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Parents and caregivers know well that babies have sensitive skin. Especially in the first couple of years, it’s not surprising to find skin irritation, especially in the form of a diaper rash or baby eczema.

No one wants to see their child in pain — which is why you may be seeking remedies to soothe and heal their irritated skin.

While hydrocortisone cream is a common solution for adults or older children, you might be wondering: Is it safe to use on babies?

The short answer is… maybe. There’s no concrete consensus. While some experts have a strict no-hydrocortisone-cream policy for babies, others say you can use it as long as you follow certain instructions.

Specifically, the concern is that the affected area shouldn’t be covered during use. But if you use hydrocortisone cream to treat diaper rash, there’s a chance that baby’s skin will absorb more of the hydrocortisone than if the irritated area were left uncovered.

So, if you want to use hydrocortisone cream to use diaper rash and your doctor approves, you should avoid putting tight-fitting diapers or plastic pants on your baby.

Likewise, many experts recommend shortening the maximum usage period from 7 days to 4 or 5 days.

Let’s talk about what hydrocortisone cream is. Officially, it’s classified as a corticosteroid.

Don’t be afraid of the “steroid” in corticosteroid. This isn’t the same kind of steroid that you hear about in the news, taken by athletes as performance-enhancing drugs.

There are a few main ways you can use hydrocortisone, but the primary option that most people are familiar with is topical, usually in the form of a cream. It can also be found as a:

  • spray
  • ointment
  • lotion
  • liquid

As a topical treatment, hydrocortisone cream is designed to manage skin discomforts such as redness, itching, and swelling associated with:

It’s readily available as an over-the-counter (OTC) medication since you don’t usually need a prescription to obtain it. You can easily find a topical 1 percent hydrocortisone cream in drugstores or the medication aisle of supermarkets and big box stores.

There are also stronger versions you can obtain, but you’ll need a prescription to do so.

Usually, the instructions recommend that you only apply OTC hydrocortisone cream for a maximum of 7 days. During that time, you’re instructed to apply a thin layer to the affected area anywhere from one to four times per day.

However, it shouldn’t be applied to broken skin or delicate areas, such as in your eyes, or taken orally. And most experts recommend that any area where hydrocortisone cream is applied should be left uncovered unless instructed otherwise by a physician.

If after 7 days your condition hasn’t improved, you should stop using it and speak with a doctor.

Side effects from excessive exposure to hydrocortisone cream can include:

  • slow wound healing
  • changes in skin color
  • sensations of burning, tingling, or a prickly feeling
  • dryness or cracking at the application site
  • area of irritation expanding
  • increased hair growth

But specifically in children, excessive exposure to hydrocortisone cream over larger areas of the body has been linked with slower growth and delayed weight gain, according to the National Eczema Association.

Because of that risk, many physicians recommend that if you child is younger than 2 years old, you shouldn’t treat their skin irritations with hydrocortisone at all.

If the idea of exposing your child to additional discomfort or developmental issues down the road is making you think twice about using hydrocortisone cream to treat a diaper rash or baby eczema, know that you’re not alone.

While hydrocortisone cream is an effective treatment, there are plenty of alternatives that pose a lower risk to your baby. You can begin with assessing possible contributing factors and follow up with natural or nonmedicated treatment options.

Identify and address the cause of the itching

When your baby has a diaper rash, there’s little doubt as to what’s causing the skin irritation. But if your child suffers from baby eczema, there may be other factors at play, like your bathing routine (yes, it’s possible!) or food sensitivities.

Bathing

To care for skin with eczema, experts recommend a specific routine for bathing to maintain moisture:

  1. Use lukewarm water.
  2. Bathe the area for 5 to 10 minutes.
  3. Use gentle cleansers and avoid scrubbing.
  4. Lightly pat dry.
  5. Within 3 minutes, liberally apply moisturizer.
  6. Wait a few minutes for the skin to absorb the moisturizer before dressing.

