Is Hydrocortisone a Good Treatment for Acne?

Available over the counter in pill form and in creams and lotions, hydrocortisone is a medication that’s easily accessible in low doses. But is it safe to use as an acne treatment?

Dermatologist Jonathan Braue, MD, explains why people think hydrocortisone is a popular go-to solution for acne, and why you may want to try something else.

How does hydrocortisone work?

Hydrocortisone works in a few different ways. When it comes to your skin, it’s often used in a cream or lotion to calm your body’s immune system. By blocking your body’s inflammatory response, it helps reduce:

• Inflammation
• Itching
• Swelling
• Redness

“It’s most commonly used for eczema, psoriasis and other types of inflammatory dermatitis on the face,” says Dr. Braue. “But acne involves a very chronic type of inflammation that requires constant treatment, and hydrocortisone is often not enough to get the job done.”

How to use hydrocortisone for acne

As a treatment for acne, hydrocortisone works best when it’s used for a short period of time and paired with other acne treatments, like:

• Oral and topical antibiotics
• Vitamin A derivatives (or retinoids), like tretinoin (Retin-A®)
• Benzoyl peroxide
• Salicylic acid

“Hydrocortisone only suppresses part of the inflammation and it won’t treat the acne long term,” explains Dr. Braue. “Instead, it’s going to put a bandage on it to allow the other treatments to catch up and start managing the acne a little better.”

Hydrocortisone can also be used to treat severe flares of inflammatory acne or if you have acneiform (acne-like) eruptions in response to certain chemotherapies.

“A lot of drug-induced acne is very itchy, so hydrocortisone is an effective short-term treatment in those situations,” he adds. “If you have a really deep inflammatory cyst that’s not improving, we could inject a cousin of hydrocortisone called triamcinolone to bring that flare down, too.”

Precautions and side effects

If you have a bacterial infection on your skin, hydrocortisone can interfere with and suppress your body’s ability to fight it off. Using hydrocortisone can also lead to several side effects if you overuse it, including:

• Discolored or blotchy skin
• Thinning skin
• Increased redness
• Returning pain or itching

“Hydrocortisone only shuts down maybe one of four different mechanisms within acne,” clarifies Dr. Braue. “When you stop using hydrocortisone and pull it back, you can get a rebound effect where your symptoms return because all those other components are still there.”

While hydrocortisone may provide momentary relief, he emphasizes that it should never be used to treat acne by itself unless recommended by a healthcare provider.

“You should talk with your dermatologist before using a topical steroid like hydrocortisone for acne because it’s only a brief answer to the problem,” Dr. Braue states. “There are safer things to try over the counter and with the direction of your healthcare provider.”