Proctofoam HC
Proctofoam HC (hydrocortisone / pramoxine) rectal foam is used to treat itching and inflammation in and around the anus. It contains hydrocortisone (a corticosteroid) and pramoxine (a pain reliever). This medication is applied to the affected area with an applicator, typically 3 to 4 times daily. Side effects aren't common by can include temporary burning and itching.
What is Proctofoam HC (hydrocortisone / pramoxine)?
What is Proctofoam HC (hydrocortisone / pramoxine) used for?
Swelling, itching, and irritation of the skin around the anal area
How Proctofoam HC (hydrocortisone / pramoxine) works
Proctofoam HC (hydrocortisone / pramoxine) is a combination of two medications:
Hydrocortisone is a topical corticosteroid. It works by lowering the amount of inflammatory chemicals that cause redness, itching, and swelling. This helps to lower skin inflammation.
Pramoxine is a local anesthetic. It stops nerve endings from sending pain signals in parts of the skin that have pain or discomfort.
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What are the side effects of Proctofoam HC (hydrocortisone / pramoxine)?
Common Side Effects
- Burning
- Itching
- Skin irritation
- Dry skin
Other Side Effects
- Acne-like bumps
- Skin discoloration
- Rash or heat rash
- Thinning skin
- Stretch marks
- Pruning or wrinkling of the skin
- Hair growth
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Cushing syndrome—increased fat around the midsection, upper back, neck, or face, pink or purple stretch marks on the skin, thinning, fragile skin that easily bruises, unexpected hair growth
- High blood sugar (hyperglycemia)—increased thirst or amount of urine, unusual weakness or fatigue, blurry vision
- Low adrenal gland function—nausea, vomiting, loss of appetite, unusual weakness or fatigue, dizziness
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
- Change in skin color
- Fragile or thinning skin that bruises easily
- Mild skin irritation, redness, or dryness
- Small, red, pus-filled bumps on skin around hair follicles
- Unexpected hair growth at application site
Pros and cons of Proctofoam HC (hydrocortisone / pramoxine)
Pros
Combines two medications into one topical product for convenience
Works directly in the area to relieve symptoms of anal discomfort
Fewer side effects than oral steroids
Cons
Need to use multiple times a day
Might raise your risk of fungal or bacterial infection
Short-term use only, otherwise it might cause skin thinning
Pharmacist tips for Proctofoam HC (hydrocortisone / pramoxine)
Wash your hands before and after using Proctofoam HC (hydrocortisone / pramoxine) to help prevent getting the medication in your eyes. If it does get into your eyes, wash your eyes with water or saline and contact your provider if irritation doesn't go away.
Use the smallest amount of Proctofoam HC (hydrocortisone / pramoxine) needed to cover the affect area. Using too much medication, especially over a longer period of time, can cause your body to absorb too much medication. This can raise your risk of side effects, like skin thinning.
Proctofoam HC (hydrocortisone / pramoxine) should only be used on skin around the anal area. You shouldn’t use it on wounds or damaged skin. To avoid side effects, don't use this medication in your eyes, nose, or ears.
Proctofoam HC (hydrocortisone / pramoxine) comes in a can which is highly flammable. Avoid open fire, heat, or smoke during and immediately after applying this medication.
More tips on how to use Proctofoam HC (hydrocortisone / pramoxine):
Shake the Proctofoam HC container with the cap on for 5-10 seconds before use.
If you're using a new container of Proctofoam HC, you need to prime the container by pressing down on the flanges 1-2 times first.
To apply Proctofoam HC inside of the rectum, first attach the perineal applicator to the container. To apply this medication on the skin around the rectum, spray the foam onto a tissue and rub it in gently.
To fill up the applicator, press down firmly on the flanges of the Proctofoam HC container cap and hold for 2 seconds. The foam will slowly expand into the applicator. Repeat this step until foam reaches fill line in the applicator, which can take 3 to 4 pumps.
While lying on your left side with bended knees, insert the perineal applicator and plush the plunger to release the Proctofoam HC foam into the rectum for a couple of seconds. Take out the applicator and clean it thoroughly once you're done. Make sure to rinse the container cap as well since foam can build up and block the opening.
Frequently asked questions about Proctofoam HC (hydrocortisone / pramoxine)
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What are the risks and warnings for Proctofoam HC (hydrocortisone / pramoxine)?
