All the Ways You Can Use Cortisone Cream, According to a Derm
"We put it on *almost* everything."
I have mad respect for the power of cortisone cream—most derms do.
"It is like the Windex of dermatology," says Kavita Mariwalla, M.D., a dermatologist in West Islip, New York. And she is certainly right. We put it on *almost* everything.
Dermatologists rely on cortisone multiple times a day in and out of the office to quell skin woes. It's the OG, untouched by other topical competitors. But, just as with any other love affair, this relationship comes with boundaries and requires detailed knowledge of limitations, including when to use it and when to not use it. Here's your guide.
What Exactly Is Cortisone Cream?
So, what is this magic cream anyway? You're probably familiar with cortisol, a stress hormone found naturally in the body that helps to keep inflammation down—but you can also harness the benefits of cortisol in a topical form. When cortisone cream is applied to an inflamed area, it decreases itch, pain, and the appearance of red, swollen skin. "Cortisol is what your body uses to neutralize inflammation, so we use it too," says Chesahna Kindred, M.D., of Kindred Hair and Skin Center in Columbia, Maryland.
Cortisone (also called steroid) cream is a bottled-up, synthetic version of all-natural, anti-inflammatory cortisol. It can be found over the counter or in varying prescription strengths (just like there are many varieties of pain medications). And if you're hunting for cortisone cream in an aisle of your drugstore, you might come across hydrocortisone cream (a type of cortisone cream) and wonder if it's the same thing or if you'll get a similar result when using it. The answer: It's also a corticosteroid and helps to relieve inflammation in various parts of the body. (Related: What’s the Best CBD Cream for Arthritis Pain?)
How to Use Cortisone Cream
Sounds all good in the derm neighborhood, right? But there are, as to be expected, a few caveats. Cortisone should not be used on the face near the eye if you have a history of glaucoma, and its use needs to be authorized by a medical professional if pregnant or nursing.
While it is safe to use for most, you shouldn't use it as an everyday skin-care cream. "Even though over-the-counter cortisone cream is mild and has a low side-effect profile, a good rule of thumb is to limit usage by not using it on the same spot for more than two weeks out of a month," warns Jeaneen Chappell, M.D., a dermatologist in Dallas, Texas. This is to avoid side effects such as skin thinning, broken capillaries, and even worsening of infections, acne, and rosacea. (Related: What Is Rosacea—and How Do You Deal with It?)
This dermatologic dream cream will forever have a place in my heart and medicine cabinet next to my sunscreen and retinol—but that doesn't mean it's a cure-all for everything. "Cortisone cream is a great first step for minor dermatoses (aka poison ivy, bug bites, an inflamed pimple) and may save you a trip to the dermatologist, but if the problem persists for more than a week, it is time to call in the professional," says Corey Hartman, M.D., Medical Director of Skin Wellness Dermatology in Birmingham, Alabama. (Related: The Skin-Care Products Derms Would Buy If They Had $30 to Spend At the Drugstore)
All the Ways You Can Use Cortisone Cream
Cortisone has been successfully doing its thing since the 1950s and has accrued a lot of different uses over the years, from reducing irritation from bug bites and poison ivy to treating cold sores and pimples. The bottom line: It can treat ~a lot~ of skin issues. Have a hardly-used tube of it in your bathroom cabinet? Ahead, a guide to all the scenarios in which this little miracle worker can come in handy. (Related: What Top Skin Docs Do When They Get a Pimple)
Chances are, you know the saying "leaves of three, let them be," but sometimes those little buggers sneak up on you—and bam! Enter misery, stage left. Luckily, cool compresses and some cortisone cream can do wonders. Just note that the cream may not stop poison ivy from spreading if the plant resin has already touched other parts of your body; an oral medication is often necessary to stop the progression of poison ivy.
