- Which hydrocortisone treatment you use for piles depends on your symptoms. Some products - such as creams and ointments - should only be used on the outside of your body.
- It's usual to apply treatments several times a day - first thing in the morning, last thing at night and after you've done a poo.
- Don't use hydrocortisone treatments for longer than recommended. The local anaesthetic in them can make your skin sensitive. Also, long term use can cause skin thinning.
- Children shouldn't use hydrocortisone piles treatments unless their doctor prescribes them.
- Hydrocortisone treatments for piles can be called by a variety of brand names including the Anusol range, Anugesic HC, Germaloids HC, Perinal, Proctosedyl, Uniroid, Xyloproct and Proctofoam HC.
Hydrocortisone treatments for piles can be used by people aged 16 years and older or 18 years and older depending on the product.
Do not use them on children unless their doctor prescribes them.
Hydrocortisone piles treatments are not suitable for some people.
To make sure hydrocortisone piles treatments are safe for you, tell your doctor or pharmacist 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.
It's usual to use most treatments for piles several times a day - first thing in the morning, last thing at night and after you've done a poo. Check the patient information leaflet which comes with the product you are using.
Some piles treatments are only for use on the skin around your back passage - such as creams, ointments and sprays. These are for piles on the outside (called 'external piles').
Some piles treatments come with an applicator so you can use the medicine inside your back passage - such as hydrocortisone suppositories and foam. These are for piles on the inside (called 'internal piles').
Don't use hydrocortisone treatments for piles for more than 7 days. Make an appointment to see your doctor if :
- your symptoms haven't got better
- they come back quickly after treatment
How to use it
Cream or ointment for external piles
- Squeeze the tube of cream or ointment and put a small amount on your finger.
- Apply the cream or ointment around the outside of your back passage with your finger.
- Wash your hands afterwards.
Spray for external piles and itchy bottom
- Wash your hands before and afterwards.
- Read the instructions in the leaflet that comes with the spray.
- Before using it the first time you need to get it ready - push the pump down once or twice to do this.
- Separate your buttocks and spray the area once.
Foam for internal piles
- Clean around your bottom with mild soap and water, rinse and pat dry.
- The can of foam comes with an applicator. Read the instructions in the leaflet that comes with them.
- Fill the applicator with foam
- Then put the tip of the applicator into your back passage.
- Push the plunger on the applicator so that the foam goes into your back passage. The leaflet explains how to do this with pictures to help you.
- Afterwards, take the applicator apart and wash it after each use. Remember to wash your hands too.
Suppositories for internal piles
- Go to the toilet beforehand if you need to.
- Wash your hands before and afterwards. Also clean around your back passage with mild soap and water, rinse and pat dry.
- Unwrap the suppository - which is a small plug of medicine.
- Stand with one leg up on a chair or lie on your side with one leg bent and the other straight.
- Gently push the suppository into your back passage with the pointed end first. It needs to go in about 1 inch.
- Sit or lie still for about 15 minutes. The suppository will melt inside your back passage. This is normal.
What if I forget to use it?
If you forget a treatment, do it as soon as you remember. If you don't remember until you are within a few hours of the next application, don't worry - just skip the missed treatment and go back to your usual treatment routine.
Like all medicines, hydrocortisone treatments for piles 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. After a few days of using the hydrocortisone treatment, this usually stops happening.
If you use hydrocortisone treatments for piles for a long time, they can thin the skin around your back passage. It's best not to use these treatments for more than 7 days, or to repeat treatments often.
Serious side effects
If you have an infection around your bottom, hydrocortisone treatments can make it worse. To stop infections, wash the itchy or sore area and pat it dry with a soft, clean towel before applying the hydrocortisone medicine.
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 high blood sugar high blood sugar
Serious allergic reaction
It's extremely rare to have an allergic reaction (anaphylaxis) to a hydrocortisone treatment for piles, but if this happens to you, contact a doctor straight away.
Call 999 or go to A&E 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 treatments for piles. For a full list see the leaflet inside your medicine packet.
You can report any suspected side effect to the UK safety scheme.
It's generally safe to use hydrocortisone treatments for piles while you're pregnant or breastfeeding but check with your doctor, midwife or pharmacist first.
Here's more information on how to treat piles in pregnancy.
Tell your pharmacist or doctor if you're trying to get pregnant, are already pregnant or if you're breastfeeding.
Taking other medicines should not affect the way hydrocortisone treatments for piles work.
How does hydrocortisone work?
The hydrocortisone in treatments for piles is a corticosteroid or 'steroid'. Like other steroids, it works by damping down immune system overactivity. This calms inflammation and helps to relieve the pain and itching of piles.
When will my symptoms improve?
The pain and itching should improve within a few days of starting treatment.
How long will I need treatment for?
Piles should heal within a week. If they haven't got better, talk to your doctor.
Can I drink alcohol with the treatment?
Yes, you can drink alcohol with hydrocortisone treatments for piles.
Is there any food or drink I need to avoid?
No, using hydrocortisone treatments for piles does not affect what foods you can eat.
It's a good idea, though to eat lots of foods which contain fibre so you don't get constipation. Examples of foods which have lots of fibre are porridge oats and wholewheat breakfast cereals, wholemeal granary breads, wholewheat pasta, pulses, potatoes with their skins on and vegetables.
To avoid constipation try to drink several glasses of water or another non-alcoholic liquid each day. If you can, it may also help to do some gentle exercise.
Will it affect my fertility?
Hydrocortisone treatments for piles don't affect male or female fertility.
Will it affect my contraception?
Can I have vaccinations?
With some hydrocortisone treatments, you need to be careful about having vaccinations. This isn't the case with hydrocortisone treatments for piles. You can have vaccinations if you need them.
Any lifestyle advice for piles?
Piles 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. Don't hold it in.
Skin moisturisers can also help relieve the pain and itching of piles. Ask your pharmacist what they recommend.