Hydrocortisone butyrate for severe inflammatory skin conditions

  • You only need to use a small amount of this preparation. Apply it thinly just to the areas affected, and then massage it gently into the skin until it disappears.
  • Topical corticosteroids should not be used for long periods of time or on large areas of the body, especially in children.
Type of medicine Potent topical corticosteroid
Used for Inflammatory skin conditions such as severe eczema
Also called Locoid®
Available as Cream, ointment, scalp lotion, and emulsion

Hydrocortisone butyrate is a potent topical corticosteroid (also referred to as a topical steroid). Topical steroids are used in addition to emollients (moisturisers) for treating inflammatory skin conditions such as eczema and dermatitis. A topical steroid is used when patches of eczema or dermatitis flare up. Hydrocortisone butyrate relieves the symptoms of a flare-up by reducing inflammation, itching and redness. It is not a cure for your condition, but it will help to relieve the symptoms.

Short courses of hydrocortisone butyrate may also be useful in the treatment of psoriasis for small areas such as the scalp, soles of the feet, or palms of the hands.

To make sure this is the right treatment for you, before you start using hydrocortisone butyrate it is important that your doctor or pharmacist knows:

  • If you have any areas of infected skin.
  • If you have rosacea or acne.
  • If you are pregnant or breast-feeding.
  • If you have ever had an allergic reaction to a skin preparation.
  • Before you start using this preparation, read the manufacturer's printed information leaflet from inside your pack. The leaflet will give you more information about topical steroids and a full list of side-effects that you may experience from using them.
  • Apply a small amount on to the areas of skin which are inflamed. Then gently rub it into the skin until it has disappeared. Do not use hydrocortisone butyrate on any broken or infected areas of skin.
  • The amount of topical steroid that you should apply is commonly measured by fingertip units (FTUs). One FTU is the amount of cream or ointment that is squeezed out along an adult's fingertip (that is, from the very end of the finger to the first crease in the finger). As a guide, one FTU is enough to cover an area twice the size of an adult hand. Your doctor will give you an idea of how many FTUs you will need to cover the area of your skin which is affected.
  • Your doctor will tell you how often to apply hydrocortisone butyrate. It must not be applied more than twice a day, and once a day is often sufficient.
  • If you are using more than one topical corticosteroid, make sure you know when and where to use each one. If you are unsure, check with your doctor or ask your pharmacist for further advice.
  • After you have applied hydrocortisone butyrate, wash your hands (unless your hands are the treated area).
  • If you are using hydrocortisone butyrate for psoriasis, make sure you follow your doctor's instructions carefully. It should not be used for large areas of psoriasis or for long periods of time, as these can cause your symptoms to flare up afterwards.
  • If you are using an emollient along with this preparation, apply the emollient first. Then wait 10-15 minutes before applying hydrocortisone butyrate. This allows time for the emollient to be absorbed before the topical corticosteroid is applied. (Your skin should be moist but not slippery when you apply hydrocortisone butyrate.)
  • Do not use this preparation on your face unless your doctor has said you should. If you have been told to use it on your face, be careful not to get any preparation near your eyes and do not use it for longer periods of time than you have been advised.
  • Unless advised to do so by your doctor, do not apply a bandage or dressing to the area being treated, as this will increase absorption of the preparation and increase the risk of side-effects.
  • Continue to use hydrocortisone butyrate until the flare-up has completely gone and then stop it. A course of treatment for 7-14 days is often sufficient. If your symptoms have not improved after this time (or if they get worse), speak again with your doctor for further advice. Topical corticosteroids like hydrocortisone butyrate should not be used for long periods of time or on large areas of the body, especially in children.
  • After you finish using hydrocortisone butyrate, continue to use your emollients every day. This will help to prevent a further flare-up.

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. You can reduce the risk of side-effects from topical corticosteroids like hydrocortisone butyrate, by applying the preparation thinly, no more than twice a day, and to the affected areas only.

Side-effects of hydrocortisone butyrate What can I do if I experience this?
Thinning of your skin, striae (like stretch marks), bruising, discolouration, or thin spidery blood vessels Speak with your doctor if you notice any of these

Speak with your doctor or pharmacist if you experience these or any other side-effects which you think may be due to hydrocortisone butyrate.

  • Keep all medicines out of the reach and sight of children.
  • Store in a cool, dry place, away from direct heat and light.
  • Make sure that the person prescribing this medicine knows about any other medicines that you are taking. This includes medicines you buy and herbal and homeopathic medicines.
  • If you buy any medicines check with a pharmacist that they are safe to take with your other medicines.
  • Before using this medicine tell your doctor if you have ever had an allergic reaction after taking any medicine.
  • Never use more than the prescribed dose. If you suspect that someone has swallowed some of this medicine, go to the accident and emergency department of your local hospital at once. Take the container with you, even if it is empty.
  • If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.
  • This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
  • Never keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
  • If you have any questions about this medicine ask your pharmacist.

Further reading & references

  • British National Formulary; 62nd Edition (Sep 2011) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
  • Manufacturer's PIL, Locoid® Cream,; Manufacturer's PIL, Locoid® Cream, Astellas Pharma Ltd, The electronic Medicines Compendium. Dated December 2010.
Original Author: Helen Allen Current Version: Peer Reviewer: Dr Hannah Gronow
Last Checked: 18/05/2012 Document ID: 4150  Version: 3 © EMIS

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.