No matter how you come down with shingles, the rash can be very itchy and uncomfortable. One of the most common questions people ask is if hydrocortisone cream can be used to reduce itching. It turns out that there are mixed reviews on this topic – some say yes, others no. So what’s the answer? We will examine both sides of this argument in order to help you decide whether or not you should use hydrocortisone cream for your shingles rash.
What is hydrocortisone?
Hydrocortisone is a steroid/corticosteroid that works to reduce inflammation and relieve itching. It also reduces the body’s immune response, which can help reduce shingles symptoms. Hydrocortisone cream can be used one to four times a day, but only a small amount should be used and spread in a thin and even layer over the affected area. It is important to note that it should not be used on broken skin (such as the open sores of a shingles rash). A doctor may prescribe hydrocortisone cream to help relieve severe pain and itching associated with shingles.
However, it would be best to be cautious about using steroid creams for shingles as steroids are only meant to provide short-term relief, not long-term. Usually, most people do not experience any side effects if only using the steroid cream for less than four weeks. If used incorrectly or too much, it can worsen symptoms in the end by weakening the skin’s natural barrier against infection. The skin layer may become thinner, and you may notice stretch marks on the skin that may be permanent.
Stop using hydrocortisone and tell a doctor straight away if:
- your skin becomes redder or swollen, or if yellow fluid is weeping from your skin – this may indicate a new skin infection or an existing one getting worse
- you have a very upset stomach, vomiting, have dizzy spells or fainting, muscle weakness, lethargy, mood changes, loss of appetite, and weight loss – these can be signs of problems with the adrenal gland
- you feel confused, sleepy, more thirsty or hungry than usual, pee more often, have hot flushes, start breathing quickly, or your breath smells of fruit – these may indicate the onset of diabetes or complications of diabetes
- you are depressed (including having suicidal thoughts), feeling high, having mood swings, feeling anxious, seeing or hearing things that are not there, or having strange or frightening thoughts – these can be signs of mental health problems
- you get a “moon face” (puffy, rounded face), weight gain in your upper back or belly – this happens gradually and can be a sign of Cushing’s syndrome
- you have any muscle pain or weakness, muscle cramps, or your heartbeats suddenly become more noticeable – these can be signs of low potassium levels
- you get severe stomach pain, severe back pain, or a severe upset stomach or vomiting – these can be signs of pancreas problems (NHS, 2020)
What are other treatment options for shingles?
Other treatment options that your doctor may recommend include:
- Prescription antiviral medicines such as acyclovir, valacyclovir, and famciclovir reduce the duration and severity of the infection. This is most effective when started within 72 hours of the onset of the rash
- Topical creams, lotions, patches, powders, and sprays for relieving shingles that typically contain topical acyclovir, lidocaine, and capsaicin. This typically provides a numbing effect.
- Antibiotics, which may be needed if bacteria infects the skin and rashes. If there is no bacteria infection, antibiotics will not be helpful.
- Painkillers such as acetaminophen, ibuprofen, and naproxen
- Lotions containing calamine that can be used on open lesions to reduce pain and pruritus
- Anticonvulsants, tricyclic antidepressants, or numbing agents to help relieve pain (Stankus et al., 2000)
- Applying a wet compress to the area of skin that is experiencing pain and inflammation
- Oral intake or topical applications of antihistamines to relieve the itchiness
Other treatment options and lifestyle changes to manage shingles include:
- Topical application of essential oils such as chamomile oil, eucalyptus oil, and tea tree oil, which are said to have anti-inflammatory properties
- Witch hazel cream to reduce inflammation and itchiness
- Keeping the rash clean and dry, covering the rash with loosely bound dressing for protection, and wearing loose-fitting clothing to reduce discomfort
- Using cool water to bathe helps not only to keep sores and blisters clean but also to relieve soreness and itchiness.
- Adding colloidal (or ground) oatmeal or baking soda to cool bath water to moisten the skin and to soothe sensitive and inflamed skin
- Improving one’s diet by taking in more food containing carotenoids such as lycopene, lutein, zeaxanthin, and provitamin A, which help to boost immune function. Foods to look out for include orange foods such as carrot, pumpkin, and apricot, red foods such as watermelon, red pepper, grapefruit, and cherry, and green foods such as kale and parsley spinach, melon, lettuce, and endive. Limiting the intake of trans and saturated fats, as well as avoiding added sugar and salt, can also reduce inflammation and improve immune function
- Quitting smoking and reducing stress, which will help to boost immunity and improve the healing function of the body
In conclusion, hydrocortisone cream can be used to reduce inflammation and pain associated with the shingles rash. Hydrocortisone cream should not be applied directly on open sores or broken skin; it should only be applied on unbroken skin. There are other treatment options such as antivirals, antibiotics, painkillers, soothing lotions, or antihistamines that your doctor may recommend in conjunction with hydrocortisone cream to help relieve symptoms of shingles. It should be noted that hydrocortisone cream can only be used in small amounts and for a short time, as long-term use may weaken your skin and may cause several systemic side effects. Consult your doctor or pharmacist before using hydrocortisone cream for shingles.
NHS. (2020, December 10). Hydrocortisone for skin. Retrieved September 19, 2021
Stankus, S. J., Dlugopolski, M., & Packer, D. (2000, April 15). Management of herpes Zoster (Shingles) And Postherpetic Neuralgia. American Family Physician