1% Hydrocortisone ointment is an effective treatment of pruritus ani: a pilot randomized controlled crossover trial
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Pruritus ani (PA) is a common condition which is difficult to treat in the absence of obvious predisposing factors. There is paucity of evidence-based guidelines on the treatment of this condition. We examined whether 1% hydrocortisone ointment is an effective treatment for PA.
Materials and methods
A pilot randomized, double-blind, placebo-controlled, crossover trial was carried out. Eleven patients consented to take part in the trial and ten completed the study. After a 2-week run-in period, patients with primary PA were randomly allocated to receive 1% hydrocortisone ointment or placebo for 2 weeks followed by the opposite treatment for a further 2-week period. There was a washout period of 2 weeks between treatments. The primary outcome measure was reduction in itch using a visual analogue score (VAS). The secondary outcome measures were improvement in quality of life measured using a validated questionnaire (Dermatology Life Quality Index, DLQI) and improvement in clinical appearance of the perianal skin using the Eczema Area and Severity Index (EASI) score.
Treatment with 1% hydrocortisone ointment resulted in a 68% reduction in VAS compared with placebo (P = 0.019), a 75% reduction in DLQI score (P = 0.067), and 81% reduction in EASI score (P = 0.01).
A short course of mild steroid ointment is an effective treatment for PA.
KeywordsPruritus ani Steroids Hydrocortisone Crossover trial Randomized controlled trial
This study was approved by the King’s College Hospital Ethics Committee. All costs of running the trial were paid for using departmental research funds. The authors have no conflict of interest to declare.
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