Corticosteroids and local anesthetics

About 60 percent of all topical proctological preparations contain corticosteroids, which bring rapid and sustained relief of symptoms when combined with local anesthetics.
Creams, ointments and suppositories containing corticosteroids display anti-inflammatory and analgesic effects at the site of application. Upon local application, they alleviate pain, itching and burning, and lead to the reduction of swelling and inflammation in the region being treated. Since they exert their effect by inducing certain changes in the cells affected, relief of symptoms may be delayed. Adding an anesthetic ameliorates pain and itching almost immediately and allows time for the anti-inflammatory action of the corticosteroid to take effect.

Fixed combinations of corticosteroids and anesthetics are effective not only in treating piles, but also for relieving symptoms before and after hemorrhoid surgery. Your doctor may also prescribe them for other indication i.e. proctitis, anal fissures or anal eczemas.

In general, use of a topical preparation reduces the potential for systemic side effects because the required dose exerts its effect only on a circumscribed area of the body. The safety profiles of topical corticosteroids have been demonstrated in a number of clinical studies and in routine clinical practice for many decades. However, when used not only in acute phases, but also over very long periods, they may cause the skin to become thinner. You should therefore follow the treatment regime recommended by your doctor and talk to him if you feel that you may need long-term treatment.

Symptoms Topical corticosteroids + anesthetics Topical anesthetics alone
Pain + +
Burning + +
Itching + +
Swelling + -
Inflammation + -
Onset of action Immediately Immediately
Number of applications for relief of symptom Once per day Several times per day