Is Hydrocortisone Cream Effective For Hemorrhoids?

Hydrocortisone, a corticosteroid drug, is available as a cream that can be used for the treatment of numerous skin conditions, including hemorrhoids. Although it doesn’t cure hemorrhoids, it can ease the symptoms. 

What are hemorrhoids?

Hemorrhoids are swollen and inflamed veins that develop inside the lower rectum or under the skin around the anus. They can cause symptoms such as pain, itchiness, and rectal bleeding.

This condition is also called piles.

Hemorrhoids are common, especially in adults over the age of 50.¹

Hydrocortisone cream for hemorrhoids

Hydrocortisone cream is available over the counter (OTC) and by prescription to ease hemorrhoid symptoms.

Mild forms contain less than 1% hydrocortisone, meaning they contain 10mg of hydrocortisone per gram. In the US, hydrocortisone is generally available over the counter up to 1%. 

Obtaining stronger forms typically requires a doctor’s prescription. Prescription-strength topical hydrocortisone is typically 2.5%, such as Anusol HC or Proctosol HC.

How does hydrocortisone help ease symptoms of hemorrhoids?

Hydrocortisone has anti-inflammatory and antipruritic properties. When absorbed through the skin, it prevents the skin cells from releasing chemicals that cause inflammation. This can help manage hemorrhoid symptoms, such as itching and swelling.²

How is hydrocortisone cream used for hemorrhoids?

Follow the advice given by your doctor and the instructions on the packet when using topical hydrocortisone.

Hydrocortisone cream should be applied 2–4 times daily. A good guide is to apply it as soon as you wake up, after you have a bowel movement, and before you go to bed.³

Hydrocortisone cream should only ever be applied to external hemorrhoids. You should apply a thin layer to the rectal area and rub it in gently. Avoid using hydrocortisone on healthy skin.

Avoid covering the area where hydrocortisone was applied with an occlusive dressing such as a bandage. Doing so can cause too much hydrocortisone to be absorbed through the skin and lead to adverse effects.

Tell your doctor if your symptoms do not ease within seven days of using an OTC medication. Topical hydrocortisone should not be used for hemorrhoids for longer than one week to avoid adverse reactions.

For prescription hydrocortisone cream, let your doctor know if your symptoms do not improve.⁴

Potential adverse effects

Topical hydrocortisone is considered safe for most people when used as instructed. However, like any other medication, it can cause adverse effects.

Potential common adverse effects from hydrocortisone cream include the following:

• Burning

• Itchiness

• Irritation

• Dry skin

• Inflamed hair follicles

• Excess hair growth

• Acne-like bumps

• Lightening of the skin

• Itchy rash

• Macerated skin (skin may appear lighter and wrinkled)

• Secondary infection

• Thinning of the skin

• Stretch marks

• Heat rash

Adverse effects are more common in people using stronger creams or with prolonged use. Applying occlusive dressings can further increase risk.

Potential serious adverse effects include:

• Adrenal gland problems — symptoms include low blood pressure and rapid heart rate

• Signs and symptoms of Cushing’s syndrome

• High blood glucose levels

• Excess sugars in the urine

Serious adverse effects with OTC topical hydrocortisone are extremely rare if you follow the usage instructions carefully.

If you experience any severe side effects, you should contact your doctor as soon as possible. 

Precautions to be aware of before using hydrocortisone cream

Some precautions to be aware of before using hydrocortisone cream include the following:

Pregnancy and breastfeeding

Mild-to-moderate topical steroids are not associated with the risk of adverse pregnancy outcomes. Your doctor will recommend using the least potent product over the shortest possible time.⁵

It is unknown whether sufficient quantities of topical corticosteroids like hydrocortisone are systemically absorbed to be detected in breast milk. Although most manufacturers recommend caution, topical corticosteroids are generally considered acceptable for use in people who are breastfeeding.⁶

Consult with your OB-GYN before starting any medication during pregnancy or breastfeeding, including OTC drugs.

Children

Children are more at risk of developing adverse effects when using topical hydrocortisone. This is because the ratio of skin surface to body weight is higher, meaning more medication can be absorbed systemically.

Your child’s doctor will recommend the shortest course of treatment possible to achieve the desired results.⁷

Allergies

People who are allergic to hydrocortisone or other ingredients in the cream should not use this cream.

Existing medical conditions

Before using topical hydrocortisone, you should let your doctor know if you have Cushing’s syndrome, diabetes, high blood sugar, or intracranial hypertension.

Existing skin infections

Your doctor may advise against using hydrocortisone if you have an existing skin infection. As an immunosuppressant, hydrocortisone can exacerbate skin infections.

Drug interactions

It’s best to tell your doctor if you’re taking any other medications before using topical hydrocortisone for hemorrhoids.

Other topical medications for hemorrhoids

Other creams and ointments are also effective at treating or managing symptoms of hemorrhoids. These include the following: 

Lidocaine cream

Lidocaine is a medication that can be used as a local anesthetic. It works by blocking pain signals from reaching the brain.

The cream formulation can help reduce pain, burning, and itching caused by hemorrhoids.⁸

Zinc oxide cream/ointment

Zinc oxide creams or ointments, like Calmoseptine, can help to protect the skin and reduce the symptoms of hemorrhoids, such as burning, pain, discomfort, and itching.

Zinc oxide cream can be applied as needed once or twice daily outside the anus.⁹

The lowdown

Hydrocortisone cream can be an effective method for managing the symptoms of hemorrhoids, such as itching, swelling, and bleeding. However, it won’t cure the condition. 

If you experience symptoms of hemorrhoids, it’s recommended to speak with your doctor to find out whether hydrocortisone cream could benefit you.

Frequently asked questions

What does hydrocortisone do to hemorrhoids?

Topical hydrocortisone is used to manage symptoms caused by hemorrhoids, but it doesn’t shrink or remove the hemorrhoids.

A cream that contains hydrocortisone can help by reducing inflammation. This helps reduce the redness, swelling, itching, and irritation associated with hemorrhoids.

Can I put hydrocortisone cream on hemorrhoids?

Hydrocortisone cream can only be applied to external hemorrhoids located under the skin around the anus. Hydrocortisone cream is not designed to be applied to internal hemorrhoids found inside the lower rectum.

How long does it take for hydrocortisone to work on hemorrhoids?

It generally takes a few days for hydrocortisone cream to relieve symptoms of hemorrhoids. If your symptoms worsen or don’t resolve seven days after regularly applying hydrocortisone, you should contact your doctor. You may need a higher strength of hydrocortisone or a different type of cream.

Can you overuse hydrocortisone cream?

It’s important to use the correct dose of hydrocortisone cream.

Although hydrocortisone is safe for most people, adverse effects can occur when too much is absorbed through the skin or when it’s used for an extended period.