"I was prescribed Locoid, how much should I apply?" "I heard steroids are scary and addictive." "Can I apply it to my face?" "How is it different from Kindavate or Rinderon?" — This one article will answer all your questions about Locoid.
To get straight to the point, Locoid can be used on the face for short periods. Locoid is classified as a medium-strength topical steroid, which is considered relatively safe for use on the face and neck, but prolonged continuous use should be avoided. Below, we will explain in detail the correct usage, side effects, and how to discontinue it.
Locoid (hydrocortisone butyrate) is a medium-strength topical steroid. When used correctly, it is safe and effective, but it is also a drug that is often misunderstood. In this article, a doctor from Mona Aoyama Clinic will provide an honest explanation based on medical evidence.
Locoid can be prescribed nationwide via online consultation.
Consultations for eczema, dermatitis, and atopy are also accepted online.
Prescription and shipping on the same day (for payments made by 4 PM)
What is Locoid? Basic Information
Item
Content
Generic Name
Hydrocortisone Butyrate
Type of Drug
Topical Steroid (Adrenocortical Hormone External Preparation)
Strength Rank
Medium – 4th out of 5 levels (2nd from the bottom)
Dosage Form
Ointment, Cream, Lotion
Main Indications
Eczema, dermatitis, atopic dermatitis, contact dermatitis, seborrheic dermatitis, etc.
Use on Face
Possible under doctor's supervision (caution for long-term/large-quantity use)
Difference Between Locoid Ointment and Locoid Cream
Locoid comes in three formulations: ointment, cream, and lotion. They all contain the same active ingredient and have the same effect, but they differ in feel and suitability for different areas.
Formulation
Characteristics
Suitable Areas/Symptoms
Ointment
Oily and can feel sticky, but less irritating and highly moisturizing.
Dry affected areas, weeping affected areas (if exudate is present).
Cream
Spreads well and is less sticky, but may feel slightly more irritating than ointment.
Large areas, for daytime application, areas where stickiness is to be avoided.
Lotion
Smooth and easy to spread.
Scalp and other hairy areas.
Your doctor will determine which formulation to choose based on the condition of the affected area and the site of application. Even with the same prescription, you can consult with your doctor if you prefer a different formulation, for example, "the ointment didn't suit me, so I'd like to switch to the cream."
5-Level Strength Ranking of Topical Steroids
Topical steroids are ranked into 5 levels based on their potency. The strength varies greatly, from over-the-counter drugs to those prescribed by medical institutions. Locoid (hydrocortisone butyrate) is classified as "Medium" (normal), the second lowest of the 5 levels, and is a relatively easy-to-use steroid for the face and delicate areas. Let's check its overall positioning in the list below.
Rank (Strength)
Representative Ingredients (Main Product Names)
Main Uses
Ⅰ. Strongest
Clobetasol propionate (Dermovate), Diflorasone diacetate (Diacort)
Severe inflammation on thick skin areas such as palms and soles of feet. Not to be used on the face.
Ⅱ. Very Strong
Mometasone (Flumetasone), Betamethasone butyrate propionate (Anatebate), Difluprednate (Myzer)
Significant inflammation on the body and limbs.
Ⅲ. Strong
Betamethasone valerate (Rinderon-V, Betnovate), Fluocinolone acetonide (Flucort)
General eczema/dermatitis on the body and limbs.
Ⅳ. Medium
Hydrocortisone butyrate (Locoid) , Clobetasone butyrate (Kindavate), Alclometasone dipropionate (Almeta)
Delicate areas like face, neck, genitals, and eczema in children.
Ⅴ. Weak
Prednisolone, Hydrocortisone acetate
Very mild inflammation. Common in over-the-counter drugs.
