Steroid and Antibiotic Creams for Infected Eczema: Fucibet, Fucidin H, Trimovate and More
What combination creams are, when they’re used, how Fucibet, Fucidin H, Trimovate and the betamethasone combinations compare, and how to use them safely.
Part of our eczema and dermatitis guide.
Get urgent help first. Call 999 or go to A&E if you have swelling of the lips, face or tongue or difficulty breathing. Contact NHS 111 or your GP the same day if eczema suddenly gets much worse with clusters of painful blisters or punched-out sores and a fever (possible eczema herpeticum), if redness is spreading fast, or if you feel feverish or unwell. Online treatment isn’t suitable in these situations.
Key fact: combination creams pair a steroid, which calms inflamed skin, with an antibiotic or antifungal. They’re used for short courses, usually a week and no more than 2 weeks, on eczema that is, or may be, infected. NICE advises that most people with mildly infected eczema who are otherwise well don’t need an antibiotic at all, so these creams are for a small infected patch, not every flare.
Adults only online, and not in pregnancy or breastfeeding. Access Doctor’s online eczema service is for adults aged 18 and over, and can’t supply treatment if you’re pregnant or breastfeeding: your GP or midwife can help. Children with infected eczema should see their GP or a pharmacist.
What are steroid and antibiotic creams?
These creams contain two medicines in one tube. The steroid reduces the redness, swelling and itch of eczema. The anti-infective, an antibiotic, an antifungal or both, treats bacteria or yeast that have got into the broken skin.
Eczema skin is often colonised by a bacterium called Staphylococcus aureus, and sometimes it becomes truly infected: weepy, crusted and sore. When the skin is both inflamed and infected, a combination cream treats both at once. The BNF notes that these combinations may have a place in infected eczema, used regularly for a short time, typically twice a day for about a week, because longer use encourages resistance and allergy.
When are they used, and when aren’t they needed?
- Used for: a small, localised patch of eczema that looks infected (weeping, golden crusts, small pus spots) in someone who is otherwise well.
- Often not needed: NICE guidance (NG190) says that if you’re not otherwise unwell, antibiotics usually add little to treating the eczema with the right-strength steroid. Not every weepy flare is infected.
- Not enough on their own: widespread or severe infection needs antibiotic tablets, usually flucloxacillin, from a GP.
- Not for: eczema herpeticum (a cold sore virus infection), which is an emergency, or a rash that could be a fungal infection like ringworm, unless the cream also contains an antifungal and a prescriber has advised it.
For the signs to look out for, see how to spot infected eczema.
The combination creams compared
| Cream | Steroid (strength) | Anti-infective | Covers | Course in the product information |
|---|---|---|---|---|
| Fucidin H | Hydrocortisone acetate 1% (mild) | Fusidic acid 2% | Bacteria | Twice a day; usually no more than 2 weeks; review if no better in 7 days |
| Nystaform HC | Hydrocortisone 0.5% (mild) | Nystatin and chlorhexidine 1% | Yeast (Candida) and bacteria | 2 or 3 times a day for up to 7 days |
| Fucibet | Betamethasone valerate 0.1% (potent) | Fusidic acid 2% | Bacteria | Twice a day; a course shouldn’t normally exceed 2 weeks |
| Trimovate | Clobetasone butyrate 0.05% (moderate) | Oxytetracycline 3% and nystatin | Bacteria and yeast (Candida) | Once or twice a day for up to 7 days |
| Betamethasone with clioquinol | Betamethasone valerate 0.1% (potent) | Clioquinol 3% | Bacteria and fungi | 2 or 3 times a day; stop if no better within 7 days |
| Betamethasone with neomycin | Betamethasone valerate 0.1% (potent) | Neomycin 0.5% | Bacteria | 2 or 3 times a day; no more than 7 days without medical supervision |
For what mild, moderate and potent mean, see our steroid cream strengths guide. Plain Fucidin cream contains fusidic acid only, with no steroid. It treats a bacterial skin infection, such as impetigo, but not the eczema underneath.
Fucibet vs Fucidin H vs Fucidin
These three are often confused because they share the same antibiotic, fusidic acid. The difference is the steroid:
- Fucidin: fusidic acid only. An antibiotic cream with no steroid.
- Fucidin H: fusidic acid with hydrocortisone, a mild steroid. Suited to milder infected eczema and thinner skin.
- Fucibet: fusidic acid with betamethasone, a potent steroid and the same one as in Betnovate. Used for more inflamed infected eczema on the body, arms and legs.
The product information for both Fucidin H and Fucibet says a course shouldn’t normally go beyond 2 weeks, because bacteria become resistant to fusidic acid with longer or repeated use.
Trimovate, Nystaform HC and the betamethasone combinations
Trimovate
Trimovate combines a moderate steroid (clobetasone) with an antibiotic (oxytetracycline) and an antifungal (nystatin). Because it covers yeast as well as bacteria, it’s used where Candida may be involved, such as in skin folds, as well as for infected atopic and seborrhoeic dermatitis. It’s a yellow cream that can lightly stain skin, hair and fabric; washing usually removes it. Use it for no more than 7 days without medical review.
