Hydrocortisone Cream for Babies

Carrie Madormo, RN, MPH
·7 min read

Medically reviewed by Chris Vincent, MD

Babies can experience itchy, red skin for a variety of reasons. Their skin is sensitive and easily irritated. While hydrocortisone cream is a go-to for adults with irritated skin, it typically is not recommended for children under the age of 2 unless otherwise directed by a healthcare provider.

This article will discuss hydrocortisone cream for babies, and other ways to treat itchy skin.

What Is Hydrocortisone Cream?

Hydrocortisone cream is a topical corticosteroid medication. It works by activating the natural substances in the skin that can reduce swelling.

Over-the-counter hydrocortisone 1% cream is generally not recommended for children under age 2 due to potential health risks associated with it. Although harmful side effects are rare, children who use hydrocortisone cream regularly for a long time may be more likely to experience slowed growth rates and delayed weight gain.

It is generally safe in children over age 2 when used for brief periods (one to two weeks at a time) but check with your pediatrician or healthcare provider if in doubt. It is used to treat skin conditions that cause redness, swelling, or itching.

Hydrocortisone cream can help to relieve these symptoms but will not cure the underlying cause. It should always be used exactly as prescribed by your healthcare provider.

Learn More: Understanding How Topical Steroids Work

Side Effects and Risks for Babies

Common side effects of hydrocortisone cream include skin dryness and irritation, as well as increased hair growth.

Prolonged use of topical steroids can cause adrenal gland insufficiency, a condition where the body doesn't make enough of the hormone cortisol.

Other side effects can include allergic reactions and symptoms can look similar to the reasons you would use the cream, such as:

  • Burning, itching, irritation, redness, or dryness of the skin

  • Skin color changes

  • Small white or red bumps on the skin

If the rash or symptoms get worse than they were originally, it is likely an allergic reaction.

Side effects to report to your healthcare provider include:

Reasons to Use Hydrocortisone Cream on Babies

Strong steroid creams should be avoided in babies due to the potential health risks associated with them. However, mild steroid creams such as over-the-counter hydrocortisone 1% cream may be used for babies with eczema, but check with your pediatrician or other healthcare provider before using it.

Alternative Treatments

The best way to treat your baby’s itchy skin is to determine the underlying cause. Some possible causes of itchy skin include diaper rash, eczema, and allergies.

Possible treatments for itchy skin include moisturization, daily baths, antihistamines, and plant oils. Some good examples of moisturizers include:

  • Humectants like glycerin and urea attract water from the environment and the skin’s surface into deeper layers of skin. They also help the skin to shed dead cells and appear healthier.

  • Occlusives like beeswax and mineral oil increase the water content of the skin by preventing water loss through evaporation. They are most effective when applied to damp skin, such as after toweling off from a bath.

  • Emollients like lanolin and propylene glycol linoleate act as lubricants that fill in the crevices between skin cells. They improve skin’s hydration and smoothness.

For conditions like diaper rash, baby eczema, and allergies, here are some specific alternative treatments and at-home remedies.

Diaper Rash (Baby Contact Dermatitis)

The key to treating diaper rash is prevention. Help your child avoid diaper rash by changing dirty diapers (even wet ones) as soon as possible. When moisture is trapped in the diaper, skin breakdown can occur. Other diaper rash remedies include:

  • Gentle cleansing: To prevent diaper rash from becoming infected, it is important to keep your child’s skin clean and dry. Use a warm washcloth or alcohol-free wipes when changing your child’s diaper. If the rash is severe, use a squirt bottle with warm water to avoid rubbing the skin.

  • Going diaper-free: Once you have washed your child’s skin, allow them to remain diaper-free as long as possible. This allows the skin to air dry, which can lead to quicker healing.

  • Zinc oxide: Choose a diaper rash cream that contains zinc oxide and use it frequently. Apply a thick layer with each diaper change and continue using until your child’s skin heals.

Related: Identify and Treat a Yeast Diaper Rash at Home

Baby Eczema

One of the most effective treatments for eczema in babies is to avoid your child’s triggers. These can include saliva, sweat, dry air, tobacco smoke, pet dander, foods, or other irritants.

If you can determine your child’s triggers, work with your child's pediatrician or healthcare provider to create a plan for avoiding them. In addition, eczema treatments for babies include:

  • Moisturization: Apply a thick, quality moisturizer to your child’s skin at least twice a day.

  • Topical calcineurin inhibitors: These medications (recommended for children over the age of 2) can help to prevent redness and itching in the skin.

  • Antibiotics: Antibiotics may be needed if a patch of skin becomes infected due to scratching.

  • Antihistamines: Antihistamines can help to relieve the itching associated with eczema.

  • Steroid creams: Your healthcare provider may recommend a short course of steroid cream (for children over 2) to get your child’s eczema symptoms under control.

  • Oatmeal bath: Colloidal oatmeal or oat oil can add moisture and decrease inflammation. Oats have antioxidant properties that may help promote wound healing.

  • Coconut oil: As a natural remedy coconut oil is a safe and effective treatment for dry skin. It moisturizes the skin while improving the skin’s barrier function, but more study is needed to establish it as an effective treatment for eczema. It's also important to note that in rare cases people can be allergic to coconut oil.

  • Cool compress: Apply a cool, wet washcloth to your child’s skin to help ease the redness and itching.

  • Prevent scratching: It is natural for babies and young children with eczema to scratch their skin. This can make eczema worse and lead to infection. Try to keep any eczema areas of the skin covered and keep your child’s nails trimmed. 

Daily baths are an important part of eczema treatment in babies. First, the bath works to remove dirt and other irritants from the skin. After the bath, gently pat your baby’s skin dry and apply a thick moisturizing cream to help lock in moisture.

Eczema skin is very dry, so using a moisturizer after bathing can be very effective. Be sure to use lukewarm water in your child’s bath and avoid any soaps that contain dyes, fragrances, or harsh additives.

Learn More: What Is Baby Eczema?

Allergies

If your baby is allergic to a certain food or group of foods, they could experience a flare (worsening of symptoms) in their eczema symptoms anytime they come in contact with it.

However, it can be difficult to determine if your child’s eczema is related to food allergies because skin allergic reactions may occur days after exposure. Practitioners generally do not recommend elimination diets for eczema.

If you are concerned that your child’s eczema gets worse after eating certain foods, talk with your child's healthcare provider. They may recommend temporarily removing dairy or processed foods from your child’s diet and observing their skin for changes.

Depending on which allergen caused your baby’s skin irritation, the treatment options will vary. Your doctor may recommend a short-term course of steroids to ease the symptoms. From there, your medical team will work with you to determine which substances irritate your baby’s skin and how to avoid them. 



Explainer

To help prevent skin irritation, wash your baby’s clothes in a gentle detergent that is free of scents. Look for baby products that are free of dyes, scents, or other additives.



Learn More: Moisturizer Ingredients: Understanding the Label

Summary

Hydrocortisone cream is a topical corticosteroid medication used to treat redness, itching, and swelling in the skin. It is generally not recommended for children under age 2 unless directed by your healthcare provider. Your baby’s skin may itch because of diaper rash, eczema, allergies, or other health conditions.

Several medicinal, natural, and home remedies may be appropriate for different conditions. Talk with your child's healthcare provider about the best remedies for your child's condition.

Read the original article on Verywell Health.