Conservative treatment

Other measures include:

• ensuring the perineum is dried and washed after defaecation:
  • these measures help to prevent/treat pruritus ani
  • the application of talcum powder after cleaning is a simple measure that will keep the perineum dry
  • dabbing the area dry is preferable to wiping as this is less traumatic to the skin
    
    
• digital replacement of prolapsed haemorrhoids:
  • this can lead to symptomatic relief
    
    
• local anaesthetic creams and ointments. These should only be used for a few days in order to prevent anal skin sensitisation. If topical steroids are used to reduce pain and inflammation, local infection must be excluded before use and they should only be used for a week at most since regular use may lead to dermatitis, and skin atrophy or sensitisation.
  
  
• treatment aimed at reducing spasm of the internal anal sphincter:
  • nitroglycerine ointments:
    • glyceryl trinitrate 0.2-0.3% (unlicensed)
  • botulinum toxin injection