Nystaform HC
Nystaform HC combines a mild steroid (hydrocortisone 0.5%) with an antifungal (nystatin) and an antiseptic (chlorhexidine). It’s licensed for inflamed skin where a yeast or bacterial infection is present, such as infected eczema or intertrigo in skin folds, where Candida is common. Its steroid is the mildest of the combination creams, and it’s used for no more than 7 days.
Betamethasone with clioquinol
This combines a potent steroid with clioquinol, which acts against both bacteria and fungi. It can stain hair, skin and fabric, so the product information suggests covering it with a dressing. It isn’t for children under 2, and facial use should be limited to 5 days.
Betamethasone with neomycin
This combines a potent steroid with neomycin, an antibiotic. Neomycin can cause skin allergy with repeated use, and if large amounts are absorbed it can damage hearing and the kidneys, so it shouldn’t be used over large areas or for long periods. It isn’t for children under 2 and isn’t recommended in pregnancy or breastfeeding.
How to use a steroid and antibiotic cream
1
Apply a thin layer to the infected patch only
Usually twice a day, or as your prescriber or the label says. Don’t spread it onto clear skin.
2
Keep the course short
Most courses last up to 7 days. Stop when the infection has cleared, then carry on with your usual eczema treatment, a plain steroid if needed and your emollient.
3
Get reviewed if it isn’t working
If the patch isn’t clearly better within 7 days, or it’s spreading, you feel unwell or you get a fever, stop and speak to a prescriber, your GP or NHS 111.
4
Don’t keep leftovers for next time
Repeated courses of fusidic acid make bacteria resistant to it, so the cream works less well when you really need it. Don’t share it either.
5
Keep using your emollient
Keep up your emollient routine. Leave a gap of around 30 minutes between the emollient and the cream. Use a fresh pot or a pump dispenser, as emollient tubs can harbour bacteria.
The face, genitals and fungal infections
- Face: creams containing a potent steroid, such as Fucibet and the betamethasone combinations, aren’t usually used on the face, which thins easily and is prone to rosacea and perioral dermatitis. Fucidin H, with its mild steroid, is the usual choice there, and still only briefly. Never use any of them for rosacea or perioral dermatitis.
- Genitals and skin folds: this skin absorbs steroids readily. Potent combinations aren’t used here without a prescriber’s advice. Itching around the anus or genitals without inflammation shouldn’t be treated with them.
- Fungal infections: Fucibet and Fucidin H don’t treat fungal infections such as ringworm or thrush, and the steroid can make them worse. Trimovate, Nystaform HC and betamethasone with clioquinol do contain an antifungal, but a fungal rash should be confirmed by a prescriber first.
Side effects and who shouldn’t use them
Most people use a short course without problems. Possible side effects include stinging or itching where applied, skin allergy to an ingredient, and, with potent steroids used for too long, thinning skin. The MHRA warns that, rarely, stopping a steroid after long-term daily use can cause burning, spreading redness; if your skin gets worse within 2 weeks of stopping, get advice before restarting.
Don’t use these creams on:
- Cold sores, chickenpox or other viral skin infections, including eczema herpeticum
- Skin infections that aren’t being treated, or an infection the cream doesn’t cover
- Rosacea, acne or perioral dermatitis
- Broken, ulcerated skin or wounds (betamethasone with neomycin)
- Babies under 2 (the betamethasone combinations)
How our online service supplies Fucibet and Fucidin H: adults 18 and over, only for a small, localised infected patch in someone who is otherwise well. One tube for up to 7 days, and no repeat within 3 months without a GP review. Anyone with a fever, widespread infection or possible eczema herpeticum is referred to their GP or NHS 111. Other combination creams are supplied only where a prescriber judges them suitable.
Eczema patch looking infected?
Our GPhC-registered pharmacist independent prescribers can assess your skin online and, if suitable, prescribe a short course of treatment, or tell you if you need to see your GP. Adults 18 and over. Dispensed from our UK pharmacy. Approved before 3pm, Monday to Friday? Dispatched the same day, by Royal Mail Tracked 48, Tracked 24 or Special Delivery guaranteed by 1pm next working day: you choose.
Start Eczema Consultation →UK safety and reporting side effects
Steroid and antibiotic creams are prescription-only medicines in the UK. Before one is prescribed, a GPhC-registered pharmacist independent prescriber reviews your consultation, including what the skin looks like, whether you’re otherwise well and what you’ve used before. Always read the patient information leaflet. Never share antibiotic creams or keep leftovers for another time: return unused tubes to a pharmacy.
If you think you’ve had a side effect, tell your pharmacist or doctor. You can also report it to the MHRA through the Yellow Card scheme, which helps keep medicines safe for everyone.
In England, people with infected insect bites or impetigo may be able to get treatment through the NHS Pharmacy First service. Infected eczema isn’t covered, so see your GP or use a private service. Our online service is for adults aged 18 and over.
