Best external hemorrhoid treatment over the counter

Find out more about other ways you can use hydrocortisone for different health conditions.

2. Key facts

• Some hydrocortisone products creams and ointments can only be used on the outside of your body. The best type of treatment for you depends on your symptoms.
• You'll usually apply treatments several times a day – first thing in the morning, last thing at night and after you've done a poo. Always follow advice from a pharmacist or doctor, or the leaflet that comes with your medicine.
• Do not use hydrocortisone treatments for longer than recommended, or use more than you're supposed to. The local anaesthetic in them can make your skin sensitive. Also, long-term use can make your skin thinner.
• Do not let children use hydrocortisone unless their doctor prescribes it for them.
• Hydrocortisone treatments for piles can be called by a variety of brand names including the Anusol range, Anugesic, Germaloids, Perinal, Proctosedyl, Uniroid and Xyloproct.

3. Who can and cannot use hydrocortisone for piles and itchy bottom

Hydrocortisone treatments for piles and itchy bottom can be used by most adults (aged 18 years and older).

Young people aged 16 to 17 years can only use some products. Do not use these treatments on children under the age of 16 unless a doctor prescribes them.

Hydrocortisone treatments are not suitable for some people. To make sure they are safe for you, tell your pharmacist or doctor if you:

• are allergic to hydrocortisone or any other medicine
• have a skin infection
• are pregnant, trying to get pregnant or you're breastfeeding
• are taking other medicines, such as codeine, which might be making you constipated. Being constipated means you're more likely to get piles.

4. How and when to use hydrocortisone for piles and itchy bottom

You'll usually use most treatments for piles or itchy bottom several times a day – first thing in the morning, last thing at night and after you've done a poo. Check the leaflet which comes with the product you are using.

Some treatments are only used on the skin around your anus – such as creams, ointments and sprays. These are for piles on the outside (called external piles) or itchy bottom.

Some piles treatments, such as hydrocortisone suppositories, are used inside your anus. These are for piles on the inside (internal piles).

Do not use hydrocortisone treatments for more than 7 days. Make an appointment to see your doctor if your symptoms:

• have not got better
• come back quickly after treatment

How to use cream or ointment for external piles

Read the instructions in the leaflet that comes with the cream or ointment.

1. Wash your hands before and afterwards.
2. Squeeze the tube of cream or ointment and put a small amount on your finger.
3. Apply the cream or ointment around the outside of your anus with your finger.

How to use spray for external piles and itchy bottom

Read the instructions in the leaflet that comes with the spray.

Before using the spray for the first time you need to get it ready. Push the pump down once or twice to do this.

1. Wash your hands before and afterwards.
2. Separate your buttocks and spray the area once.

How to use suppositories for internal piles

Read the instructions in the leaflet that comes with the suppositories.

1. Go to the toilet beforehand if you need to.
2. Wash your hands before and afterwards. Also clean around your anus with mild soap and water, rinse and pat dry.
3. Unwrap the suppository.
4. Stand with one leg up on a chair or lie on your side with one leg bent and the other straight.
5. Gently push the suppository into your anus with the pointed end first. It needs to go in about 2cm to 3cm (1 inch).
6. Sit or lie still for about 15 minutes. The suppository will melt inside your anus.

What if I forget to use it?

If you forget a treatment, do it as soon as you remember. If you do not remember until you are within a few hours of the next application, do not worry. Just skip the missed treatment and go back to your usual treatment routine.

5. Side effects

Like all medicines, hydrocortisone treatments can cause side effects, although not everyone gets them.

If you use hydrocortisone for a short time, it's very unlikely to cause side effects. You may get a slight increase in burning when you first apply the treatment, but this only lasts a few minutes. This usually stops happening after a few days.

If you use hydrocortisone for a long time, it can thin the skin around your anus. It's best not to use these treatments for more than 7 days and not to repeat these treatments too often.

Serious side effects

If you have an infection around your bottom, hydrocortisone treatments can make it worse. To prevent infections, wash the itchy or sore area and pat it dry with a soft, clean towel before applying the treatment.

Very rarely hydrocortisone gets into the bloodstream. This can cause side effects in other parts of your body.