Diet

For babies who are exclusively breastfed, consider the diet of the breastfeeding parent. If your baby’s eczema worsens shortly after you eat a specific food, they may have a food sensitivity.

Keeping a detailed food journal can help you identify this issue. Doctors don’t suggest simply eliminating foods without good cause, so take some time to verify that that’s the reason.

And for formula-fed babies, it’s not advised to constantly switch out brands of formula since some children develop skin irritations from ingredients in formulas, too. Instead, work with your pediatrician to identify and eliminate any possible issues.

Household products

Also consider household products. It’s possible that baby’s skin irritation is caused by your detergent or soap, especially if it includes dyes or perfumes — common household irritants.

If you suspect that your laundry detergent is the culprit, consider switching to either a plant-based formula or one that’s free of color dyes and chemical fragrances when you wash anything that might come into contact with your baby.

Likewise, make sure that any soaps, shampoos, conditioners, and lotions you’re using on your baby are designed with delicate skin in mind.

Other considerations

Other hidden causes, like dressing your baby in synthetic fibers or clothing that’s too tight, can also contribute to skin irritation.

And if you have a habit of waiting longer to change wet diapers, make it a point to address all diaper changes as soon as possible to keep your baby’s skin clean and dry.

Natural solutions for baby’s itchy skin

If you’ve pinpointed an underlying behavioral cause of your baby’s irritated skin and you’ve already addressed those issues, it’s time to focus on treating the current irritation.

Keep in mind that every baby’s skin is different, and while the below solutions are generally considered safe, a child can be allergic to any of these natural remedies.

Colloidal oatmeal

If your baby has extensive skin irritation, consider switching your regular bath time soap for colloidal oatmeal. This naturally occurring ingredient can help soothe dry or itchy skin and is easily found at places that also sell health and beauty products.

Be mindful to use warm — not hot — water for oatmeal baths and to keep bath time to a maximum of 20 minutes. Be sure to gently pat your baby dry after bath time and immediately follow up with a thick cream moisturizer.

Castor oil

Castor oil is a multifaceted natural oil that’s been linked with improved hair growth and helps deeply moisturize dry skin. While it can be a little heavy as a moisturizer, it’s great to use alone without the need for a carrier oil to promote wound healing for skin irritation.

Specifically, the oil helps maintain a moist skin environment that encourages healing and prevents the affected area from drying out. It can also stimulate tissue growth and work as a barrier between the skin and the outside environment to prevent the risk of infection.

For the best results and to minimize the risk of an adverse reaction, look for options that say a cold-pressed process was used to extract the oil from the castor seeds and that don’t contain fillers. This will reduce the risk that harsh chemicals were used during the production process.

Coconut oil

Coconut oil is another great natural option that can be used for a wide variety of purposes. While most people are familiar with coconut oil for cooking or beauty routines, the oil also has antiseptic and anti-inflammatory properties.

A study from 2019 considered the use of virgin coconut oil and found that it provides anti-inflammatory benefits as well as skin protection, improving the skin barrier.

Just like with castor oil, look for virgin coconut oil products that are made with cold-pressed processing and don’t contain any fillers to minimize the risk of chemicals being used during production.

Cream-based moisturizers

There are a variety of cream moisturizers and emollients designed specifically for sensitive skin.

Whether they contain ceramides or are made from oils derived from vegetables, these moisturizers are significantly thicker than traditional lotions and are incredibly effective at keeping parched or irritated skin properly moisturized.

They also help create an effective barrier to prevent irritation from recurring, according to a 2013 research review.

For best results, these moisturizers should be applied immediately after bathing and as needed throughout the day.

Itchy skin is as frustrating for you to treat as it is for your baby to endure.

Hydrocortisone creams aren’t officially cleared for use in children under the age of 2, but there are plenty of natural alternatives — along with behavioral changes — that you can use to soothe your child’s itchy skin.