Hydrocortisone is not recommended for rosacea but is effective on other skin conditions.

You’re ready to head out the door for a busy day when you start to feel warmth and itching on your face. You check the mirror, and there’s redness across your forehead, nose, and cheeks. Uh oh—you’re having a rosacea flare-up.

We know you want to reach for a product that provides quick relief for your symptoms, but it’s important to understand that not every skincare product is a good rosacea treatment. To understand the best treatment options for rosacea and why hydrocortisone for rosacea is not a good choice, let’s take a quick look at the underlying mechanisms that cause rosacea.

What is rosacea?

No one knows the exact cause (or causes) of rosacea, and currently, there’s no cure. We do know specific triggers can cause rosacea symptoms—aka “flare-ups” (more on those here). Symptoms can sometimes flare up for weeks or months. In addition to skin and eye symptoms, rosacea can also trigger psychological symptoms, including anxiety, depression, and embarrassment.¹ Rosacea may be mistaken for other skin conditions. Here’s what to watch for.

What are symptoms of rosacea?

Rosacea is a chronic skin condition that typically causes flushing or redness, visible blood vessels, and acne-like bumps across the nose, chin, cheeks, and forehead.² These symptoms can fluctuate between flare-ups and remissions.³ While there is no cure, treatment can help keep flare-ups under control.

Rosacea appears more commonly in women between the ages of 30 and 50.⁴ When men develop rosacea, the condition can be more severe.⁵ Because rosacea can be complex, it’s been classified into four subtypes: ocular, phymatous, papulopustular, and erythematotelangiectatic.⁶

Phymatous rosacea subtype is typically seen more on men’s noses.⁷ It’s called rhinophyma and causes the skin to thicken, which can be mistaken for changes to the nose that are commonly linked to chronic alcohol use.⁸ Eye symptoms occur in 50% to 75% of all people with rosacea. These symptoms include redness, tearing, tingling/burning sensation, light sensitivity, blurred vision, foreign-body sensation, and dryness.⁹

How to calm a rosacea flare-up naturally

When you identify rosacea flare-up triggers and avoid them, you can help reduce your risk. Consider the following triggers that are known to trigger flare-ups and how you can avoid them.

• Gut-skin connection: Although more research is needed, there may be a gut-skin connection in rosacea that could help explain how certain foods trigger rosacea flare-ups. These foods include hot foods, alcohol, capsaicin, and cinnamaldehyde.¹⁰ By avoiding these foods and spices, you may naturally help calm flare-ups.

• Stress: This is a common trigger for rosacea flare-ups. Stress reduction techniques may also help reduce the possibility of a flare-up since stress can increase your risk.¹¹

• Weather exposure: The sun¹² and extreme weather exposure¹³ can trigger rosacea flare-ups. Saunas, hot steam, and tanning beds can have the same effect.

• Skincare routine: Avoid harsh cleansers, exfoliants, and chemical peels to reduce the appearance of rosacea flare-ups. A rosacea-friendly skincare routine¹⁴ can help lower your risk and keep your skin hydrated. Consider the gentle cleansers and moisturizers available for Curology clients that hydrate and protect your skin.

What is hydrocortisone used for?

Hydrocortisone cream is a low-potency topical corticosteroid that is typically used in certain skin conditions to relieve redness, swelling, and itching. Skin conditions that doctors may prescribe hydrocortisone cream for include eczema, dermatitis, and psoriasis.¹⁵ However, it’s crucial that your medical provider manages treatment with topical hydrocortisone since there are potential side effects.¹⁶

The different forms of hydrocortisone

People with skin problems are typically treated with topical hydrocortisone, so the condition is treated directly at the source. When the drug is intended for use in the joints, or systemic inflammation, it is generally administered orally.

• Topical hydrocortisone: Topical steroids may be used to treat skin conditions and can come in several forms, including creams, ointments, lotions, sprays, gels, and foams. This medication is available by prescription and over-the-counter in smaller doses. Topical hydrocortisone should only be used on the skin and not applied in the mouth or eyes.¹⁷

• Oral corticosteroids: This medication may be prescribed for inflammatory conditions like allergies, arthritis, asthma, and more.¹⁸ Your oral medication will be prescribed by your physician, which must be followed closely.

Should you use hydrocortisone to treat rosacea?

The answer is a firm no. Hydrocortisone is not a treatment for rosacea, and it can potentially make the condition worse. Because hydrocortisone treats many symptoms that are commonly associated with rosacea—like redness, swelling, and irritation—it may seem like a good option.

As a general rule, people should avoid putting hydrocortisone on their faces unless advised to do so by their healthcare provider. Long-term use of topical corticosteroids can cause rosacea-like symptoms,¹⁹ including facial redness, hotness, telangiectasia, and rebound papulopustular eruption.

Complications of topical hydrocortisone

Hydrocortisone is effective on other types of skin inflammation. But it can also cause side effects, such as:²⁰

• Perioral dermatitis

• Acne-like lesions

• Skin thinning

• Stretch marks

• Facial redness

• Folliculitis (infection of the hair follicles)

• Hair loss

What are the best options for the treatment of rosacea?

