Hydrocortisone with clotrimazole

How it works

Hydrocortisone suppresses local inflammation through glucocorticoid receptor activation, while clotrimazole inhibits fungal ergosterol synthesis, disrupting the fungal cell membrane.

Prescribing in practice

• The steroid component can mask and worsen untreated fungal infection if used alone or too long, so limit to short-term use for the inflammatory phase and continue antifungal cover until the infection clears.
• It is not a substitute for a plain antifungal in non-inflamed tinea.
• Avoid prolonged application to the face and flexures because of steroid-induced atrophy.

Monitoring

Review after a short course; once inflammation settles, consider switching to a plain antifungal until mycological cure.

Counselling the patient

• Apply a thin layer to the affected area as directed and continue until advised to stop.
• Do not use this combination long term or on undiagnosed rashes.
• Keep the skin dry and avoid sharing towels to prevent spread.

Evidence & guidelines

Short-term combined steroid-antifungal use for inflamed dermatophyte infection reflects established dermatology prescribing practice.