Yes, standard Anusol products are available over the counter in most countries. The key distinction is between the regular Anusol line, which you can buy without a prescription, and Anusol-HC, which contains a steroid called hydrocortisone and may require a prescription depending on the strength and where you live.
What You Can Buy Without a Prescription
Standard Anusol comes in ointments, creams, and suppositories that contain a combination of zinc oxide, bismuth oxide, and balsam of Peru. None of these ingredients are steroids, and none are restricted. You can pick them up at a pharmacy, drugstore, or grocery store without speaking to a doctor first.
These ingredients work by forming a protective barrier over irritated skin. Zinc oxide acts as an astringent, meaning it tightens tissue and helps reduce swelling, while also absorbing moisture and limiting bacterial growth. Bismuth oxide provides similar protective and mild antiseptic effects on raw or inflamed surfaces. Balsam of Peru, a plant-based resin, has a gentle antiseptic quality and is thought to encourage skin healing. Together, they’re designed to relieve the itching, soreness, and discomfort of hemorrhoids and other minor anal irritation.
When You Need a Prescription
Anusol-HC is a different product. It contains hydrocortisone, a corticosteroid that reduces inflammation more aggressively than the standard formula. In the United States, Anusol-HC cream at 2.5% hydrocortisone is classified as a prescription-only drug. The Anusol-HC suppository, which contains 25 mg of hydrocortisone acetate per suppository, is also prescription-only in the U.S.
In the UK, lower-strength hydrocortisone products for hemorrhoids can sometimes be purchased from a pharmacist after a consultation, but higher-strength versions still require a prescription. The rules vary by country, so if you specifically need the hydrocortisone version, check with your local pharmacy.
The general rule is simple: if the product name includes “HC,” it contains hydrocortisone and is more likely to need a prescription. If it’s just labeled “Anusol,” it’s the standard formula and is sold over the counter.
How to Use Standard Anusol
For the OTC ointment or cream, you typically apply a small amount to the affected area several times a day, especially after bowel movements. Suppositories are inserted morning and night, or as directed on the packaging. Most people notice relief from itching and discomfort within the first few applications, though the underlying hemorrhoid takes longer to shrink.
If you’re using a hydrocortisone version that was prescribed, the typical regimen for suppositories is one in the morning and one at night for about two weeks. More severe cases may call for three times daily. Your doctor will set the duration, but steroid-containing products are generally not meant for long-term use because prolonged steroid exposure can thin the skin in the treated area.
Safety During Pregnancy and Breastfeeding
The standard OTC Anusol products are generally considered safe during pregnancy, which is relevant because hemorrhoids are extremely common in the third trimester and after delivery. Even the hydrocortisone versions are considered low-risk during pregnancy and breastfeeding, according to NHS guidance. Only a small amount enters the bloodstream, not enough to affect a baby. If you’re breastfeeding and using the hydrocortisone version, washing your hands before handling your baby is a sensible precaution.
When OTC Treatment Isn’t Enough
OTC Anusol is designed for mild to moderate hemorrhoid symptoms: itching, minor swelling, and general discomfort. It won’t fix a large prolapsed hemorrhoid or stop significant bleeding. If your symptoms haven’t improved after a week of consistent use, that’s a signal to see a doctor rather than just continuing to apply the product.
Rectal bleeding deserves particular attention. While small amounts of bright red blood on toilet paper are common with hemorrhoids, you should not assume that all rectal bleeding comes from hemorrhoids. Changes in bowel habits, dark or unusually colored stools, or bleeding that doesn’t stop should be evaluated by a healthcare provider, since these can overlap with more serious conditions including colorectal cancer. Large amounts of rectal bleeding accompanied by dizziness or faintness is a reason to seek emergency care.