Combination creams from Access Doctor
Following an online consultation, our prescribers can supply steroid and antibiotic creams where they’re suitable, as part of our eczema and dermatitis treatments.
Potent steroid + antibiotic · Rx
Fucibet Cream
Betamethasone with fusidic acid, for infected eczema on the body. Not for the face.
View product →Mild steroid + antibiotic · Rx
Fucidin H Cream
Hydrocortisone with fusidic acid, for milder infected eczema.
View product →Moderate steroid + antibiotic + antifungal · Rx
Trimovate Cream
Where both bacteria and yeast may be involved, including skin folds.
View product →Mild steroid + antifungal + antiseptic · Rx
Nystaform HC Cream
The mildest combination, for infected skin folds where yeast is likely.
View product →Potent steroid + antibacterial/antifungal · Rx
Betamethasone with Clioquinol Cream
A potent steroid with clioquinol. Can stain skin and fabric.
View product →Frequently Asked Questions
What is Fucibet cream used for?
Fucibet is used for eczema that is, or may be, infected with bacteria, including atopic, discoid, contact and seborrhoeic eczema. It contains betamethasone, a potent steroid that calms the inflammation, and fusidic acid, an antibiotic. It’s applied twice a day for a short course, normally no more than 2 weeks.
Is Fucibet the same as Fucidin?
No. Both contain the antibiotic fusidic acid, but Fucidin is an antibiotic cream with no steroid, while Fucibet also contains betamethasone, a potent steroid. Fucidin treats a bacterial skin infection such as impetigo; Fucibet treats eczema that has become infected.
What is the difference between Fucidin and Fucidin H?
Fucidin contains only fusidic acid, an antibiotic. Fucidin H also contains hydrocortisone, a mild steroid, so it treats the inflammation of eczema as well as the infection. Fucidin H is used for mildly infected eczema; plain Fucidin is used for bacterial infections without eczema.
Can I use Fucibet on my face?
Not usually. Fucibet contains a potent steroid, and facial skin is thin and prone to side effects such as thinning, rosacea and perioral dermatitis. Fucidin H, with a mild steroid, is the usual choice for the face, and only briefly. Our online service doesn’t supply potent steroids for the face.
Can Fucibet treat a fungal infection?
No. Fusidic acid treats bacteria, not fungi, and the steroid in Fucibet can make a fungal infection such as ringworm or thrush worse. Creams such as Trimovate contain an antifungal as well, but a fungal rash should be checked by a prescriber before using any steroid cream on it.
Can Fucibet cream be used on private parts?
Not without a prescriber’s advice. Genital skin is thin and absorbs steroids readily, and Fucibet contains a potent steroid. Genital itching is often caused by thrush or other conditions that Fucibet doesn’t treat and can worsen, so get it assessed first.
How long can I use a steroid and antibiotic cream?
Only for a short course. Fucibet and Fucidin H shouldn’t normally be used for more than 2 weeks, Trimovate, Nystaform HC and the betamethasone combinations for no more than 7 days without review, and our service supplies Fucibet and Fucidin H for up to 7 days. Longer or repeated use makes bacteria resistant.
Do I need an antibiotic cream for infected eczema?
Not always. NICE says that if you’re otherwise well, antibiotics usually add little to treating the eczema with the right steroid. A small infected patch may be treated with an antibiotic or combination cream for a short course, while widespread infection or feeling unwell needs a GP and usually antibiotic tablets.
What is Trimovate used for?
Trimovate is used for inflamed skin conditions where a bacterial or yeast infection is present or likely, such as infected atopic eczema, seborrhoeic dermatitis and intertrigo in skin folds. It contains a moderate steroid (clobetasone), an antibiotic (oxytetracycline) and an antifungal (nystatin), and is used for up to 7 days.
References
- NICE. Secondary bacterial infection of eczema and other common skin lesions: antimicrobial prescribing (NG190). nice.org.uk
- Joint Formulary Committee. British National Formulary: topical corticosteroids (compound preparations). bnf.nice.org.uk
- Fucibet Cream: summary of product characteristics. medicines.org.uk
- Fucidin H Cream: summary of product characteristics. medicines.org.uk
- Trimovate Cream: summary of product characteristics. medicines.org.uk
- Nystaform HC Cream: summary of product characteristics. medicines.org.uk
- Betamethasone valerate/clioquinol cream: summary of product characteristics. medicines.org.uk
- Betamethasone valerate/neomycin sulphate cream: summary of product characteristics. medicines.org.uk
- MHRA. Topical corticosteroids: information on the risk of topical steroid withdrawal reactions. Drug Safety Update, September 2021. gov.uk
Medical disclaimer: This article is for information only and isn’t medical advice. Steroid and antibiotic creams are prescription-only medicines and need a clinical consultation before they can be supplied. If your skin is spreading red, you have a fever or you feel unwell, seek medical advice the same day. In a medical emergency, call 999.