Visual disturbance may be reported with systemic and topical corticosteroid use. If a patient presents with symptoms such as blurred vision or other visual disturbances, the patient should be considered for referral to an ophthalmologist for evaluation of possible causes which may include cataract, glaucoma or rare diseases such as central serous chorioretinopathy (CSCR) which have been reported after use of systemic and topical corticosteroids. There is no good evidence that topical corticosteroids are efficacious against immediate (Type 1) allergic skin reactions or short-lived weal and flare reactions from other causes.

In infants and children long-term treatment should be avoided especially on the face as adrenal suppression can occur. Topical corticosteroids may be hazardous in psoriasis for a number of reasons including rebound relapses following development tolerance, the risk of generalised pustular psoriasis and local and systemic toxicity due to impaired barrier function of the skin; careful patient supervision is important. Topical corticosteroids are ineffective in granulomatous conditions and other inflammatory reactions involving the deeper regions of the dermis. Appropriate antimicrobial therapy should be used treating inflammatory lesions which have become infected. Any spread of infection requires withdrawal of topical corticosteroid therapy, and systemic administration of antimicrobial agents.Topical corticosteroids are not generally indicated in psoriasis excluding widespread plaque psoriasis provided that warnings are given. Although generally regarded as safe, even for long-term administration in adults, there is potential for adverse effects if overused in infancy. Extreme caution is required in the dermatoses of infancy including napkin eruption. In such patients, courses of treatment should not normally exceed seven days.

As with all corticosteroids, application to the face may damage the skin and should be avoided. Caution should be taken to keep away from the eyes. Epidermal thinning, telangiectasia and striae may occur in areas of high absorption such as skin folds, the face and where occlusive dressings are used. Local atrophic changes may occur in intertriginous areas or in nappy areas in young children where moist conditions favour hydrocortisone absorption.

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In infants and children particularly, care should be taken that the lowest strength of hydrocortisone cream that is clinically effective is used. The 2.5% strength is normally only necessary in the more severe cases and is better avoided in infants. Skincalm Bite and Sting Relief 1% Hydrocortisone Cream helps to relieve irritation, inflammation and itching caused by bites and stings. Hydrocortisone 1%, Cetomacrogol Emulsifying Wax, Liquid Paraffin, Macrogol 300, White Soft Paraffin, Purified Water, and the preservative Chlorocresol.