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

Abstract

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.

• Authors: R Al-Ghnaniem, K Short, A Pullen, L C Fuller, J A Rennie, A J M Leather
• Journal: International journal of colorectal disease (Int J Colorectal Dis) Vol. 22 Issue 12 Pg. 1463 (Dec 2007) ISSN: 0179-1958 [Print] Germany
• PMID: 17534634 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Antipruritics
• Ointments
• Hydrocortisone

Topics

• Administration, Topical
• Adult
• Antipruritics (administration & dosage)
• Cross-Over Studies
• Double-Blind Method
• Female
• Humans
• Hydrocortisone (administration & dosage)
• Male
• Middle Aged
• Ointments
• Pilot Projects
• Pruritus Ani (drug therapy, pathology)
• Quality of Life
• Severity of Illness Index
• Skin (drug effects, pathology)
• Surveys and Questionnaires
• Treatment Outcome