Areas such as the face, neck, armpits, and genitals have thin skin and absorb medication easily, so Locoid or similar treatments in rank IV (Medium) are often chosen. On the other hand, stubborn eczema on the hands and feet may require a stronger rank, so the choice of treatment is generally based on the area and symptoms. Long-term use of strong-ranked steroids on the face can lead to side effects such as thinning skin or redness. Do not continue using strong steroids on your own; consult a doctor if you are unsure.
How strong is Locoid in terms of steroid strength?
It is ranked "Medium" (normal), the second from the bottom of the 5 levels. It is a strength that is easy to use on the face and delicate areas, but it is important not to use it continuously for long periods, and to gradually reduce the dosage according to your doctor's instructions once symptoms have subsided.
What is the difference between over-the-counter steroids and prescription steroids?
Over-the-counter drugs are mainly weaker ranks (Weak to Medium). Stronger ranks, such as Strong and above, are prescribed after a doctor's diagnosis. If symptoms are severe, widespread, or recurrent, it is quicker to see a doctor than to wait and see with over-the-counter drugs.
It is generally understood that both Locoid and Kindavate are classified as Medium-class. Rather than simply comparing their strengths, doctors use them differently depending on the symptoms, area, and age.
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Correct Application - Adhere to the FTU Amount
Area
Approximate Amount
Entire Face
Approx. 1 FTU (approx. 0.5g)
Neck
Approx. 1 FTU
Entire Arm (one)
Approx. 2 FTU (approx. 1g)
Entire Leg (one)
Approx. 4 FTU (approx. 2g)
Trunk (front)
Approx. 7 FTU (approx. 3.5g)
Usage and Precautions by Body Area
Area
Usability
目安の使用期間
Precautions
Face (Cheeks, Forehead, Nose Area)
△ Short-term use OK
Within 1-2 weeks
Risk of steroid rosacea and telangiectasia with long-term continuous use
Around the Eyes
⚠️ Caution required
Follow doctor's instructions
Risk of glaucoma/cataracts. Avoid self-medication
Neck
△ Short-term use OK
Within 1-2 weeks
Similar to face. Avoid long-term continuous use
Trunk/Limbs
✅ Generally usable
2-4 weeks
Low risk of side effects with standard use
Palms/Soles of Feet
✅ Usable
2-4 weeks
Lower absorption rate due to thicker stratum corneum
Genitals/Groin
⚠️ Caution required
Short-term, follow doctor's instructions
Very high absorption rate due to thin skin
Side Effects
Side Effect
Conditions for Occurrence
Frequency
対処法
Skin atrophy (thinning of the skin)
Long-term continuous use on the same area
Can occur with long-term use
Use for appropriate duration and frequency. Gradually reduce dosage after symptom improvement.
Telangiectasia (spider veins)
Long-term use, especially on the face
Can occur with long-term use
Avoid long-term use on the face.
Steroid-induced rosacea/perioral dermatitis
Long-term continuous use on the face
Rare
Limit facial use to short periods.
Worsening of infection
Use on an infected area
Rare
Consult a doctor before use if infection is suspected.
Correct Way to Stop — It's Important Not to Stop Abruptly
Reduce frequency of use once symptoms subside — gradually from daily to 3-4 times a week, then 1-2 times a week.
Continue with moisturizers — compensate for reduced steroid use by supplementing skin barrier with moisturizers.
Restart early if symptoms recur — using a small amount early on will result in less overall usage than waiting for it to worsen and then using a large amount.
Consult a doctor for timing of reduction/cessation — there are limits to stopping on your own.
About the Use of Locoid for Heat Rash (Miliaria)
Heat rash is an inflammation caused by sweat getting trapped in the sweat glands, accompanied by small red bumps and itching. For severe itching or widespread redness, a medium-strength topical steroid like Locoid may be prescribed.
Severity of Symptoms
Guideline for Response
Mild (redness, mild itching only)
First, observe with self-care such as frequently wiping away sweat and wearing breathable clothing.
Severe itching, widespread redness
Topical medications like Locoid may be effective. Consider use under a doctor's examination.
