1% Hydrocortisone ointment is an effective treatment of pruritus ani : a pilot randomized controlled crossover trial

• Published in: International journal of colorectal disease Vol. 22; no. 12; pp. 1463 - 1467
• Main Authors: AL-GHNANIEM, R, SHORT, K, PULLEN, A, FULLER, L. C, RENNIE, J. A, LEATHER, A. J. M
• Format: Journal Article
• Language: English
• Published: Heidelberg Springer 01.12.2007; Berlin Springer Nature B.V
• Subjects: Administration, Topical; Adult; Allergic diseases; Antipruritics - administration & dosage; Biological and medical sciences; Bones, joints and connective tissue. Antiinflammatory agents; Cross-Over Studies; Double-Blind Method; Female; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Hydrocortisone - administration & dosage; Immunopathology; Male; Medical sciences; Middle Aged; Ointments; Pharmacology. Drug treatments; Pilot Projects; Pruritus Ani - drug therapy; Pruritus Ani - pathology; Quality of Life; Severity of Illness Index; Skin - drug effects; Skin - pathology; Skin allergic diseases. Stinging insect allergies; Surveys and Questionnaires; Treatment Outcome; Human; Steroid; Allergy; Corticosteroid; Immunopathology; Skin disease; Steroid hormone; Antiinflammatory agent; Ointment; Hydrocortisone; Randomized controlled trial; Quality of life; Treatment; Anal itching; Adrenal hormone; Eczema; Gastroenterology; Crossover trial; Pruritus ani; Steroids
• ISSN: 0179-1958; 1432-1262
• DOI: 10.1007/s00384-007-0325-8

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. 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.