An anal fissure is a small tear or crack in the lining of the anal canal, often causing pain and bleeding, particularly during bowel movements. This condition can arise from trauma, such as passing hard stools, or from persistent diarrhea. Hydrocortisone, a type of corticosteroid, is a medication used to reduce swelling, redness, itching, and rashes caused by various skin conditions. For anal fissures, it helps reduce inflammation and discomfort in the affected area.
How Hydrocortisone Addresses Fissures
Hydrocortisone works as a topical corticosteroid by binding to glucocorticoid receptors in the body, which leads to a reduction in inflammation. This action helps to decrease swelling and irritation around the anal fissure, alleviating pain.
Reducing inflammation also helps break the cycle of pain and muscle spasm often seen with fissures. When a fissure occurs, the internal anal sphincter muscle can go into spasm, restricting blood flow and hindering healing. By reducing inflammation, hydrocortisone may indirectly support improved blood flow to the area, facilitating the healing process. While its effectiveness can vary, it is generally considered safe for short-term use.
Proper Application and Usage
For anal fissures, hydrocortisone is typically applied topically as a cream or ointment directly to the affected area. Before application, clean the area gently with mild soap and water, then rinse well and pat dry. A small amount of cream or ointment can be applied to the outside of the anus and rubbed in gently.
If directed by a healthcare professional, an applicator tip may be used to apply the product just inside the anus, usually about 1/2 to 1 inch (1.5 to 2.5 centimeters). Apply hydrocortisone products two to four times daily, or after each bowel movement. The duration of use is typically for a short period, often a few weeks, or as advised by a doctor, with some recommendations suggesting no more than 1-2 weeks for low-strength formulations. Always follow the specific instructions provided by a healthcare professional or on the product’s packaging.
Potential Effects and Considerations
Common side effects at the application site can include burning, itching, redness, or irritation, which may initially increase but typically subside. Prolonged or improper use, especially on large areas or areas with thin skin, can lead to more serious effects. These can include skin thinning, stretch marks, and color changes.
Hydrocortisone should be used with caution, particularly avoiding application on infected areas unless specifically guided by a medical professional, as it can worsen infections. Individuals with certain skin conditions or allergies to hydrocortisone should avoid its use. It is important to consult a healthcare professional for diagnosis and personalized advice, especially if symptoms persist, worsen, or if signs of infection like fever, swelling, or pus develop.
Comprehensive Fissure Care
Managing anal fissures often involves a multifaceted approach beyond hydrocortisone to promote healing and prevent recurrence. Dietary adjustments include increased fiber intake (25-35 grams per day) and adequate hydration to soften stools and prevent constipation. Fiber-rich foods like whole grains, fruits, vegetables, and legumes help achieve this.
Sitz baths, soaking the anal area in warm water for 10-20 minutes several times a day, soothe discomfort, reduce pain, and relax anal muscles. Over-the-counter stool softeners can also be used to ease bowel movements and reduce straining. Avoiding straining during bowel movements is important to prevent further injury to the anal lining. If fissures do not improve with conservative measures within a few weeks, or if symptoms are severe or accompanied by significant bleeding or signs of infection, professional medical evaluation is necessary. Persistent fissures may require different medical interventions or, in some cases, surgical options.