Proctofoam HC (hydrocortisone / pramoxine) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk of fire
Risk factors: Being near open fire or heat during or after applying Proctofoam HC (hydrocortisone / pramoxine) | Smoking during or after applying Proctofoam HC (hydrocortisone / pramoxine) | Holes or damage to the can
Because of the propellant in Proctofoam HC (hydrocortisone / pramoxine), this product can easily catch on fire. Make sure to handle this medication carefully during and after application. Don't store the can in extreme heat or temperatures above 120°F. Proctofoam HC (hydrocortisone / pramoxine) is under pressure, so avoid damaging the can by puncturing holes or leaving it by open flame.
Risk of hormone-related side effects
Risk factors: Using Proctofoam HC (hydrocortisone / pramoxine) for a long period of time | Using more Proctofoam HC (hydrocortisone / pramoxine) than recommended | Covering applied area with a bandage | Young children
Using topical steroids, especially high-potency steroids, for longer than recommended and over a large skin area can cause a medical condition called adrenal suppression. This is when your body stops making its own steroid hormones because of the presence of the steroid medication. And if you stop the medication suddenly, it can lead to symptoms of withdrawal include skin swelling, rash, and burning.
This side effect is unlikely to happen with Proctofoam HC (hydrocortisone / pramoxine) because hydrocortisone is a very low-potency steroid. But to be safe, your healthcare team will prescribe the lowest amount of Proctofoam HC (hydrocortisone / pramoxine) for the shortest period of time needed to treat your condition. If you need to use this medication for a longer period of time or over a larger skin area, your care team might ask you to do some lab work to test how well your adrenal gland works. Don't stop using Proctofoam HC (hydrocortisone / pramoxine) suddenly without talking to your healthcare team first.
Skin problems
Risk factors: Excessive and inappropriate use of Proctofoam HC (hydrocortisone / pramoxine) | Using a lot of Proctofoam HC (hydrocortisone / pramoxine)
Using Proctofoam HC (hydrocortisone / pramoxine) longer than directed by your healthcare team can raise your risk skin-related side effects, including skin thinning or easy bruising. To prevent severe skin reactions from happening, your care team will prescribe the lowest possible dose of Proctofoam HC (hydrocortisone / pramoxine) to treat your symptoms for the shortest amount of time. Let your healthcare team know right away if you notice any new or worsening skin problems.
New or worsened skin infection
Risk factors: Using Proctofoam HC (hydrocortisone / pramoxine) for a long period of time
Using Proctofoam HC (hydrocortisone / pramoxine) long term can raise the risk of fungal or bacterial infections. Don't use Proctofoam HC (hydrocortisone / pramoxine) if you have a skin infection because it can make your infection worse. Let your healthcare team know if you have redness, swelling, pain, pus, or if your current symptoms don't improve after 2 to 3 weeks of treatment. These can be signs and symptoms of a new infection.
Proctofoam HC (hydrocortisone / pramoxine) dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 10g of 1%/1% | 1 can | $185.91 | $185.91 |
Typical dosing for Proctofoam HC (hydrocortisone / pramoxine)
Proctofoam HC foam contains hydrocortisone 1% and pramoxine 1%.
This medication is typically applied to the affected area(s) 3 to 4 times daily. Use the applicator supplied by the manufacturer to insert the foam rectally. If you're applying it to skin around the anus, use a tissue to transfer some of the foam to the affected area and rub in gently.
How much does Proctofoam HC (hydrocortisone / pramoxine) cost?
What are alternatives to Proctofoam HC (hydrocortisone / pramoxine)?
Swelling, itching, and irritation of the skin around the anal area
Anal itching - cream
Hemorrhoids - suppository
Proctitis (swelling and redness inside the rectum) - suppository
Chronic ulcerative colitis, as an add-on treatment - suppository
Cryptitis (swelling and redness in the in the guts) - suppository
What is the latest news about Proctofoam HC (hydrocortisone / pramoxine)?
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References
Best studies we foundAmerican College of Obstetricians and Gynecologists. (2020). What can I do for hemorrhoids during pregnancy?
Ebrahimi, N., et al. (2011). The fetal safety of hydrocortisone-pramoxine (Proctofoam-HC) for the treatment of hemorrhoids in late pregnancy. Journal of Obstetrics and Gynaecology Canada.
Lam, L. H., et al. (2016). Adrenal suppression with chronic topical corticosteroid use in psoriasis patients. Journal of Drugs in Dermatology.
Meda Pharmaceuticals Inc. (2025). Proctofoam HC- pramoxine hydrochloride hydrocortisone acetate aerosol, foam [package insert]. DailyMed.
MedlinePlus. (2017). Pramoxine.
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