Tell your doctor straight away if you get:

• more inflamed skin around your bottom – this can be a sign of a skin infection
• very upset stomach or vomiting, very bad dizziness or fainting, muscle weakness, feeling very tired, mood changes, loss of appetite and weight loss – these can be signs of adrenal gland problems
• confused, sleepy, more hungry or thirsty, peeing more often, breathing fast or breath that smells like fruit – these can be signs of diabetes or complications of diabetes

Serious allergic reaction

It's extremely rare to have an allergic reaction (anaphylaxis) to hydrocortisone.

Immediate action required: Call 999 or go to A&E now if:

• you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
• you're wheezing
• you get tightness in the chest or throat
• you have trouble breathing or talking
• your mouth, face, lips, tongue or throat start swelling

You could be having a serious allergic reaction and may need immediate treatment in hospital.

These are not all the side effects of hydrocortisone for piles or itchy bottom. For a full list see the leaflet inside your medicine packet.

Information:

You can report any suspected side effect using the Yellow Card safety scheme.

Visit Yellow Card for further information.

6. Pregnancy and breastfeeding

Hydrocortisone creams that you buy from a pharmacy can be used in pregnancy and while you are breastfeeding.

Important

For safety, tell your pharmacist or doctor if you're trying to get pregnant, are already pregnant or if you're breastfeeding.

Here's more information on how to treat piles in pregnancy.

For more information about using hydrocortisone during pregnancy, read this leaflet on the Best Use of Medicines in Pregnancy (BUMPS) website.

7. Cautions with other medicines

Taking other medicines should not affect the way hydrocortisone treatments for piles or itchy bottom work.

Important: Medicine safety

Tell your doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins or supplements.

8. Common questions about hydrocortisone

How does hydrocortisone work?

The hydrocortisone in treatments for piles and itchy bottom is a steroid (corticosteroid).

Like other steroids, it works by calming your immune system. This reduces inflammation and helps to relieve the pain and itching of piles.

When will my symptoms get better?

The pain and itching should get better within a few days of starting treatment.

How long will I need treatment for?

Piles and itchy bottom should get better within 7 days. Talk to your doctor if your piles have not got better or the itching gets worse.

Are there other medicines that help piles or itchy bottom?

There are other treatments available to buy that do not contain hydrocortisone. These include creams and suppositories containing zinc oxide or other soothing ingredients.

Your doctor may be able to prescribe stronger medicines for piles or itchy bottom.

Is there any food or drink I need to avoid?

No, using hydrocortisone treatments for piles does not affect what you can eat and drink.

It's a good idea, though to eat lots of foods which contain fibre so you do not get constipation. Examples of foods with lots of fibre are porridge oats and wholegrain breakfast cereals, wholemeal breads, wholewheat pasta, pulses, potatoes with their skins on and vegetables.

To avoid constipation, try to drink several glasses of water or other non-alcoholic drinks each day. If you can, it may also help to increase your levels of exercise.

Can I drink alcohol with it?

Yes, you can drink alcohol while using all hydrocortisone treatments for piles and itchy bottom.

Will it affect my fertility?

There is no clear evidence that hydrocortisone treatments for piles or itchy bottom affect male or female fertility.

Will it affect my contraception?

Hydrocortisone treatments for piles do not affect any type of contraception, including the combined pill and emergency contraception.

But if hydrocortisone makes you sick (vomit), your contraceptive pills may not protect you from pregnancy.

Look on the pill packet to find out what to do.

Find out what to do if you're on the pill and you're being sick.

Can I have vaccinations?

With some hydrocortisone treatments, you need to be careful about having vaccinations. However, this is not the case with hydrocortisone treatments for piles or itchy bottom. You can have vaccinations if you need them.

Is there any lifestyle advice for piles or itchy bottom?

Piles and itchy bottom often settle down without treatment, but there are some things you can do to help. Piles can be brought on by too much straining on the toilet. Straining is often because of constipation. You're less likely to get constipated if you:

• increase the amount of fibre you eat, like wholemeal bread, fruit and vegetables
• drink lots of water every day
• exercise regularly
• go to the toilet as soon as you feel you need to. Do not hold it in.

Skin moisturisers can also help relieve the pain and itching of piles. Ask your pharmacist what they recommend.

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