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Lidocaine for piles and itchy bottom - Cream, ointment, spray and suppositories

On this page

  1. About lidocaine treatments for piles
  2. Key facts
  3. Who can and can't use lidocaine for piles
  4. How and when to use it
  5. Side effects
  6. Pregnancy and breastfeeding
  7. Cautions with other medicines
  8. Common questions

1. About lidocaine treatments for piles

Lidocaine is a local anaesthetic. It's used in some medicines to treat:

These treatments do not cure piles but they can help with the pain and itching.

Lidocaine treatments for piles come as creams, ointments, sprays and suppositories. You can buy them from a pharmacy.

Some treatments contain lidocaine mixed with a corticosteroid like hydrocortisone. If you're using hydrocortisone treatments for piles, read the leaflet that comes with your medicine as the instructions are different.

Other types of lidocaine

There are different types of lidocaine, including medicated plasters, injections and gels.

Find out more about using lidocaine for mouth ulcers, teething and sore throat or lidocaine skin cream for numbing the skin before a procedure involving a needle.

2. Key facts

  • Lidocaine treatments are used in different ways. Some creams and ointments are for internal use only, while others go on your skin. Always check the instructions.
  • You'll generally use lidocaine for piles several times a day – first thing in the morning, last thing at night and every time you poo.
  • Do not use lidocaine for longer than recommended. The local anaesthetic can make your skin sensitive over time or if you use it for too long.
  • Do not use lidocaine to treat piles in children under the age of 12 years – unless their doctor prescribes it.
  • There are a number of brand names, including the Anusol range, Boots haemorrhoid range, Germaloids range, Perinal and Xyloproct.

3. Who can and can't use lidocaine for piles

Most adults and children from the age of 12 years can use lidocaine treatments for piles.

Do not give this medicine to children younger than 12 years, unless they have a prescription from a doctor.

Lidocaine treatments are not suitable for some people.

To make sure this medicine is safe for you, tell your doctor or pharmacist if you are:

  • allergic to lidocaine or any other medicine
  • 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 it

It's usual to use most treatments for piles several times a day – first thing in the morning, last thing at night and every time you poo. Check the patient information leaflet that comes with your medicine.

Some piles treatments are only for use on the skin near your bottom (anus) – including 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 bottom – including suppositories. These are for piles on the inside (called "internal piles").

How to use it

Read the instructions that come with your medicine first.

Wash your hands before and after using lidocaine.

Cream or ointment for external piles

  1. Squeeze the tube and put a small amount of cream or ointment on your finger.
  2. Gently put it around the outside of your anus with your finger.
  3. Replace the cap on the tube.

Spray for external piles and itchy bottom

  1. Before using your spray for the first time you need to get it ready – push the pump down once or twice to do this.
  2. Separate your buttocks.
  3. Spray the area around the outside of your anus once.

Cream or ointment for internal piles

  1. Clean around your anus with mild soap and water, rinse and pat dry.
  2. Gently insert the applicator into your anus.
  3. Squeeze a small amount of the medicine into your anus.
  4. Remove the applicator, take it apart and wash it with soap and water.

Suppositories for internal piles

  1. Go to the toilet beforehand if you need to.
  2. Clean around your anus with mild soap and water, rinse and pat dry.
  3. Unwrap the suppository – which is a small plug of medicine.
  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.
  6. Sit or lie still for about 15 minutes. The suppository will melt inside your bottom. This is normal.

Giving suppositories to children

If your child has a prescription for lidocaine for piles, visit the Medicines for Children website for advice on how to give rectal medicines.

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 one, do not worry – just skip the missed treatment and go on with your usual treatment routine.

5. Side effects

Like all medicines, lidocaine treatments for piles can cause side effects although not everyone gets them.

If you use lidocaine for a short time, it's very unlikely to cause side effects.

You may get a "burning" feeling when you first apply the treatment but this only lasts a few minutes. After using it for a few days, this usually stops happening. If this bothers you, stop using the lidocaine treatment and ask a pharmacist or doctor for advice.

Serious side effects

If your treatment for piles contains lidocaine only (and is not combined with a steroid) then you are unlikely to have any serious side effects.

Serious allergic reaction

It's extremely rare to have an allergic reaction (anaphylaxis) to a lidocaine treatment for piles.

Immediate action required: 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 lidocaine 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.

6. Pregnancy and breastfeeding

It's safe to use lidocaine treatments for piles while you're pregnant or breastfeeding.

However, check with your doctor, midwife or a 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.

7. Cautions with other medicines

Lidocaine can potentially affect the way other medicines work. However, this is more likely when you're using lidocaine at higher doses or if you're having lidocaine injections.

If you're using your lidocaine treatment for piles as directed, it will not usually affect any other medicines.

Speak to your pharmacist if you have any questions.

Mixing lidocaine with herbal remedies and supplements

There's very little information about taking herbal medicines and supplements with lidocaine.


For safety, tell your doctor or pharmacist if you're taking any other medicines, including herbal remedies, vitamins or supplements.

8. Common questions

How does lidocaine work?

Lidocaine is a local anaesthetic that numbs the area where you've used it.

It works by stopping nerves from sending pain signals to your brain.

If you use lidocaine treatment for piles, it helps relieve any pain and itching.

When will my symptoms improve?

Lidocaine works quickly.

Most people will start to feel better within an hour.

How long will I need to treat my piles?

Piles should heal within a week.

Talk to your doctor if the pain and itching are not better after using lidocaine for 7 days, or if you keep getting piles.

Is it safe to use lidocaine for a long time?

Talk to your doctor if your symptoms last for more than 7 days or if you keep getting piles. They may want to find out what's causing this.

If you use these treatments for a long time, there's also more chance of your skin becoming sensitive to lidocaine.

Are there other treatments for piles?

There are various types of treatments for piles. Some are available on prescription from your doctor. There are others that you can buy in a pharmacy.

These treatments contain different local anaesthetics and are likely to provide similar relief for your symptoms.

Some treatments also contain corticosteroids, such as hydrocortisone.

Ask your doctor or a pharmacist about the best treatment options to help with your symptoms. They may recommend:

  • creams to ease the pain, itching and swelling
  • treatment to help constipation and soften poo
  • cold packs to ease discomfort
Can I drink alcohol with it?

Yes, you can drink alcohol with lidocaine treatments for piles.

Is there any food or drink I need to avoid?

Lidocaine treatments for piles do not affect what you can eat or drink.

However, it's a good idea to get more fibre into your diet so you do not get constipated. Constipation can make your symptoms worse.

Good sources of fibre include:

  • porridge oats and wholegrain breakfast cereals
  • wholemeal or granary bread
  • brown pasta and brown rice
  • pulses such as lentils, peas and beans
  • potatoes with their skins on

Other tips for preventing constipation include drinking plenty of fluids and doing some gentle exercise, if you can.

Will it affect my fertility?

There is no firm evidence that lidocaine treatments for piles affect male or female fertility.

Will it affect my contraception?

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

Is there any lifestyle advice for piles?

Piles often settle down without treatment but there are some things you can do to help your symptoms.

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:

Useful resources

Page last reviewed: 11 October 2019
Next review due: 11 October 2022