How does Proctofoam-Hc work? Learn how its two ingredients fight inflammation and numb pain, how fast it works, and what makes it different from other treatments.
If you've been prescribed Proctofoam-Hc for hemorrhoids, anal fissures, or another anorectal condition, you might be wondering what it actually does inside your body. How does a foam reduce swelling? Why does it stop the itch? And how is it different from the Preparation H you can buy at the drugstore?
This guide explains the mechanism of action of Proctofoam-Hc in plain, everyday language.
Proctofoam-Hc contains two active ingredients, each with a different job:
Hydrocortisone is a synthetic version of cortisol, a hormone your body naturally produces to manage inflammation. When you apply Hydrocortisone to an inflamed area, it does several things:
Think of it like a fire extinguisher for inflammation. Your body's immune response is the fire — sometimes it overreacts, causing more swelling and discomfort than the original problem warrants. Hydrocortisone dials that response down.
Pramoxine is a local anesthetic — it numbs the area where it's applied. It works by blocking the nerve signals that carry pain and itch sensations from the skin to your brain.
Here's a simple way to think about it: your nerves are like telephone wires carrying "pain" and "itch" messages. Pramoxine essentially cuts the line, so those messages don't get through. The inflammation may still be there, but you stop feeling it while the Hydrocortisone does its work.
Unlike some anesthetics (like Lidocaine or Benzocaine), Pramoxine is less likely to cause allergic reactions or sensitivity, which is one reason it's commonly used in anorectal products.
Proctofoam-Hc is delivered as an aerosol foam, which has some practical advantages over creams, ointments, or suppositories:
Most people notice some relief within minutes of application, thanks to the Pramoxine anesthetic component. The numbing effect typically kicks in within 3 to 5 minutes.
The anti-inflammatory effects of Hydrocortisone take longer. You may start to notice reduced swelling and less persistent itching within a few days of regular use. Full benefit usually occurs within 1 to 2 weeks of consistent application (3 to 4 times daily as prescribed).
If you don't see improvement after 2 to 3 weeks, your doctor may want to re-evaluate your condition. For more on what to watch for, see our guide on Proctofoam-Hc side effects.
The numbing effect of Pramoxine typically lasts 1 to 2 hours per application. The anti-inflammatory effect of Hydrocortisone is cumulative — it builds up with regular use rather than wearing off between doses.
This is why the standard dosing is 3 to 4 times daily: it maintains the numbing effect throughout the day while the Hydrocortisone continuously works on the underlying inflammation. For full dosing instructions, see our article on Proctofoam-Hc uses and dosage.
There are several other medications used to treat hemorrhoids and anorectal conditions. Here's how Proctofoam-Hc compares:
Preparation H Hydrocortisone is available over the counter and contains a lower concentration of Hydrocortisone. It does not contain Pramoxine. Proctofoam-Hc offers stronger anti-inflammatory action plus the added numbing benefit, but it requires a prescription.
Analpram HC contains the exact same active ingredients — Hydrocortisone Acetate and Pramoxine Hydrochloride — but in cream form rather than foam. The cream is more widely available and has affordable generic versions (starting around $41). The foam may offer better internal coverage, but for many patients, the cream works just as well. See our alternatives guide for more options.
Hydrocortisone rectal suppositories deliver the corticosteroid internally but without the anesthetic component. They're widely available as generics and can be effective for internal hemorrhoids, but they don't provide the immediate numbing that Pramoxine offers.
Rectiv works through a completely different mechanism — it relaxes the smooth muscle around the anus and increases blood flow, which helps heal anal fissures. It doesn't reduce inflammation or numb pain the way Proctofoam-Hc does. Rectiv is typically used specifically for chronic anal fissures rather than hemorrhoids.
Proctofoam-Hc uses a two-pronged approach: Hydrocortisone calms the inflammation while Pramoxine numbs the pain and itch. The foam delivery system helps both ingredients reach the affected area effectively, whether you're treating internal or external symptoms.
If you've been prescribed Proctofoam-Hc, you should feel some relief within minutes of your first application, with the full anti-inflammatory benefits building over the first 1 to 2 weeks. Just be sure to use it as directed and watch for interactions with other medications.
Need help finding Proctofoam-Hc at a pharmacy near you? Use Medfinder to check availability.
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