crotamiton + hydrocortisone: clinical use

Prescribing considerations

• Confirm a licensed inflammatory, pruritic dermatosis rather than untreated infection or another diagnosis.
• Restrict application to small areas and avoid occlusion, damaged skin, mucosa and periocular use.
• Children under 10 years require medical supervision.
• Counsel about treated-fabric flammability and potentially sensitising excipients.
• Product-specific pregnancy and breastfeeding restrictions take precedence over evidence concerning hydrocortisone alone.

Contraindications and cautions

• Hypersensitivity to either active ingredient or an excipient.
• Bacterial, viral or fungal skin infection.
• Acute exudative dermatosis.
• Application to ulcerated areas.

Monitoring

• Review worsening disease, severe irritation or signs of secondary infection.
• Assess new blurred vision or other visual disturbance; ophthalmology referral may be appropriate.
• Consider topical steroid withdrawal if spreading redness, burning or stinging recurs after stopping; seek specialist advice before reapplication.

Clinical pharmacology

Crotamiton provides antipruritic activity, while hydrocortisone supplies mild glucocorticoid anti-inflammatory, anti-allergic and vasoconstrictive effects. Product-specific pharmacokinetic data are unavailable.

Formulation and product differences

• The product is a white-to-cream-coloured topical cream.
• It contains propylene glycol, stearyl alcohol, parabens and fragrance components that may irritate the skin or cause immediate or delayed allergic reactions.
• The cream contains paraffin; fabric contamination increases fire risk.