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.
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.
You can report any suspected side effect using the Yellow Card safety scheme.
6. Pregnancy and breastfeeding
Hydrocortisone creams that you buy from a pharmacy can be used in pregnancy and while you are breastfeeding.
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?
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.
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.