Hydrocortisone ointment is a relatively safe steroid that you can purchase over-the-counter, or your doctor may prescribe a stronger version. Hydrocortisone ointment is typically used to treat itchy rashes caused by skin conditions such as eczema, poison ivy, insect bites or allergic reactions. It's important to follow the manufacturer or your doctor's directions for use, in order to minimize the chance of experiencing unwanted side effects. If your rash persists or seems to be getting worse, you should contact your doctor.
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Itching and Burning
Although hydrocortisone ointment is used to treat itching, you may be surprised to learn that it can also cause itching. This reaction most often results from hypersensitivity -- that is, an allergy to the ointment itself -- which manifests as a rash called allergic contact dermatitis. If you experience itching or worsening of your rash, you should discontinue hydrocortisone, because you may be allergic to it. Burning at the site of application may also occur with the use of hydrocortisone. This reaction is usually temporary.
The extended and frequent use of hydrocortisone may cause the skin to change or lose color due to hypopigmentation or telangiectasia. Hypopigmentation is a fading of the skin and telangiectasia is the chronic dilation or widening of capillaries, which results in red blotches on the skin. These discolorations usually occur around the treatment area. To minimize the risk of experiencing these side effects, apply the ointment sparingly. You should also limit the application to the affected areas only. The skin color will typically return to normal after you discontinue the drug.
Hydrocortisone may also cause skin atrophy or a thinning of the skin. Heavy application of the ointment, frequent use, overuse, or covering the application site increase the the risk for this side effect. Covering the site may also cause the skin to soften due to excessive moisture. To minimize the risk of experiencing skin atrophy, you should apply only a thin layer of the ointment to the affected areas.
Secondary Skin Infections
Hydrocortisone ointment lowers the body's immune response, thereby increasing the risk for developing infections. At the same time, other side effects, such as skin atrophy and softening of the skin affect, affect the integrity of the skin and put you at greater risk of developing secondary fungal or bacterial skin infections. In addition, if you apply hydrocortisone ointment to a weeping or oozing rash or to broken skin, your chance of developing an infection goes up. Secondary infections are usually minor and may be treated with an antibiotic or antifungal medication. However, to minimize your risk, keep the treated area clean and dry.