A mild topical steroid. Steroid phobia means most people use far too little for far too short a time.
Explained by a GMC-registered GP, not a leaflet
Honest about what we can and cannot prescribe remotely
Side effects given the same weight as benefits
Your NHS records in the room, with your consent
Care led personally by Dr Khan
Attentive, unhurried care that listens properly
Five-star Google reviews from the people we have looked after
Registered with the Care Quality Commission
Hydrocortisone is a mild topical corticosteroid. Applied to skin it reduces inflammation, redness and itching.
Topical steroids come in four potency classes — mild, moderate, potent and very potent. Hydrocortisone is the mildest. Stronger ones are used for thicker skin or more stubborn disease, and matching potency to both the site and the severity is the whole skill of using them.
Low-strength hydrocortisone is available over the counter; stronger steroids are prescription-only.
It does not treat fungal infections, and using a steroid on ringworm or athlete's foot makes it spread while masking its appearance — a genuinely common mistake.
Apply the right amount, and this is where most treatment fails. Use the fingertip unit: the amount squeezed from the tube along an adult fingertip, from the tip to the first crease. One fingertip unit covers an area about the size of two adult palms.
Apply once or twice daily to the affected skin only.
Moisturiser is the foundation, not the steroid. Use emollient generously and often — far more of it than steroid. Leave around 20 minutes between applying emollient and steroid so neither dilutes the other.
Treat until the skin is genuinely settled, not until it looks slightly better. Stopping too early is why eczema flares back within days.
Used correctly for appropriate periods, mild topical steroids are safe. The commonly feared effects come from prolonged use of potent steroids on thin skin, not from a week of hydrocortisone.
With excessive or prolonged use: skin thinning, stretch marks, visible small blood vessels, and lightening of skin colour — which can be more noticeable and more distressing on darker skin.
On the face specifically: perioral dermatitis and a rebound acne-like rash.
The more common problem in practice is the opposite one. Steroid phobia is widespread and well documented — people apply too little, too infrequently, for too short a period, and conclude the treatment does not work. Under-treated eczema causes far more misery than the side effects being avoided.
Topical steroid withdrawal after prolonged inappropriate use of potent steroids is recognised but uncommon, and is not a reason to avoid short courses of a mild one.
Be cautious about site. Skin thickness varies enormously — the face, eyelids, genitals and skin folds absorb far more than the forearm, so only mild steroids are used there and only briefly. In young children, potency and duration both need more care.
Systemic absorption from a mild topical steroid used appropriately is minimal, so drug interactions are not generally a concern.
Absorption rises with: potency, area treated, duration, occlusion under dressings or nappies, and application to thin skin or broken skin.
Monitoring is clinical rather than laboratory. Anyone using topical steroids long term should have the skin reviewed periodically — both to check for thinning and, just as importantly, to check the disease is actually controlled.
Yes, and skin assesses genuinely well remotely provided the photographs are good — see our guide to photographing a skin problem.
Where a consultation adds most value is in getting the potency and quantity right. Most people presenting with uncontrolled eczema are not using a treatment that failed; they are using too weak a steroid, too sparingly, for too short a time, with not enough emollient. Correcting that is often the entire intervention.
What we check: whether the rash is actually eczema, whether it is infected, whether the site dictates a milder preparation, and whether the emollient routine is adequate.
Where we will refer rather than prescribe: anything needing a biopsy, any changing mole, widespread or blistering rashes, or eczema not responding to appropriate treatment — which may need dermatology input rather than a stronger cream.
This page is information, not an offer to supply.
Hydrocortisone 1% cream is available over the counter for a few pounds, and for a small patch of mild eczema that is the sensible route. No appointment needed.
Stronger steroid creams are prescription-only, and on a private prescription cost the drug plus a dispensing fee — usually modest.
Not on the steroid — on the emollient, and on getting the potency right.
Most people with poorly controlled eczema are using too weak a steroid, too sparingly, for too short a time, alongside far too little moisturiser. A consultation that fixes those three things is worth considerably more than another tube of 1%.
