Most initial formulations of The Spot Cream Erase, The Spot Cream M+, and The Spot Peel contain hydrocortisone in it to help minimize discomfort and irritation, this helps your skin adjust to this new treatment. It is important not to use hydrocortisone past the first fill since long-term use of it can cause thinning of the skin and other unwanted side effects, such as worsening of acne and rosacea. You can add OTC (over-the-counter) 1% hydrocortisone cream and add it to The Spot Cream to use occasionally when your skin is irritated or red.