Over-use of any steroid cream, especially for long periods, on large areas of skin, can result in the body absorbing too much steroid. This may occasionally lead to a thinning and weakening of the skin. Some people with cracked or moist skin notice irritation when they apply the cream.
If you have a skin infection, this may spread or get worse. Red marks or lines may appear on the skin, the skin may become inflamed, you may get acne, or you may see a mild loss of pigment (colour) in the skin where the cream is used.
Skin thinning may occur where the skin rubs together or in the nappy area of young children.
Rarely local sensitivity may occur requiring discontinuation of treatment.
If you notice these or any other unusual effects, tell your doctor.
Samples for serum cortisol are taken at t=0 (typically 8am) prior to the patient’s first hydrocortisone dose, then at one, two, five and nine hours after this dose. For patients taking hydrocortisone three times a day, the second dose should be given after the five hour sample and the third after the nine hour sample. Patients taking hydrocortisone twice daily should take their second dose at seven hours with an additional sample taken at that time. Clearly mark the patient’s details, date and time on each bottle.