Hydrocortisone for piles and itchy bottom

Hydrocortisone is used in some medicines to treat:

• piles (haemorrhoids) inside or around your bottom (anus)
• itchy bottom

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

Hydrocortisone is a type of medicine known as a steroid (also called a corticosteroid). Corticosteroids are not the same as anabolic steroids.

Hydrocortisone treatments for piles and itchy bottom come as creams, ointments, sprays and suppositories. You can buy some smaller sizes from a pharmacy, but others are only available on prescription.

Some of these medicines also contain local anaesthetics and other medicines to soothe the symptoms.

Most adults aged 18 years old and over can use hydrocortisone treatments for piles and itchy bottom.

Young people aged 16 or 17 years old can only use some products.

Children aged 2 to 15 years old can use some hydrocortisone treatments if a doctor prescribes them.

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

• have ever had an allergic reaction to hydrocortisone, any local anaesthetics or any other medicine
• have a skin infection
• are taking other medicines, such as codeine, that might be making you constipated – being constipated means you're more likely to get piles

You'll usually use most hydrocortisone treatments for piles and 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're using.

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.

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 after applying the spray.
2. Separate your buttocks and spray the area once.

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

1. Go to the toilet first if you need to.
2. Wash your hands before and after inserting the suppository. 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.

Do not use hydrocortisone treatments for more than 7 days.

Make an appointment to see your doctor if your symptoms:

• have not got better after 7 days
• come back quickly after treatment

If you forget a treatment, use it as soon as you remember, unless you do not remember until a few hours before you're due to use it again. In this case, just skip the missed treatment and then go back to your usual treatment routine.

Using more than the recommended dose of hydrocortisone treatments for piles and itchy bottom is unlikely to cause problems.

Speak to a pharmacist or doctor if you're worried, or if your child has used too much.

If you use hydrocortisone for piles and itchy bottom 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 make the skin around your anus thinner. It's best not to use these treatments for more than 7 days and not to repeat these treatments too often.

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 can get into your blood. This can cause side effects in other parts of your body.

Call your doctor or call 111 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

Serious allergic reaction

It happens rarely, but it's possible to have an allergic reaction (anaphylaxis) to hydrocortisone.

Call 999 now if:

• your lips, mouth, throat or tongue suddenly become swollen
• you're breathing very fast or struggling to breathe (you may become very wheezy or feel like you're choking or gasping for air)
• your throat feels tight or you're struggling to swallow
• your skin, tongue or lips turn blue, grey or pale (if you have black or brown skin, this may be easier to see on the palms of your hands or soles of your feet)
• you suddenly become very confused, drowsy or dizzy
• someone faints and cannot be woken up
• a child is limp, floppy or not responding like they normally do (their head may fall to the side, backwards or forwards, or they may find it difficult to lift their head or focus on your face)

You or the person who's unwell may also have a rash that's swollen, raised, itchy, blistered or peeling.

These can be signs of a serious allergic reaction and may need immediate treatment in hospital.

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

Hydrocortisone creams, ointments, sprays and suppositories for piles and itchy bottom can be used in pregnancy.

Only a small amount of the medicine gets into your blood, and this will not harm your baby.

Hydrocortisone creams, ointments, sprays and suppositories for piles and itchy bottom can be used while breastfeeding, but try to only use them for a short time.

It's not known how much passes into breast milk, but it's likely to be a tiny amount, and your baby will not be able to absorb much of it into their body. It's unlikely to cause any side effects in your baby.

Wash your hands after using the treatment and before picking up your baby.

Treatments for piles and itchy bottom containing hydrocortisone may also contain other ingredients such as local anaesthetics. It's still OK to use them while breastfeeding.

If you notice that your baby is not feeding as well as usual, is not putting on weight as you would expect, or if you have any other concerns about your baby, talk to your health visitor, midwife, pharmacist or doctor as soon as possible.

There's no evidence that hydrocortisone treatments for piles and itchy bottom affect fertility in either men or women.

Taking other medicines should not affect the way hydrocortisone treatments for piles and itchy bottom work. This includes prescribed medicines and ones you buy from a pharmacy or shop.

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