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

Last reviewed: March 2026

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 and ointments in a 1% concentration without a prescription. Suppositories containing hydrocortisone are generally prescription-only products; OTC anorectal hydrocortisone products are formulated for external use only.

How It Works

Hydrocortisone belongs to a class of medications called corticosteroids. When applied topically, it activates natural substances in the skin to reduce swelling, redness, and itching. Specifically, it:

  • Reduces inflammation by suppressing the release of inflammatory chemicals in the affected tissue
  • Decreases itching by reducing the local immune response that causes irritation
  • Minimizes swelling through its anti-inflammatory action on the affected tissue

Common Uses

Topical hydrocortisone for hemorrhoids is used to treat:

  • External hemorrhoids — swollen veins outside the anal opening
  • Internal hemorrhoids — OTC hydrocortisone cream should not be inserted into the rectum; prescription formulations are used for internal symptoms under medical supervision
  • 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 only — OTC hydrocortisone creams and ointments are for external use only; do not insert into the rectum
  • 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

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