I will always remember a conversation I had with Dr. Jack Arbiser, the Thomas J. Lawley Professor of Dermatology at Emory University, where he summarized the history of crucial medications. Antibiotic use started in the 1930s and helped end death from infections such as syphilis, tuberculosis, and bacterial pneumonia. Corticosteroids such as prednisone came about in the 1950s, and helped patients suffering from autoimmune diseases such as lupus and rheumatoid arthritis. By the 1960s, physicians learned that long-term prednisone was not a good long-term treatment plan for many because of its side effects. Non-prednisone immunosuppressant medications came about in the 1970s. These medications are still used today and commonly used in transplant patients to prevent rejection of their transplanted organ. Today, biologics, which are medications that target certain proteins of the immune system, help conditions such as psoriasis, rheumatoid arthritis, Crohns disease and even cancer. The history of medicine is amazing. What else will it bring in the years to come?
The reason we walk through the history of these medicines is to remind us of the good they have done throughout the years. But remember, all medications carry benefits and risks. It is up to physicians and patients to make informed decisions about their use together.
This discussion will focus on over the counter (OTC) hydrocortisone, a medication used as an anti-itch and anti-inflammatory to treat conditions such as bug bite reactions and mild skin rashes. The question we will answer today is: is hydrocortisone cream safe for babies?
Hydrocortisone is a corticosteroid that works as an anti-inflammatory agent. Topical corticosteroids have been around in medicine for more than 50 years and are used to treat skin conditions such as eczema, psoriasis, autoimmune diseases such as lupus, lymphoma, drug reactions and rashes, and severe allergic reactions. It reduces redness, itching, swelling, and other discomfort caused by these significant skin conditions, as well as the more common skin conditions such as bug bites, poison ivy, skin allergies, and mild eczema. In mild eczema, topical OTC hydrocortisone helps to minimize the itch-scratch cycle.
Topical hydrocortisone is found in both over-the-counter (OTC) and prescription strengths and is found in a variety of forms including creams, lotions, ointments, spray, gel, foam, and stick. In the USA, topical corticosteroids are categorized into seven categories, based upon their strength and potency. Category I is the strongest and VII is the weakest. OTC 1% hydrocortisone falls into category VII and is known to be one of the weakest topical corticosteroids. Even though it is one of the weakest corticosteroids, OTC 1% hydrocortisone should be respected as a medication and not over used.
As for the proper use of a topical hydrocortisone and other corticosteroids, it is very important that you use this medicine only as directed by your doctor. In children, OTC 1% hydrocortisone is intended for use in children over the age of two. It can be used safely with babies when used in small amounts and for short periods of time. The Baby Pibu team recommends that parents contact a physician before using Baby Pibu Rash Relief, which contains 1% hydrocortisone.
As a rule of thumb, if you are treating a rash with topical hydrocortisone and you do not see significant improvement after three days, you should contact your physician for further supervision. Also, if you are finding yourself using OTC topical hydrocortisone once a week, it could mean that you are developing chronic use of the corticosteroid and you should contact a physician. Topical hydrocortisone can be used on all body parts but should not be used for extended periods of time on the face, groin and backs of knees and elbows. Do not use topical hydrocortisone for the treatment of diaper rash.
As with any medicine, there can be significant side effects from the long-time use of topical hydrocortisone. Long-term use of a topical corticosteroid (no matter if weak or strong) can lead to the thinning of skin and formation of grooves. Chronic use can also lead to loss of pigmentation (color) in the skin. If used all over the body for extended periods of time, there can be widespread absorption of the hydrocortisone that could potentially lead to adrenal gland dysfunction.
Topical OTC 1% hydrocortisone can significantly help common baby skin conditions such as mild flare ups of eczema, drool rash, baby acne, cradle cap, and bug bite reactions. Because it is an anti-inflammatory agent, it can provide relief for itchy, uncomfortable babies. However, before using an OTC 1% hydrocortisone cream, talk with your doctor and make sure it’s safe for your baby. And remember, hydrocortisone is a medicine, and while medicines are amazing and have made tremendous progress over the years, there are still risks associated with them. The bottom line: is hydrocortisone cream safe for babies? Yes. Just be sure to keep talking with your doctor and use them as directed.
For more information on hydrocortisone use with babies and the whole family, read the following: