Anusol Plus HC

Anusol Plus HC is a pharmacy medicine – you can buy it from a pharmacy without a prescription, but the pharmacist will ask you a few questions to make sure it is right for you. It is designed to give you short-term relief from the pain, itching, swelling and general discomfort of haemorrhoids (piles) – both the kind that appear around your back passage (external piles) and the kind that form just inside it (internal piles). It is also used for pruritus ani – the medical term for persistent anal itching. The medicine comes in two forms: a ointment and a suppository. The ointment is a cream that you apply to the affected area. You can use it for both internal and external piles, and you can also apply it to the skin around your back passage to soothe itching. The suppository is a small, bullet-shaped solid dose that you insert into your back passage. It melts inside your body and is specifically designed to treat internal piles. The ointment and suppositories are both intended for short-term use. A single course of treatment should not exceed seven days.

Anusol Plus HC contains a combination of six active ingredients that work together to tackle the different symptoms of piles. The most important ingredient is hydrocortisone acetate, which belongs to a group of medicines called corticosteroids. Hydrocortisone is a mild steroid. Its job is to reduce inflammation – the redness, swelling, heat and irritation that make your piles so uncomfortable. When you apply it to the swollen tissues of a pile, it calms the overactive immune response in that area, which quickly reduces the swelling and stops the itching. The other five ingredients are not steroids. They work alongside the hydrocortisone to provide additional relief and protection. Zinc oxide, bismuth subgallate and bismuth oxide are astringents – they cause the swollen tissues of the pile to shrink slightly, which reduces swelling. They also form a protective barrier over the raw, irritated skin, which helps to stop further irritation from moisture and friction. Balsam Peru has a mild antiseptic effect, helping to prevent bacterial infection in the raw skin around a pile. It also has a mild local anaesthetic effect, which contributes to the cream's itch-relieving action. It does, however, carry a small risk of allergic reactions in susceptible people. Benzyl benzoate is an emollient, helping the other ingredients to spread smoothly and stay in place on the skin. Together, these ingredients provide a four-way action: reducing inflammation, shrinking swollen tissues, soothing itch and discomfort, and protecting the raw area from infection.

Using the ointment correctly is very important for it to work properly. It is for topical use only – meaning you apply it to the surface of your skin or, using the plastic nozzle, a short way inside your back passage. Here is the correct, step-by-step method: Prepare the area. Gently wash the anal area with a mild, unperfumed soap and lukewarm water. Pat it dry with a soft towel or with cotton wool. Do not rub – the skin in this area is very delicate and can be easily irritated. Wash your hands. Wash your hands thoroughly with soap and water before you handle the tube. Apply the ointment externally. Squeeze a pea-sized amount of ointment onto your fingertip. Gently spread it over the sore or itchy area around your anus. Do not rub it in forcefully – a gentle application is all that is needed. For internal use. If you need to treat internal piles, attach the plastic nozzle supplied with the tube. Gently insert the whole nozzle into your back passage – but no more than about half an inch to one inch. Squeeze the tube gently while slowly withdrawing the nozzle, so the ointment is deposited along the anal canal. Clean the nozzle. After each use, detach the nozzle and wash it thoroughly in warm, soapy water. Rinse it well and let it dry completely before the next use. This stops bacteria from building up on the nozzle and causing a secondary infection. Wash your hands again. After you have finished applying the ointment, wash your hands thoroughly with soap and water to remove any residue. You should apply the ointment at night, in the morning, and also after each bowel movement. Do not use it more than four times in one day.

The suppositories are designed to treat internal piles. They are inserted directly into your back passage, where they melt at body temperature and release the active ingredients. Here is the correct, step-by-step method: Prepare the area. Gently wash the anal area with a mild, unperfumed soap and lukewarm water. Pat it dry with a soft towel or with cotton wool. Wash your hands. Wash your hands thoroughly with soap and water. Unwrap the suppository. Remove one suppository from the plastic wrapper. Try not to handle it for too long – it will start to melt in your warm hands. Moisten the tip (optional). You may moisten the pointed tip of the suppository with a few drops of water. This helps it to slide in more comfortably. Get into the correct position. Lie down on your left side with your right knee bent up towards your chest. This position straightens the anal canal and makes insertion easier and more comfortable. Insert the suppository. Gently push the suppository, pointed end first, into your back passage with your finger. Push it deep enough so that it does not slide back out. Do not push it into the stool – just far enough so it stays in place. Stay lying down. Remain lying down for a few minutes to give the suppository time to melt and the medicine time to start working. Wash your hands again. After you have finished, wash your hands thoroughly with soap and water. Lie down for a few minutes. For the best results, lie down for about 15 minutes after inserting the suppository to allow the medicine to spread evenly through the anal canal. You should insert one suppository at night, in the morning, and also after each bowel movement. Do not use more than three suppositories in one day.

This is one of the most important rules, so please pay close attention. You should use Anusol Plus HC for a maximum of seven consecutive days. This applies to both the ointment and the suppositories. The seven-day limit exists because the product contains a steroid – hydrocortisone. Prolonged or excessive use of any steroid, even a mild one, can cause side effects such as thinning of the skin (steroid atrophy), stretch marks, and visible small blood vessels. If your symptoms have not improved after seven days, or if they come back after you stop using the product, you should stop using it and speak to your doctor or pharmacist. Do not simply start another course on your own. If your symptoms improve within the seven-day period, you should stop using the product as soon as you feel better – you do not need to use the whole course if your symptoms have already settled.

Piles can be a recurring problem. If your symptoms clear up with a course of Anusol Plus HC but then return weeks or months later, a second short course may be appropriate. However, this should be done under the supervision of a doctor or pharmacist – do not simply buy and use more of the product on your own without asking for advice. If you find that you need repeated courses, or that your piles are becoming a chronic issue, your doctor may need to investigate the underlying cause. Common causes include chronic constipation, prolonged sitting on the toilet, heavy lifting, and being significantly overweight. Your doctor may recommend lifestyle changes, dietary adjustments, or in some cases, a different type of treatment.

Most people use Anusol Plus HC without any problems, especially when they stick to the seven-day limit. However, side effects can occur, although they are usually mild and affect only the area where you apply the product. Local irritation. Some people may experience a mild burning or stinging sensation, itching, redness or dryness in the treated area. This is usually temporary and often lessens with continued use. Allergic reactions. Allergic reactions are rare, but they can happen. The most likely cause of an allergic reaction is Balsam Peru, which is known to cause skin sensitisation in susceptible individuals. Signs of an allergic reaction include a spreading red rash, intense itching that is worse than your original symptoms, small blisters, or swelling of the skin in the treated area. If you notice any of these, stop using the product immediately and speak to your doctor or pharmacist. Skin thinning (atrophy). This is a known risk of using steroid-containing products, but it is only likely to happen if you use the product for longer than seven days or if you use it very heavily over a large area. Signs of skin thinning include shiny, fragile skin that tears easily, visible small blood vessels (telangiectasia), or stretch marks (striae). If you notice any of these, stop using the product and speak to your doctor. Systemic side effects (very rare). In very rare cases, enough of the steroid could be absorbed through your skin to affect the rest of your body. This is called systemic absorption, and it can cause symptoms such as unusual tiredness, dizziness when standing up, nausea, and poor recovery from minor illnesses. This is extremely unlikely with the small amounts used in this product, but the risk increases if you use it for longer than seven days, use it on broken or infected skin, or use it over a very large area. Visual disturbances. Topical corticosteroids have been associated, in very rare cases, with visual problems. These include blurred vision, seeing halos around lights, or other changes in your vision. If you experience any change in your vision while using Anusol Plus HC, you should stop using it and contact your doctor immediately. If you experience a severe allergic reaction – such as swelling of your face, lips, tongue or throat, or difficulty breathing – stop using the product immediately and seek emergency medical help.

There are several situations where you should not use Anusol Plus HC, or where you should speak to your doctor before using it. Do NOT use Anusol Plus HC if: You have an infection in the anal area. This includes tubercular, fungal and most viral infections – particularly herpes simplex, chickenpox (varicella), or the infection that can occur after smallpox vaccination (vaccinia). Using a steroid on an infection can make the infection much worse by suppressing your body's natural immune response. You are allergic (hypersensitive) to any of the active ingredients – especially Balsam Peru, which is a known cause of contact dermatitis in some people – or to any of the other ingredients in the product. You are under the age of 18 years. Anusol Plus HC is not recommended for children or adolescents under 18. You are pregnant or breastfeeding. The official guidance states that you should not use Anusol Plus HC during pregnancy or while breastfeeding. There is inadequate evidence of safety in human pregnancy, and animal studies have shown a very small risk of harm to the developing baby. If you are pregnant, planning to become pregnant, or are breastfeeding, you must speak to your doctor or pharmacist before using this product. You have rectal bleeding or blood in your stool without a known cause. Before using Anusol Plus HC, you should talk to your doctor if you have rectal bleeding or blood in your stool. These symptoms can be a sign of a more serious underlying disorder, such as inflammatory bowel disease or, in rare cases, bowel cancer. Do not simply treat yourself with Anusol Plus HC without getting a proper medical assessment first. You are taking other medicines that contain corticosteroids, whether applied to your skin, taken by mouth, or used in other ways. Using multiple steroid-containing products at the same time increases the likelihood of systemic side effects. You are taking medicines that are strong inhibitors of an enzyme called CYP3A4 (such as the HIV medicine cobicistat). These can increase the amount of steroid absorbed into your body.

You can use the ointment and the suppositories together, as part of the same treatment course. Some people find it useful to use the ointment to lubricate the area before inserting the suppository, or to apply the ointment externally while using the suppository internally. However, you should not use Anusol Plus HC at the same time as other corticosteroid-containing products (such as other steroid creams, ointments, inhalers or tablets) unless your doctor has told you to. Using multiple steroid products together increases the risk of systemic side effects. You should also not use Anusol Plus HC alongside other topical treatments applied to the same area unless you have been told to do so by a doctor or pharmacist.

While Anusol Plus HC treats the symptoms of an existing pile, there are lifestyle changes you can make to reduce the chance of them returning. Avoid straining when you go to the toilet. Straining puts pressure on the veins in your anus and can make piles worse. If you find yourself straining, speak to your pharmacist about a gentle laxative to soften your stools. Do not delay going to the toilet when you feel the urge. Holding it in leads to harder stools that are more difficult to pass, which in turn encourages straining. Stay hydrated – drink six to eight glasses of water a day. Dehydration is a common cause of constipation. Eat more fibre – include plenty of fruits, vegetables, beans, and whole grains in your diet to keep your bowel movements regular. Avoid sitting for long periods on the toilet. Sitting on the toilet for a long time increases pressure on the anal area. If you are having difficulty passing a stool, get up and try again later. Take regular exercise. Walking, swimming or other forms of gentle exercise help to keep your bowels regular and reduce the pressure inside your abdomen that contributes to piles. Maintain a healthy weight. Being significantly overweight increases the pressure on the veins in your pelvis and anus, making piles more likely.

Store Anusol Plus HC below 25°C (room temperature) in a dry place, away from direct sunlight and heat. Keep the tube and the suppository strips out of the sight and reach of children. Do not use the product after the expiry date shown on the packaging – the active ingredients become less effective over time. If you have any leftover product at the end of your seven-day treatment course, do not throw it away in household waste or pour it down the sink. Take it to your local pharmacy, where they will dispose of it safely for you.