Indications
Esculin is an ingredient of ointments and suppositories used for piles (haemorrhoids) and anal fissures. These products usually combine Esculin with other ingredients such as a corticosteroid (for example Hydrocortisone), an antibiotic (for example Framycetin) and a local anaesthetic (for example Butyl Aminobenzoate or Lidocaine). Together they relieve pain, itching, swelling and minor bleeding around the anus.
How It Works
Esculin is a natural plant compound (a coumarin glycoside, originally from horse chestnut) that is thought to strengthen small blood vessels and reduce their leakiness, which may help reduce swelling and bleeding of piles. The other ingredients in the product reduce inflammation, prevent infection and numb pain.
Dosage and Administration
Use as directed on the label or by your doctor. Ointment is usually applied in the morning, at night and after each bowel movement, using the applicator for internal piles. Suppositories are usually inserted in the same pattern. Wash your hands before and after use. Products containing a steroid are usually used for no more than 7 days unless your doctor advises otherwise.
Interactions
Interactions are unlikely with short-term use on the skin. Avoid using other anal or rectal products at the same time unless your doctor advises it.
Contraindications
Do not use if you are allergic to any ingredient. Products containing a steroid should not be used on viral (herpes), fungal or tuberculous infections of the area, and products with an antibiotic should not be used if you are allergic to that antibiotic.
Side Effects
Mild burning, stinging or irritation may occur when first applied. Allergic skin reactions are uncommon. Long-term use of steroid-containing products can thin the skin.
Get urgent medical help if you have heavy bleeding from the back passage, black or tarry stools, severe pain, fever, or signs of a serious allergic reaction such as swelling of the face or difficulty breathing.
Pregnancy and Lactation
Piles are common in pregnancy. Short-term use of these products is generally considered low risk, but ask your doctor before use in pregnancy or while breastfeeding, as the product contains other ingredients such as a steroid.
Precautions and Warnings
See a doctor if symptoms do not improve within 7 days, or if you have rectal bleeding for the first time, a change in bowel habits or weight loss, as these need checking for other causes. Eat a fibre-rich diet and drink plenty of water to avoid straining. Not for use in children unless prescribed.
Overdose
Overdose is unlikely with use on the skin. If a product is swallowed, contact a doctor or poison centre.
Therapeutic Class
Anti-haemorrhoidal preparation (vasoprotective agent).
Storage
Store below 30°C in a dry place, away from light and out of the reach of children. Suppositories may need to be kept cool to stop them softening; follow the label.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.