Emollients are available on prescription in large quantities, which is far cheaper than buying 500g tubs repeatedly — and an adult with widespread eczema may genuinely need 500g a week.
Topical steroids are used in short bursts to bring a flare under control, then stopped — not applied indefinitely.
Treat until the skin is genuinely smooth, not until it merely looks less red. Stopping too early is the commonest cause of the flare returning within days, and of the endless cycle people find themselves in.
For skin that flares repeatedly in the same place, applying the steroid on two consecutive days a week after clearing it — sometimes called weekend therapy — prevents relapse better than treating each flare from scratch.
It is a well-established approach and is rarely offered.
Far more harm comes from under-treating eczema than from appropriate steroid use. Thinning of the skin is associated with prolonged use of potent steroids on delicate areas, not with a week of 1% hydrocortisone on an arm.
Chronically inflamed, scratched, infected skin does more lasting damage than the treatment does.
Not with appropriate short courses of a mild steroid. Thinning is associated with prolonged use of potent steroids, particularly on the face and in skin folds.
Under-treated eczema does more damage than correctly used steroid does, and fear of the cream is a bigger practical problem than the cream.
Measure it in fingertip units — the amount squeezed from the tip of an adult finger to the first crease. One unit covers roughly the area of two flat adult palms.
Most people apply a fraction of what is needed, then conclude the treatment does not work.
Usually up to seven days on the face and up to fourteen elsewhere without review.
If you are needing it continuously, the plan needs changing rather than the tube refilling.
Leave a gap of around twenty minutes between them so one does not dilute or spread the other.
Order matters less than actually using both. The moisturiser is the treatment; the steroid handles the flare.
Mild hydrocortisone, briefly, yes. Facial skin is thinner and absorbs more.
Never use a potent steroid on the face without being told to, and never on the eyelids without advice — that is where real harm happens.
Usually because the moisturising has stopped, or the steroid was stopped as soon as the redness faded.
Eczema is a barrier problem, and the barrier needs maintaining when the skin looks fine.
Weeping, golden-yellow crusting, rapidly worsening redness, or feeling unwell with it.
Small painful blisters spreading quickly need urgent assessment — that can be a herpes infection of eczematous skin, which is serious.
No. This is a corticosteroid applied to skin, not an anabolic steroid, and not the same as steroid tablets.
Very little is absorbed into the body from short-term use on a small area.
Mild hydrocortisone is widely used in children, in short courses and sparingly on the face.
Get advice for infants under one, and for anything not settling.
Clinically reviewed by Dr Mohammad Zubair Khan, GMC 7563469
Last reviewed
August 24, 2026
On this page
Ongoing
Time to be seen
Appointment length
Your NHS record in the room
Written treatment plan
Told when a test isn’t needed
Cost
Same day, usually
20 minutes
Yes, with your consent
Included
Yes, and told why
£40 for 20 minutes
Varies by practice
Typically 10 minutes
Yes, your full record
Not routinely
Usually
Free
Same day
Often 10 to 15 minutes
Usually not
Sometimes charged
Varies by provider
Often a subscription
Same-day access is usually available, from 6am to 10pm, seven days a week. You choose a time that suits you rather than waiting on hold at 8am.
Yes. Care is led personally by Dr Mohammad Khan, so you are not passed between clinicians. Continuity is the point of a small practice: someone who knows your history and is listening attentively rather than working through a checklist.
Yes, with your consent. We can access your Summary Care Record during the consultation, so your current medications, allergies and significant history are in the room. That means fewer questions you have already answered elsewhere, and safer prescribing.
No. We are not here to replace GPs, only to support them. Your NHS practice remains responsible for your ongoing care, and with your consent we write to them after the consultation. We are useful when you need to be seen sooner, or want more time than a standard appointment allows.
Twenty unhurried minutes and a comprehensive assessment. A written treatment plan is included, along with any prescription, sick note or referral letter arising from the consultation, at no extra charge.
£40 for 20 minutes, self-pay. Membership is optional and never required. Priced for fairness, because we are not here to charge extortionate amounts for access to a doctor.
It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
Patient reviews