Accompanied by blisters or pus (impetigo-like)
May be accompanied by bacterial infection, and steroids alone may not be sufficient. Seek early medical attention.
Heat rash tends to recur during hot weather, so even after symptoms improve, it's important to continue daily preventive measures like wearing breathable clothing and frequently wiping away sweat. Do not use over-the-counter steroid topical agents for extended periods without medical advice, and consult a doctor if symptoms persist.
About the Use of Locoid for Insect Bites
When bitten by mosquitoes, mites, or gnats, a medium-strength topical steroid like Locoid may be prescribed if itching or redness is severe. It can be an option if over-the-counter insect bite remedies are ineffective, or if the area is large or the swelling is severe.
Severity of Symptoms
Guideline for Response
Mild (redness, mild itching)
Observe with over-the-counter insect bite remedies or cooling.
Severe itching, spreading swelling
Topical medications like Locoid may be effective. Consider use under a doctor's examination.
Accompanied by blisters, severe swelling, or fever
May be an allergic reaction to insect bites (insect bite hypersensitivity) or infection due to scratching. Early medical attention is necessary.
Insect bites tend to worsen when scratched, so it's important to suppress itching with Locoid during periods of severe itching and keep the affected area clean. If you are repeatedly bitten in the same spot or if symptoms persist, do not continue to use over-the-counter medicines on your own; consult a doctor.
About the Misconception "Steroids are Scary"
Common Concerns
Facts
"Steroids are addictive"
Physical dependence is almost non-existent with topical agents. Recurrence after discontinuation is not "addiction" but the original condition returning.
"Skin will thin and never return to normal"
Mild skin atrophy often improves upon discontinuation. Severe atrophy after long-term/large-quantity use may take time to recover.
"Absolutely must not be applied to the face"
Appropriate short-term use is possible under a doctor's guidance. Long-term continuous use (more than 2 weeks) should be avoided.
"Affects internal organs"
Systemic absorption of topical agents is very minimal. There is almost no effect on internal organs with normal topical use.
In many cases, the vicious cycle of "not using steroids due to fear of side effects → prolonged inflammation → skin damage" carries a higher risk. It is important to use the appropriate strength for the symptoms for the correct duration.
Frequently Asked Questions
It depends on the area. Continuous use on the face for two weeks requires caution, but it is usually not a problem for the trunk and limbs. If symptoms persist, do not stop abruptly; consult your doctor and gradually reduce the dosage.
In most cases, this is not "rebound (dependence)" but the original condition returning. Using an appropriate amount early when symptoms recur can reduce the total amount of medication used compared to letting it worsen. However, if recurrences are frequent, a review of the treatment plan may be necessary, so please consult a doctor.
Systemic absorption of topical steroids is minimal, so appropriate use is generally considered safe. Always inform your prescribing doctor that you are pregnant before use.
Please avoid self-adjusting the steroid strength. If the effect is insufficient, it may be necessary to review not only the strength of the medication but also the application method, amount, or even the diagnosis itself. Please consult a doctor.
Locoid is a Medium-class steroid, which is relatively easy to use, but particular attention must be paid to the amount, duration, and application area when used in children. Always follow your doctor's instructions.
Generally, it is recommended to apply moisturizer first, wait for a while (5-10 minutes), and then apply the steroid. However, if you have specific instructions from your doctor, please follow those.
Locoid is a topical steroid, so it is not a direct treatment for acne itself. Steroids suppress immune function, and using them for acne involving Propionibacterium acnes can actually worsen it. If acne inflammation is severe, antibiotics or specific topical medications are more appropriate than steroids. Therefore, avoid self-medicating with Locoid and consult a doctor.
The genital area has thin skin and a high absorption rate, so caution is required when using it. It may be used for a short period and in small amounts under a doctor's supervision, but avoid self-medication or long-term continuous use, and always consult a doctor to confirm the appropriate duration and amount.
Online consultations for eczema, dermatitis, and atopy are also available.
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