Hydrocortisone 1% risks related to skin thinning

[oceanbreeze718]

I've been using a mixture of Lac-Hydrin with 1% Hydrocortisone for three years once daily to control my rosacea. it has worked relatively well. My derm says this mixture is too weak to produce skin thinning or other side effects. Lately, my forehead skin has been all dried out and seems to be thinned out (very shiny & crinlky). I am very concerned that the long term use of this mixture has caused this condition. Information on the Internet regarding hydrocortisone 1% seems to indicate the potential for skin thinning. Is there a real potential for skin thinning ? If so, is this thinning reversible and how should it be treated ? Should I continue this mixture ? If not, what other treatments are available ? What is the best way to stop using hydrocortisone (how should I diminish it's use and over what time frame ?
A lot of questions from an anxious person !  

[Alan Rockoff, MD]

There is no real risk of skin thinning from 1% hydrocortisone.  In any case, skin thinning is reversible.  My main concern is that hydrocortisone is not the proper treatment for rosacea--it tends to suppress this condition a bit but overall to perpetuate it.  Your dermatologist might want to consider prescribing a topical antibiotic like metronidazole along with an oral antibiotic like doxycycline, which should blunt any rebound from stopping hydrocortisone.

Best.

Dr. Rockoff