Ever wonder why your flesh is the feast bugs choose? I do. They eat me alive. I always have a little tube of cortisone cream chillin' in my fridge to slap on the second I get attacked. Cool cortisone quickly decreases itch and puffiness. (Related: This $10 Product Painlessly Sucks Insect Saliva from Under Your Skin to Get Rid of Itching and Stinging)
Allergic Contact Dermatitis (ACD)
Allergic contact dermatitis results when a chemical, product, or plant (such as poison ivy) that you are allergic to touches the skin. Think of the nickel in jewelry, the dye in your go-to jeans, the fragrance in your favorite perfume, bandages, nail polish, detergents, and rubber soles in shoes. If allergic, the skin will react with an itchy, red scaly rash, that will not abate until you eliminate the trigger. Sometimes it takes a bit of investigative work to find the culprit—but in the meantime, cortisone cream can provide sweet relief.
Eczema or Winter Itch
Sometimes in the winter, when I take my socks off, a plume of dead skin cells flies into the air like confetti at a party. Nasty, I know. Embarrassing too, given my profession. And that ash can itch. This condition is called winter itch and is a form of eczema. To remedy the discomfort, I lube up my legs with Vaseline during the day and dab a bit of steroid cream on at night to reduce the itch. (Need relief from eczema? Check out more expert-approved creams here.)
If you were out in the sun for too long or forgot to reapply your SPF, you might be dealing with a painful sunburn. (Just remember that one severe sunburn can double your risk of developing skin cancer, so you'll want to take sun protection seriously.) To lessen the pain, first seek shade. Next, make sure to apply and reapply a broad-spectrum SPF of 30 or higher to your entire body every two hours. Treat your reddened skin with a bit of cortisone to decrease inflammation and pop an anti-inflammatory such as Aspirin if you're really miserable. Drink loads of water to keep your body and skin adequately hydrated, and lastly, never fry again.
Cold sores are a form of the herpes virus. They're most commonly found on the lips or nose and can recur with menses, exposure to ultraviolet light, immune suppression, and in times of stress. While cold sores can be painful, cortisone cream can be helpful (in addition to antiviral medications), particularly if applied right when you feel the lesion coming out. The steroid does not stop it from coming out, however applying it does make the lesion smaller, less red, and much less painful. If only a small amount of cream is applied, there should be no risk of applying near your mouth. (Related: Is It a Lip Cold Sore or a Pimple? Plus, How to Get Rid of It In 24 Hours)
Bring on the steroid cream! A little dab right on a pimple can make all the difference in the world. This will make the lesion less obvious, less red, and much more likely to resolve quickly. Just don't slather it all over your face, as that can make acne worse. There is no great scientific answer as to why large amounts of steroid cream used make acne worse; however it certainly is something we see in our offices daily. Instead, put a deliberate dose right on the zit—similar to an acne spot treatment—for optimal results.
Irritant Contact Dermatitis (ICD)
With all the hand washing and countertop scrubbing you're doing right now, your skin is no stranger to ICD. When the skin barrier is disrupted by harsh chemicals or irritants, it can become red, flaky, and irritated. Outside of the COVID-19 pandemic, ICD is commonly caused by overuse of skin-care products and ingredients such as retinoids, alpha hydroxy acids, or benzoyl peroxide. In addition to using cortisone to settle things down, make sure to choose gentle, non-soap cleansers, moisturize often, and identify potential triggers so that they can be eliminated or used differently. (Related: Everything You Need to Know About Retinol and Its Skin-Care Benefits)
Besides "maskne" (read: acne breakouts from mask-wearing), these new necessary accessories can cause allergic or irritant contact dermatitis from the detergents you use to wash them and from the rubber and metal used in their construction. Meena Singh, M.D., a dermatologist at the Kansas City Medical Clinic, points out that in her experience cortisone cream is "helpful for face rashes, especially those which come from using masks." At the risk of sounding like a broken record, make sure to use just a small amount to prevent complications. (In other news, here's what's going on with your skin during quarantine.)
Hyperpigmentation, the darkening of the skin in an area that's been injured, affects all skin tones. But those with darker skin are at a higher risk for discoloration after a bite, rash, pimple, or scrape, since it triggers the skin to make extra melanin, the substance that gives skin its color. "When used correctly, cortisone cream can provide a 'quick in and quick out,' by reducing the inflammation and thereby reducing the post-inflammatory hyperpigmentation that may occur in skin of color," says Nokubonga Khoza, M.D., a dermatologist in Durban, South Africa.