A topical local anaesthetic for itch and pain (also called pramoxine)
Pramocaine
An over-the-counter local anaesthetic applied to the skin to numb itching and soreness, found in haemorrhoid and bite products.
What is Pramocaine?
Pramocaine, also called pramoxine in the United States, is a local anaesthetic applied to the skin to numb itching and soreness. It is found in products for haemorrhoids (piles), such as Anusol Plus, and in some creams for insect bites, stings and minor skin irritation. It works by temporarily blocking the nerve signals in the skin that carry the feeling of itch and pain, so the area feels more comfortable. A thin layer is applied to the affected area as directed for short-term relief. It is for external, short-term use, and you should stop using it and seek advice if it causes irritation or if symptoms do not improve.
Education and reference only. This is a plain-language guide to Pramocaine — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Pramocaine is a local anaesthetic used on the skin and around the back passage to relieve itching, soreness and discomfort. It is included in a range of over-the-counter products, particularly creams and ointments for haemorrhoids, and in some treatments for insect bites, stings and minor skin irritation. In the United States the same ingredient is called pramoxine. It is available without a prescription and is chosen for its ability to numb an uncomfortable area quickly, giving short-term relief while the underlying problem settles or is treated.
How it works
Pramocaine works as a local anaesthetic by temporarily blocking the tiny nerve endings in the skin that send signals of itch and pain to the brain. When it is applied to an itchy or sore area, it dampens these signals so the area feels numbed and more comfortable. The effect is local and lasts for a limited time, which is why it is reapplied as directed for ongoing relief. It does not treat the cause of the itching or soreness, such as the inflammation of haemorrhoids or a reaction to a bite, but it makes the symptoms easier to cope with while the problem improves.
Company & origin
Originated / developed by: Various (widely available).
A topical local anaesthetic used in UK products for itching and soreness, including haemorrhoid creams and bite and sting treatments. It is known in the United States as pramoxine.
Practical use
How to take Pramocaine
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Apply a thin layer to the affected area as directed on the pack, for short-term relief of itch or soreness.
- Wash and dry the area gently before applying, and wash your hands afterwards.
- Use it for a limited period rather than continuously over long stretches.
- Stop using it if the area becomes more red, sore or itchy after applying it.
- See a pharmacist or GP if symptoms are severe or do not improve within a few days.
Weighing it up
Advantages & disadvantages of Pramocaine
Advantages
- Numbs itching and soreness quickly for short-term relief.
- Available in convenient creams and ointments, including haemorrhoid and bite products.
- Acts locally where it is applied rather than throughout the body.
Disadvantages
- Eases symptoms but does not treat the underlying cause.
- Only for short-term, external use rather than long-term continuous treatment.
- Can occasionally cause stinging, irritation or an allergic reaction.
Practical use
Good to know
Pramocaine gives short-term relief from itching and soreness but does not treat the underlying cause, so it is best used alongside measures that tackle the actual problem, such as the other ingredients in a haemorrhoid product or general bite care. It is for external use and is applied as a thin layer to the affected area as directed on the pack, for a limited period rather than continuously over long stretches. Like other local anaesthetics, it can occasionally cause stinging, irritation or, rarely, an allergic reaction, so it should be stopped if the area becomes more red, sore or itchy after using it. Symptoms of haemorrhoids, bites or skin irritation that are severe, spreading, or not improving within a few days should be checked by a pharmacist or GP, who can advise on the right treatment.
Who should not take it / use with caution
- People who have had an allergic reaction to pramocaine (pramoxine) or local anaesthetics should not use it.
- It should not be used in the eyes, and not put on large areas of broken skin without advice.
- Anyone whose symptoms are severe or not improving should seek medical advice rather than continue self-treating.
Monitoring
- No routine monitoring is needed for short-term external use.
- Checking that symptoms are improving rather than worsening.
- Watching the skin for signs of irritation or an allergic reaction.
Side effects
- Stinging, burning or mild irritation where it is applied.
- Increased redness or itching if the skin reacts to it.
- Rarely, an allergic reaction, which needs medical attention.
Key interactions
- Avoid using several different numbing or anaesthetic products on the same area at once.
- It is not known to interact in any important way with most medicines taken by mouth.
- Tell the pharmacist about other creams or ointments you are using on the same area.
Available as: Creams and ointments applied to the skin and around the back passage.
Answers
Pramocaine: frequently asked questions
What is pramocaine used for?
It is a local anaesthetic applied to the skin to numb itching and soreness. It is found in haemorrhoid products and in some creams for insect bites, stings and minor skin irritation.
Is pramocaine the same as pramoxine?
Yes. Pramocaine is the name used in the UK, while pramoxine is the name used in the United States. They are the same local anaesthetic ingredient.
Does it treat the cause of haemorrhoids?
No. It numbs the itch and soreness for short-term relief, but it does not treat the underlying cause. It is often combined with other ingredients in haemorrhoid products.
How long can I use it for?
It is intended for short-term use. If your symptoms are severe or do not improve within a few days, see a pharmacist or GP rather than continuing to use it.
What if it makes my skin worse?
Stop using it if the area becomes more red, sore or itchy after applying it, as this can be a sign of irritation or an allergic reaction, and ask a pharmacist for advice.
Authoritative sources
- BNF
- NICE CKS
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