The key to developing the right treatment protocol is getting a proper diagnosis.²¹ Prompt diagnosis and treatment are necessary to prevent scarring, persistent redness, and eye problems. A licensed dermatology provider will recommend lifestyle changes to reduce flare-ups. They may also ask you to help identify possible triggers and to avoid known triggers such as ultra-violet (UV) light, spices, alcohol, and weather changes.²²

Your licensed dermatology provider may also prescribe oral medication, topical creams, or recommend other treatments. Persistent redness and telangiectasias,²³ which are dilated red blood vessels on the skin, may require additional treatment. This includes laser light therapy that can help reduce the appearance of prominent blood vessels.

Rosacea can cause sensitive skin, so avoid products that increase irritation; all skincare products you use should be pH balanced.²⁴ You should also regularly use moisturizer to protect your skin barrier.

Prescribed topical treatments may include azelaic acid, ivermectin, or metronidazole.²⁵ Oral antibiotics have an anti-inflammatory effect that may help those who are slow to respond to topical treatments.²⁶

Got rosacea? Curology can help

Curology was founded in 2014 by dermatologists who wanted to provide accessible skincare solutions. We are a telemedicine company that offers personalized prescription formulas to address skin concerns related to acne, signs of aging, hyperpigmentation, and rosacea. If you have rosacea, becoming a member is easy.* Just answer a few questions about your skin, snap some selfies, and if Curology is right for you, one of our licensed dermatology providers will evaluate your skin to prescribe a personalized formula for your concerns.

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Get your personalized skincare routine with Curology

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Curology can treat rosacea with proven effective ingredients like ivermectin, metronidazole, and azelaic acid, using a personalized prescription formula** prescribed by one of our licensed in-house dermatology providers.

P.S. We did the homework so you don’t have to:

1. Farshchian, M. and Daveluy, S. Rosacea. StatPearls. (2023, August 8).

2. Farshchian, M. and Daveluy, S. Rosacea. StatPearls. Ibid.

3. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Rosacea. (May 2021).

4. Farshchian, M. and Daveluy, S. Rosacea. StatPearls. Ibid.

5. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Rosacea. Ibid.

6. Mikkelsen, C.S., et al. Rosacea: a Clinical Review. Dermatology Reports. (2016, June 15).

7. Mikkelsen, C.S., et al. Rosacea: a Clinical Review. Dermatology Reports. Ibid.

8. Liu, A., et al. Rhinophyma: when Red Nose Day is no laughing matter. British Journal of General Practice. (March 2019).

9. Farshchian, M. and Daveluy, S. Rosacea. StatPearls. Ibid.

10. Weiss, E. and Katta, R. Diet and rosacea: the role of dietary change in the management of rosacea. Dermatology Practical & Conceptual. (2017, October 31).

11. Heisig, M. and Reich, A. Psychosocial aspects of rosacea with a focus on anxiety and depression. Clinical, Cosmetic and Investigational Dermatology. (2018, March 6).

12. American Academy of Dermatology Association. 6 Rosacea Skin Care Tips Dermatologists Give Their Patients. (n.d.).

13. Buddenkotte, J. and Steinhoff, M. Recent advances in understanding and managing rosacea. F1000 Research. (2018, December 3).

14. American Academy of Dermatology Association. 6 Rosacea Skin Care Tips Dermatologists Give Their Patients. Ibid.

15. Gabros, S., et al. Topical Corticosteroids. StatPearls. (2023, July 10).

16. Coondoo, A., et al. Side-effects of topical steroids: A long overdue revisit. Indian Dermatology Online Journal. (October-December 2014).

17. American Society of Health-System Pharmacists. Hydrocortisone Topical. MedlinePlus. (2018, January 15).

18. Hodgens, A. and Sharman, T. Corticosteroids. StatPearls. (2023, May 1).

19. Hameed, A.F. Steroid Dermatitis Resembling Rosacea: A Clinical Evaluation of 75 Patients. International Scholarly Research Notices. (2013, April 21).

20. Coondoo, A., et al. Side-effects of topical steroids: A long overdue revisit. Indian Dermatology Online Journal. Ibid.

21. Farshchian, M. and Daveluy, S. Rosacea. StatPearls. Ibid.

22. Farshchian, M. and Daveluy, S. Rosacea. StatPearls. Ibid.

23. Farshchian, M. and Daveluy, S. Rosacea. StatPearls. Ibid.

24. Farshchian, M. and Daveluy, S. Rosacea. StatPearls. Ibid.

25. Farshchian, M. and Daveluy, S. Rosacea. StatPearls. Ibid.

26. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Rosacea: Diagnosis, Treatment, and Steps to Take. (May 2021).

27. Hameed, A.F. Steroid Dermatitis Resembling Rosacea: A Clinical Evaluation of 75 Patients. International Scholarly Research Notices. Ibid.

28. Farshchian, M. and Daveluy, S. Rosacea. StatPearls. Ibid.

29. Mikkelsen, C.S., et al. Rosacea: a Clinical Review. Dermatology Reports. Ibid.

30. Gabros, S., et al. Topical Corticosteroids. StatPearls. Ibid.

31. American Society of Health-System Pharmacists. Hydrocortisone Topical. MedlinePlus. Ibid.

Elise Griffin is a certified physician assistant at Curology. She received her Master of Medical Science in physician assistant studies from Nova Southeastern University in Jacksonville, FL.

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Written by

Curology Team

Medically reviewed by

Elise Griffin, PA-C