Hydrocortisone (Topical): Uses, How It Works, and Safety Information

Overview

Hydrocortisone is a mild corticosteroid available over-the-counter in topical formulations for treating hemorrhoid symptoms. It works by reducing inflammation, itching, and swelling in the affected area.

Topical hydrocortisone for hemorrhoids is typically available as creams, ointments, and suppositories in concentrations of 0.5% to 1% without a prescription.

How It Works

Hydrocortisone belongs to a class of medications called corticosteroids. When applied topically, it:

Reduces inflammation by suppressing the release of inflammatory chemicals in the affected tissue
Decreases itching by reducing the immune response that causes irritation
Minimizes swelling by constricting blood vessels in the area

Unlike some hemorrhoid treatments that only provide surface-level relief, hydrocortisone addresses the underlying inflammatory process that causes discomfort.

Common Uses

Topical hydrocortisone for hemorrhoids is used to treat:

External hemorrhoids — swollen veins outside the anal opening
Internal hemorrhoids (with suppositories) — swollen veins inside the rectum
Perianal itching — itching around the anal area (pruritus ani)
Post-hemorrhoid procedure discomfort — irritation following hemorrhoid treatments

When to See a Doctor

Seek medical attention if you experience:

Bleeding that doesn’t stop or is heavy
Severe pain not relieved by over-the-counter treatments
Symptoms lasting more than 7 days of treatment
A lump that is hard, painful, or growing
Changes in bowel habits along with hemorrhoid symptoms
Symptoms that return frequently

Rectal bleeding can have causes other than hemorrhoids, so new bleeding should be evaluated by a healthcare provider, especially for people over 50 or with a family history of colorectal cancer.

Important Considerations

Short-term use only — Topical hydrocortisone should not be used for more than 7 consecutive days without medical supervision, as prolonged use can thin the skin
External use — Creams and ointments are for external use only unless directed otherwise
Not for infections — Hydrocortisone should not be used if there are signs of infection (increased redness, warmth, pus)
Pregnancy and breastfeeding — Consult a healthcare provider before use

Sources

FDA Drug Label Information
American Society of Colon and Rectal Surgeons — Hemorrhoids Clinical Practice Guidelines
UpToDate — Hemorrhoids: Treatment
MedlinePlus — Hydrocortisone Topical