As is common with most medical treatments, there are situations in which Hydrocortisone 1% cream should be used cautiously or not at all. If you have a skin infection (such as impetigo, herpes simplex, or a fungal infection) and if you have reacted to other steroid preparations before, Hydrocortisone 1% is not recommended. It’s advised you don’t use this cream on the face or around the anal or genital areas unless told to do so by your doctor. You shouldn’t use this treatment if you have an allergy to any of the active or inactive ingredients.
A common mistake is to be too cautious about topical steroids. Some parents undertreat their children's eczema because of an unfounded fear of topical steroids. They may not apply the steroid as often as prescribed, or at the strength needed to clear the flare-up. This may actually lead to using more steroid in the long term, as the inflamed skin may never completely clear. So, you may end up applying a topical steroid on and off (perhaps every few days) for quite some time. The child may be distressed or uncomfortable for this period if the inflammation does not clear properly. A flare-up is more likely to clear fully if topical steroids are used correctly.
Prescriptions written for topical steroids should include explicit instructions about where and how often to apply the preparation, and the body areas where use must be avoided. Pharmacists should ensure these directions are included on the dispensing label. Prescribers should bear in mind that patients may keep unused or leftover corticosteroid skin preparations for some time after they are prescribed and thus forget the original indication or instructions for use. The prescribing of unnecessarily large quantities should be avoided. Patients should be warned not to share their topical steroid preparation with other people as this may result in unsafe application to unsuitable areas such as the face, as well as the potentially inappropriate treatment of undiagnosed skin conditions.