Anusol is an over-the-counter treatment used to relieve the discomfort of hemorrhoids (piles), anal itching, anal fissures, and minor inflammation around the back passage. It comes in several forms, including creams, ointments, and suppositories, and works by soothing irritated tissue, reducing swelling, and protecting raw skin while it heals.
Conditions Anusol Treats
Anusol is designed for symptomatic relief of several common anal and rectal problems. Its primary use is for internal and external hemorrhoids, the swollen blood vessels around the anus that cause pain, itching, and sometimes bleeding. It also treats anal fissures (small tears in the lining of the anus), pruritus ani (persistent itchy bottom), and proctitis (inflammation of the rectal lining).
It’s also sometimes used after surgical procedures in the anal area, including after removal of thrombosed hemorrhoids. In these cases, it helps protect healing tissue and reduces friction during bowel movements.
How the Ingredients Work
Standard Anusol contains three active ingredients, each doing a slightly different job. Zinc oxide acts as an astringent, meaning it tightens and dries inflamed tissue. It also absorbs excess moisture, reduces friction against sore skin, and has mild antibacterial properties. Bismuth oxide forms a protective coating over raw or irritated surfaces, shielding them from further damage. Balsam Peru, a plant-derived resin, has a mild antiseptic effect and is thought to promote the growth of new skin cells, helping damaged tissue repair itself faster.
Together, these ingredients soothe the burning and itching of hemorrhoids, protect the area during bowel movements, and create conditions that support healing. They don’t shrink hemorrhoids permanently or treat the underlying cause, but they make flare-ups much more manageable.
Standard Anusol vs. Anusol HC
There are two main versions of Anusol. The standard version relies on zinc oxide, bismuth oxide, and balsam Peru. It’s available without a prescription and is suitable for mild symptoms.
Anusol HC adds hydrocortisone, a mild steroid that actively reduces inflammation and itching. The prescription-strength version contains 2.5% hydrocortisone. This version is more effective for flare-ups with significant swelling or intense itching, because the steroid calms the immune response in the tissue rather than just coating and protecting it. Hydrocortisone versions are typically applied two to four times daily depending on severity.
The key difference in practice: standard Anusol is a protective, soothing treatment you can use more freely, while Anusol HC is a stronger anti-inflammatory with a strict time limit on use.
Cream, Ointment, or Suppository
Creams are lighter and absorb into the skin more quickly, making them a good choice for external hemorrhoids and itching around the outside of the anus. Ointments are thicker and greasier, providing a longer-lasting protective barrier. They work well when you need sustained coverage, such as before a bowel movement.
Suppositories are solid capsules inserted into the rectum. They’re designed for internal hemorrhoids, where creams and ointments can’t easily reach. Some people use the cream alongside a suppository to address both internal and external symptoms at the same time.
How Long You Can Use It
For versions containing hydrocortisone, the NHS recommends using the treatment for no more than 7 consecutive days. Prolonged use of topical steroids, even mild ones, can thin the skin in the treated area and make it more vulnerable to damage. If your symptoms haven’t improved after a week, or if they return quickly after stopping treatment, that’s a sign you need a medical evaluation rather than another round of the same product.
Standard Anusol without hydrocortisone can generally be used for longer periods, but persistent symptoms lasting more than a few weeks still warrant a checkup. Ongoing rectal bleeding, pain, or itching can sometimes point to conditions other than hemorrhoids that need different treatment.
Possible Side Effects
Standard Anusol rarely causes problems, though some people experience mild irritation or an allergic reaction to balsam Peru. The hydrocortisone versions carry a slightly longer list of potential side effects, including burning, itching (paradoxically), dryness, skin lightening at the application site, and allergic contact dermatitis. Secondary infection is possible if the steroid suppresses the local immune response for too long, which is another reason for the 7-day limit.
Anyone with a known allergy to any of the ingredients should avoid the product entirely.
Use During Pregnancy and Breastfeeding
Hemorrhoids are extremely common during pregnancy, particularly in the third trimester and after delivery. Hydrocortisone-based treatments for piles can be used while breastfeeding. The amount that passes into breast milk is likely very small, and a baby would absorb little of it. Washing your hands after applying the treatment and before handling your baby is a sensible precaution.
There is no evidence that hydrocortisone treatments for hemorrhoids affect fertility in men or women. For use during pregnancy itself, checking with a pharmacist or midwife is worthwhile, as recommendations can depend on the specific formulation and the stage of pregnancy.