Locoid Side Effects: What You Should Know

Locoid (Hydrocortisone Butyrate 0.1%) is a mid-potency topical corticosteroid used to treat inflammatory skin conditions like eczema, atopic dermatitis, and contact dermatitis. Like all corticosteroids, it comes with potential side effects — most of them mild, but some worth watching for carefully. This guide covers what's common, what's serious, and when it's time to call your doctor.

What Is Locoid?

Locoid is the brand name for Hydrocortisone Butyrate, a prescription topical steroid classified as mid-potency (Group V). It's made by Bausch Health and comes in several formulations: cream, ointment, lipocream, and solution — all at 0.1% concentration. It works by reducing inflammation, redness, and itching in the skin. For a deeper dive into how this medication works, see our guide on how Locoid works.

Common Side Effects

Most people who use Locoid as directed experience few problems. When side effects do occur, they're usually mild and limited to the area where you applied the medication.

• Burning or stinging at the application site — This is the most frequently reported side effect. It usually happens when you first apply the cream and fades within a few minutes. It may be more noticeable on irritated or broken skin.
• Itching — Some people experience mild itching at the application site, which may seem counterintuitive since Locoid is meant to treat itching. If the itching is worse than before you started, let your doctor know.
• Dryness — Topical corticosteroids can dry out the skin, especially the cream and solution formulations. Using a fragrance-free moisturizer after the medication absorbs can help.
• Skin irritation — General redness or irritation at the application site can occur, particularly in the first few days of use.
• Folliculitis — Small, acne-like bumps around hair follicles can develop, especially in areas with thicker hair growth. This is more common with occlusive dressings (covering the area with bandages).

These side effects are generally manageable and often improve as your skin adjusts to the medication. If they persist beyond the first week or worsen, contact your doctor.

Serious Side Effects

Serious side effects from Locoid are uncommon when used as directed for short periods. However, they become more likely with prolonged use, application over large body surface areas, use of occlusive dressings, or use in children (who absorb more medication relative to their body weight).

Skin Thinning (Atrophy)

This is the most important long-term risk of any topical corticosteroid. With prolonged use, Locoid can cause the skin to become thinner, more fragile, and more prone to tearing or bruising. Signs include:

• Skin that looks shiny or translucent
• Visible blood vessels under the skin
• Easy bruising
• Slow wound healing

This is why treatment with Locoid is typically limited to 2 to 4 weeks at a time.

Stretch Marks (Striae)

Prolonged use can cause permanent stretch marks, especially in skin folds (armpits, groin, under the breasts). Once formed, striae from corticosteroid use are usually permanent.

HPA Axis Suppression

When too much topical corticosteroid is absorbed through the skin, it can suppress your body's natural cortisol production — a condition called hypothalamic-pituitary-adrenal (HPA) axis suppression. This is rare with Locoid but can occur with:

• Use over large body areas
• Use for extended periods
• Use under occlusive dressings
• Use in young children

Symptoms can include fatigue, weakness, dizziness, and nausea. This condition is usually reversible once the medication is discontinued.

Cushing Syndrome

In extremely rare cases of excessive or prolonged use, enough corticosteroid may be absorbed to cause Cushing syndrome — characterized by weight gain (especially in the face and midsection), high blood sugar, and muscle weakness. This is very uncommon with topical use.

Allergic Contact Dermatitis

Ironically, some people can develop an allergic reaction to the corticosteroid itself or to inactive ingredients in the formulation. If your skin condition appears to be getting worse despite treatment, this could be the cause.

Secondary Skin Infections

Corticosteroids suppress the local immune response in the skin, which can allow bacterial, fungal, or viral infections to develop or worsen. If you notice new redness, pus, crusting, or spreading of the affected area, contact your doctor.

Side Effects in Specific Populations

Children

Children are at higher risk for systemic side effects because they have a larger body-surface-area-to-weight ratio, meaning they absorb proportionally more medication through the skin. Locoid should be used for the shortest duration necessary in children, and parents should watch for signs of HPA axis suppression like growth delay, poor weight gain, or unusual fatigue.

Pregnant or Nursing Women

Locoid is Pregnancy Category C, meaning animal studies have shown potential risks but there are no adequate human studies. It should only be used during pregnancy if the benefits clearly outweigh the potential risks. Nursing mothers should avoid applying Locoid to the breast area and use it cautiously, as it's unknown whether topically applied corticosteroids are absorbed enough to appear in breast milk.

Elderly Patients

Older adults may be more susceptible to skin thinning since aging skin is already naturally thinner. No dose adjustment is needed, but extra monitoring is appropriate.

How to Manage Side Effects

Here are practical tips to minimize side effects while using Locoid:

• Use the minimum amount needed. Apply a thin film — you don't need a thick layer for it to work.
• Don't use it longer than prescribed. Most treatment courses are 2-4 weeks. Using it longer increases the risk of skin thinning and other complications.
• Moisturize. Apply a fragrance-free moisturizer after Locoid has absorbed to combat dryness.
• Avoid sensitive areas unless your doctor specifically directs you to use it there. The face, groin, and armpits absorb more medication and are more prone to side effects.
• Don't cover with bandages unless your doctor tells you to. Occlusive dressings increase absorption and side effect risk.
• Wash your hands after applying (unless you're treating your hands).
• Don't stop abruptly if you've been using it for a long time. Your doctor may want you to taper off gradually.

When to Call Your Doctor

Contact your healthcare provider if you experience any of the following:

• Your condition is getting worse, not better
• Signs of skin infection (increased redness, warmth, swelling, pus, or pain)
• Skin thinning, stretch marks, or visible blood vessels
• Signs of allergic reaction (new rash, hives, severe itching not related to your original condition)
• Symptoms of HPA axis suppression (unusual fatigue, weakness, dizziness, nausea)
• No improvement after 2 weeks of use

If you experience severe allergic symptoms like difficulty breathing or swelling of the face, lips, or throat, seek emergency medical attention immediately.

Final Thoughts

Locoid is a well-established, effective treatment for inflammatory skin conditions when used appropriately. Most side effects are mild and manageable. The key is using it as directed, for the shortest time necessary, and on the smallest area needed. If you have questions about whether Locoid is right for you, talk to your dermatologist or primary care doctor.

For more about this medication, read What Is Locoid? Uses, Dosage, and What You Need to Know. If you're having trouble finding it at your pharmacy, Medfinder can help you check stock availability near you.