effective in alleviating the itch and redness, overuse or prolonged application can lead to adverse side effects, so it’s vital to use hydrocortisone judiciously. Hydrocortisone is also not a cure for Seb Derm. 

Let’s take a deep dive:

How Hydrocortisone Works

Topical hydrocortisone works by reducing inflammation and suppressing the immune response in the skin. When applied to the affected area, hydrocortisone is absorbed into the skin and binds to specific receptors in skin cells. This binding triggers a cascade of reactions that ultimately lead to the inhibition of inflammatory mediators, such as prostaglandins and leukotrienes.

By reducing the production of these inflammatory substances, hydrocortisone helps to alleviate symptoms such as redness, swelling, and itching. Hydrocortisone can also constrict blood vessels in the skin, further reducing inflammation.

The Case For Hydrocortisone

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Clinical studies have shown that hydrocortisone, when used as a treatment for seborrheic dermatitis, can help reduce inflammation and alleviate symptoms. One study found that hydrocortisone 1% was slightly more effective than ketoconazole 2% in reducing the severity of seborrheic dermatitis symptoms, such as redness and scaling, over a four-week treatment period (87.2% vs 81.6%).

Another study found that both hydrocortisone 1% and sertaconazole 2% resulted in significant improvement of Seborrheic Dermatitis lesions after 4 weeks of use but the improvement percentage was higher in the hydrocortisone group in week 2.

Both these studies report low risk of side effects from using hydrocortisone 1% cream over a 4 week period. They also suggest that hydrocortisone can be beneficial in managing the symptoms of seborrheic dermatitis, particularly in reducing inflammation and associated discomfort.

Wait! Before you run out to buy the largest tub of hydrocortisone possible, continue reading.

Appropriate Usage of Hydrocortisone Cream

Despite the evidence behind it, I’m not a fan of hydrocortisone and other steroid creams for seborrheic dermatitis unless your symptoms are profound and you need immediate symptom relief.

However, if you’ve decided to use hydrocortisone, use the lowest strength possible. Over-the-counter options come in 0.5% and 1.0% concentrations while prescribed hydrocortisone comes in higher strengths. As you can see from the trials, hydrocortisone 1% is potent enough to improve your symptoms.

Only apply a thin layer of hydrocortisone cream to the areas of skin you want to treat and rub it in gently. Wash your hands thoroughly after. Do this twice a day, only for as long as you need to feel some relief. For most people, this will not take more than a few days.

Don’t use hydrocortisone cream for more than 1-2 weeks unless directed by your health professional.

Potential Side Effects

While hydrocortisone cream sounds like it’s too good to be true, it is.

There are plenty of reasons why I don’t like to use hydrocortisone creams unless absolutely necessary. When you apply topical hydrocortisone to Seb Derm, you run the risk of rebound inflammation when you stop it. Some people then go back to using the cream and when they stop, the rash flares up again. This ends up being a vicious cycle that ends up with you and hydrocort being ‘friends’ for a very long time.

Using hydrocortisone over a long period may lead to more significant effects, such as:

  • Skin thinning: Prolonged use can reduce skin thickness and increase susceptibility to bruising.
  • Pigment changes: You may notice lightening or darkening of the skin in the areas where the cream is applied.

As your skin barrier is impaired, there is also a risk that you may absorb hydrocortisone into your blood stream. Prolonged exposure to hydrocortisone in the blood can increase your risk of high blood pressure, diabetes, immune suppression, Cushing’s disease and a host of other issues. Bear in mind that it’s unlikely you’ll have issues if you’re only using hydrocort cream on a small area of your skin for a few days.

What Should You Use Instead Of Hydrocortisone?

Seb Derm is not life-threatening even though it can be a real hit on the self-esteem. If you can bear to wait a few more days for the symptoms to improve, I recommend not using hydrocortisone cream but to focus on more sustainable long-term treatment and prevention.

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Instead, use an anti-fungal cream like Clotrimazole twice a day for 2 weeks. You’ll see an improvement in your symptoms within days but may need to use the cream semi-regularly for a few months before the rash stops coming back.

Read The Ultimate Guide to Seborrheic Dermatitis Treatment for an in-depth take.

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