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

Author(s): Al-Ghnaniem R, Short K, Pullen A, Fuller LC, Rennie JA, Leather AJ

Affiliation(s): Department of Surgery, King's College Hospital, Denmark Hill, London, SE5 9RS, UK, reyad@doctors.org.uk.

Publication date & source: 2007-12, Int J Colorectal Dis., 22(12):1463-1467. Epub 2007 May 30.

BACKGROUND: 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. RESULTS: 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). CONCLUSION: A short course of mild steroid ointment is an effective treatment for PA.