Benzyl benzoate with bismuth oxide, bismuth subgallate, hydrocortisone acetate, Peru balsam and zinc oxide

How it works

It combines a mild topical corticosteroid (hydrocortisone acetate) to reduce inflammation with astringent and soothing/protectant components (bismuth salts, zinc oxide) and Peru balsam.

Prescribing in practice

• Because it contains a corticosteroid, limit to short-term use, as prolonged perianal application can cause skin thinning; exclude infection first.
• Peru balsam and other constituents may cause local sensitisation, so discontinue if irritation or an allergic reaction develops.
• It is intended for short courses of symptomatic relief rather than ongoing treatment.

Monitoring

No laboratory monitoring is required; review symptoms and stop if there is no improvement or if local reactions occur.

Counselling the patient

• Use for short periods only and seek review if symptoms persist, recur or worsen.
• Stop and seek advice if rectal bleeding occurs or the area becomes more irritated.
• Attention to fibre, fluids and avoiding straining helps the underlying problem.

Evidence & guidelines

Compound corticosteroid-containing haemorrhoidal preparations are recommended for short-term symptomatic relief in line with standard UK practice.