1.7.1 Soothing haemorrhoidal preparations
|Encourage self-care with OTC products as appropriate||Encourage self-care with OTC products as appropriate||Encourage self-care with OTC products as appropriate|
|1st choice||Anusol® cream, ointment or suppositories|
|2nd choice||Xyloproct® ointment (contains lidocaine 5%)|
- Topical haemorrhoidal products are widely used despite lacking evidence. There are some reported benefits to their use and the general opinion is that they may provide short-term symptomatic relief.
- Local anaesthetic ointments can be absorbed through the rectal mucosa therefore excessive application should be avoided.
- Preparations containing local anaesthetics should be used for short periods only (no longer than a few days) since they may cause sensitisation of the anal skin.
- Patients with pruritus ani (itching around the anal canal)/excoriation should avoid applying creams and ointments where possible as this often causes additional irritation. They should be advised to reduce their caffeine intake, clean with water and avoid soaps/wipes/baby wipes and excessive rubbing with toilet paper. If this fails they can be prescribed Perinal® spray (hydrocortisone with lidocaine) on a when required basis.