Hydrocortisone topical

General

• Type: Topical steroid
• Dosage Forms: 0.5%, 1%, 2.5% crm, lotion, oint
• Common Trade Names: Cortizone, Cortaid, Hytone, Texacort

Adult Dosing

Dermatoses, steroid-responsive

• Apply bid-QID

Pediatric Dosing

Dermatoses, steroid-responsive

• Apply bid-QID

Special Populations

• Pregnancy Rating: C
• Lactation: Excretion in milk unknown; use with caution
• Renal Dosing: None
• Hepatic Dosing: None

Contraindications

• Allergy to class/drug
• caution if skin infection
• caution in pediatric patients

Adverse Reactions

Serious

• HPA axis suppresion
• Cushing syndrome
• hyperglycemia
• intracranial hypertension (pediatric patients)

Common

• burning
• pruritus
• irritation
• dryness
• folliculitis
• hypertrichosis
• acneiform dermatitis
• hypopigmentation
• perioral dermatitis
• allergic contact dermatitis
• maceration
• secondary infection
• skin atrophy
• striae
• miliaria

Pharmacology

• Half-life: 8-12h
• Metabolism: liver primarily; CYP450
• Excretion: urine
• Mechanism of Action: exact mechanim of anti-inflammatory action unknown; inhibits multiple inflammatory cytokines; produces multiple gluocorticoid and mineralocorticoid effects

Indications by Condition

The following table is automatically generated from disease/condition pages across WikEM.

Indication	Dose	Context	Route	Population
COPD exacerbation	100-125 mg IV q6h x5 days	Corticosteroid (IV option)	IV	Adult
Pituitary apoplexy	100-200mg IV bolus, then 2-4mg/hr infusion	Stress-dose corticosteroid replacement	IV	Adult
Sepsis (main)	50 mg IV q6h (200 mg/day)	Stress dose steroids for septic shock	IV	Adult
Thyroid storm	300 mg IV bolus, then 100 mg IV TID	Adrenal insufficiency treatment + T4→T3 blockade	IV	Adult
Toxic megacolon	100mg q6hr	Anti-inflammatory for underlying IBD	IV	Adult

See Also

• Stress dose steroids
• Hydrocortisone (systemic)