Anusol HC Side Effects: What to Expect and When to Call Your Doctor

Anusol HC (hydrocortisone acetate) is generally well-tolerated when used as directed for short treatment courses. Most side effects are mild and local. However, because it contains a corticosteroid, there are some important systemic risks to be aware of — especially with prolonged use. Here's everything you need to know about Anusol HC side effects.

Common Side Effects (Usually Mild)

The most common side effects of Anusol HC are local and typically improve as your body adjusts to the medication. Let your doctor know if these persist or worsen:

• Burning or stinging at the application site — especially during the first few uses.
• Itching at the application site — can temporarily feel worse before it gets better.
• Skin irritation — redness or mild discomfort around the area.
• Dryness of the local skin.
• Folliculitis — inflammation of hair follicles near the application area.
• Skin lightening (hypopigmentation) — can occur with prolonged topical corticosteroid use; usually reversible.
• Fabric staining — the suppository base may stain clothing. Use protective padding.

Serious Side Effects (Less Common but Important)

These side effects are less likely but require prompt attention. Contact your doctor right away if you experience any of the following:

• Severe rectal pain or worsening bleeding: Significant increase in rectal pain or new or worsening rectal bleeding while using Anusol HC should be reported immediately.
• Signs of HPA axis suppression (rare with proper use): Unusual fatigue, muscle weakness, unexplained weight loss, or fainting — especially if stopping the medication abruptly after prolonged use.
• Signs of Cushing's syndrome (rare with short courses): Unexplained weight gain in the face or upper back, slow wound healing, stretch marks, or high blood sugar symptoms. More likely with extended or heavy use.
• High blood sugar: Confusion, increased thirst, frequent urination, or fruity-smelling breath. Patients with diabetes should monitor blood glucose levels while using corticosteroid products.
• Skin thinning or atrophy: Prolonged use of topical corticosteroids can cause thinning of the skin in the application area. Do not use longer than directed.
• Signs of infection worsening: Corticosteroids can mask infection symptoms. If you develop fever, pus, or significant new pain, your doctor needs to know.
• Allergic reactions (rare): Rash, hives, severe itching, facial swelling, or difficulty breathing. Seek emergency care immediately.

Special Populations: Additional Risks to Know

Children and teens:

Anusol HC may temporarily slow growth in children with extended use. Children may be more sensitive to systemic absorption. Use only under physician supervision in pediatric patients, with regular growth monitoring.

Pregnancy:

Animal studies have shown fetal abnormalities with corticosteroid exposure at low doses. Anusol HC should only be used in pregnancy when the potential benefit outweighs the risk. Avoid extensive use, large amounts, or prolonged treatment during pregnancy. Discuss with your OB/GYN.

Breastfeeding:

It is not known if hydrocortisone acetate passes into breast milk. The risk from rectal application is considered low due to limited absorption, but discuss with your doctor before breastfeeding while using this medication.

Older adults:

Older patients may be more sensitive to corticosteroid side effects, including bone loss (osteoporosis risk with systemic exposure), stomach/intestinal concerns, and mental/mood changes. Shorter courses and lower amounts are preferable.

How to Reduce Your Risk of Side Effects

• Use Anusol HC for the shortest duration that controls your condition.
• Don't use more than prescribed — more isn't better with corticosteroids.
• Tell your doctor about all other medications and health conditions before starting.
• Attend follow-up appointments — lab tests may be needed to monitor adrenal gland function with extended use.
• Don't handle the suppository excessively before insertion — warmth from your hands can cause it to soften prematurely.

For information about drug interactions with Anusol HC, see: Anusol HC Drug Interactions: What to Avoid. For a full medication overview, see: What Is Anusol HC? Uses, Dosage, and What You Need to Know in 2026.