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Skin School  >   Acne Basics

How is Hydrocortisone Used for Acne?

Hydrocortisone has been used for years to heal pesky pimples, but it doesn’t get as much buzz as other trendier skin care treatments. We’ll take a look at the different forms of hydrocortisone, as well as how exactly it is used to treat acne.

What is hydrocortisone?

Hydrocortisone is a steroid that treats inflammation in the body. It reduces redness, itchiness, and the overall discomfort that accompanies skin conditions.

So, exactly what is hydrocortisone used for? It has a lot of purposes, but most commonly it is used to treat allergic reactions and minimize inflammation from skin injuries. Of course, we are here to discuss one issue: acne. When it comes to pimples, as you might’ve guessed, hydrocortisone cream is used to reduce the swelling, redness, and discomfort associated with stubborn blemishes.

Topical hydrocortisone creams are often used for acne, but there are also cortisone shots, which are injected at the site of the active pimple. These are both corticosteroids – forms of steroid hormones. First, let’s talk about hydrocortisone cream.

How does hydrocortisone cream work?

A topical hydrocortisone cream is applied directly to an active pimple, where it reduces the overall inflammation of the blemish. Creams are available through a prescription (for potent formulas with a strength of hydrocortisone at 2.5%), as well as over-the-counter at a drugstore.

If you’re dealing with smaller blackheads or whiteheads, hydrocortisone cream unfortunately isn’t going to do much for you. Rather, it is best suited for cystic and nodular acne (AKA those tender spots that form deep underneath the skin). When applied to these types of blemishes, the cream works to reduce the appearance and discomfort that comes with these pesky pimples – which means you’ll be in the fast lane to healthier (and less painful) skin.

The downside to using hydrocortisone cream

If you’ve experienced painful cystic or nodular acne, this cream might sound like a miracle worker. Not to be the bearer of bad news, but there are some drawbacks. The topical comes with potential side effects, so it isn’t recommended for regular use. Common side effects include thinning skin, skin lightening, dryness, and irritation. It may even cause acne, particularly when used over an extended period of time. This is because hydrocortisone can break down the thin tissue in the follicles. This weakening may trigger a secretion of sebum, which can clog pores – and lead to more acne.

Another important note: hydrocortisone cream doesn’t actually treat acne, because it doesn’t have the ability to kill acne-causing bacteria. If you’re trying to figure out how to get rid of cystic acne or nodular acne, you’ll need a treatment that actually gets to the root of the problem.

That being said, it does provide temporary relief. Hydrocortisone cream is great for the occasional larger and more bothersome blemish that needs some extra care and attention – but you shouldn’t start using it as your go-to acne treatment for all pimples.

Face showing cystic acne

What about cortisone shots?

A cortisone shot is injected right at the site of the active pimple, and is administered by a medical professional. It’s powerful stuff: this shot has the impressive ability to dramatically reduce a pimple within 48 to 72 hours. Like with a hydrocortisone cream, it is best used to reduce inflammation in cystic and nodular acne – don’t bring out these big guns for smaller blemishes.

We’ll state the obvious concern: the thought of putting a needle into a pimple isn’t exactly appealing. Don’t worry – these shots are typically administered after applying a numbing cream.

Compared to hydrocortisone cream, cortisone shots are often more effective, since they get deeper in the skin at the root of the problem. However, as you might expect, they aren’t as cheap as hydrocortisone cream. Out-of-pocket, a single cortisone shot will typically be in the $50 to $100 range (whereas you can find a 2 ounce drugstore hydrocortisone cream for under $10, or a 1 ounce prescription cream for around $15 out-of-pocket).

The cortisone shot side effects you should know

You shouldn’t lean on cortisone shots as your regular treatment for acne. There are side effects associated with these shots, such as dry and thinning skin, skin depressions at the site of injection, and scarring.

Given the side effects – and the fact that it takes time and a pretty penny to get these shots – it is best to turn to a cortisone shot in an emergency situation. If a cyst pops up before an important day (like your wedding, for example), or if you’re dealing with a persistent cyst that won’t back down, a cortisone shot might be a good option.

Safer alternatives to hydrocortisone for acne

If you’re looking for some alternative treatments for a stubborn pimple, here are a few options to try out:

  • Try an over-the-counter solution. Get to the root of the problem with a spot treatment. Salicylic acid is a star ingredient to look for – this oil-soluble beta hydroxy acid dives into the pores to dissolve debris that is causing the breakout.

  • Apply a Mighty Patch. This is a great option if you’re looking for a gentler but effective approach. If you feel a pimple lurking under the surface, try out Micropoint for Blemishes, which delivers exfoliating salicylic acid, soothing beta glucan, and bacteria-preventing totarol to the spot.

  • Ice it. Ice isn’t just for bruises and sprained ankles. Applying an ice cube directly to the pimple for a few seconds constricts the small blood vessels, which helps reduce the redness and swelling.

  • Take a pain reliever. If pain is your biggest issue, take an over-the-counter oral pain reliever (such as ibuprofen) to find some temporary relief. While it won’t directly heal your pimple, it will help you deal with the pain as you’re waiting for other topical treatments to work their magic.

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