Best cure for hemorrhoids over the counter

Key takeaways:

• Hemorrhoid cream can help with symptoms of hemorrhoids like itching, burning, pain, and swelling. Other options like ointments are available as well.

• There are over-the-counter (OTC) and prescription hemorrhoid creams available. Your healthcare provider can help you know the right one to use.

• Besides hemorrhoid creams, your healthcare provider may recommend fiber, sitz baths, or surgery.

Hemorrhoid cream is a medication you probably hope you’ll never need. But, hemorrhoids are more common than you might think. Over 1 million U.S. adults have hemorrhoids every year. There are various treatments, and medicated hemorrhoid cream can be a helpful option.

Hemorrhoids are veins in the lower anus (opening in the rectum). These are veins that have become inflamed, or swollen, due to pressure. They’re a common cause of bright red bleeding from the rectum. Hemorrhoids are classified based on their location. They may be internal (inside the rectum) or external (under the skin around the anus). For most people, hemorrhoids won’t be serious enough to require seeing a healthcare provider. But, if you’re in a lot of pain or your bleeding is severe, you might need medical attention. This could include getting a colonoscopy to see what’s causing the bleeding.

Most often, you can manage hemorrhoids at home. Remedies surround lifestyle changes and over-the-counter (OTC) treatment. OTC hemorrhoid cream is often recommended by healthcare providers. But, it can be intimidating to use hemorrhoid creams and products if you’ve never applied them before.

In this article, we’ll cover everything you need to know about hemorrhoid creams and products. This includes what they are, how to use them, and when to contact your healthcare provider. 

What is hemorrhoid cream?

Hemorrhoid cream is a product that you apply on the outside, or just on the inside, of the anus area. The cream helps with symptoms of hemorrhoids like swelling, pain, and itching. Surprisingly, there’s not much data to prove that hemorrhoid creams are effective. However, they’re still commonly used.

There’s a few different ingredients that you can find in hemorrhoid creams. They each work in different ways. OTC and prescription hemorrhoid creams often combine two or more ingredients. These ingredients target different hemorrhoid symptoms. Common ingredients include:

• Steroids. Rectal steroids like hydrocortisone (Anusol-HC) can lower swelling, redness and itching

• Protectants. Some ingredients — like mineral oil and petrolatum — can protect the skin and irritated areas. They prevent dryness and can soothe the affected area. 

• Decongestants. Rectal phenylephrine can shrink blood vessels and relieve burning and swelling caused by hemorrhoids.

• Local anesthetics. Some products contain local anesthetics that can relieve pain and soreness from hemorrhoids. Local anesthetics are only for external use and can’t be used inside the rectum. Products like pramoxine (Proctofoam HC), lidocaine (Ana-Lex), or benzocaine can be used alone or in combination with other ingredients.

• Astringents. These products protect irritated areas and can relieve discomfort and burning. Examples include witch hazel.

Talk to your healthcare provider about which hemorrhoid cream is best for you. They can help you choose one with ingredients that will target your symptoms.

Types of hemorrhoid creams and products

There are a few types of medicated creams or ointments that help with hemorrhoids. You can find many of them OTC, but some are only available with a prescription. There is one major difference between prescription and OTC hemorrhoid creams. It is that the prescription creams are stronger. Meaning they have a higher concentration medication.

OTC hemorrhoid creams and products

OTC hemorrhoid products are widely available and inexpensive. They can help treat symptoms of mild hemorrhoids. There’s many different branded and generic products for hemorrhoid products. The table below highlights some examples of common OTC hemorrhoids products and their ingredients:

Prescription hemorrhoid cream

Symptoms from hemorrhoids not getting better? It’s a good idea to talk with your healthcare provider. They can help you figure out if there’s something else going on, or if you need a stronger treatment.

There are a few types of prescription-only hemorrhoid products. Stronger prescription hydrocortisone products are available in many forms. These include in suppositories (e.g. Anusol-AC, Protocort) and creams (e.g. Proctocream HC). Other steroid prescription products include a combination of hydrocortisone and lidocaine (e.g. Ana-Lex). These products may help with hemorrhoids that aren’t relieved by OTC hydrocortisone. However, you should only use them if your healthcare provider tells you to.

Other prescription products for hemorrhoids include nitroglycerin ointment (Rectiv) and nifedipine ointment. A thrombosed hemorrhoid happens when a blood clot forms inside a hemorrhoid. Both nitroglycerin ointment and nifedipine ointment can treat pain caused by thrombosed hemorrhoids. However, they’re not FDA-approved for hemorrhoids. They’re most commonly used for anal fissures (small tears in the lining the anus.) Nifedipine ointment is not available commercially. So, if your healthcare provider prescribes this medication, a compounding pharmacy has to make it.

How to apply hemorrhoid cream

Each hemorrhoid cream comes with directions on how to apply the cream to the rectal area. Many of the creams come with an applicator. Applying hemorrhoid cream works best just after a bowel movement, to ensure the medication can stay where it needs to.

Here are some steps you can follow for how to apply hemorrhoid cream:

• Wash your hands and the affected rectal area with a gentle soap and warm water

• Dry rectal area gently by patting or blotting with toilet tissue or a soft cloth

• Apply a thin layer of cream to the affected area 

• If treating internal hemorrhoids (inside the anus), an applicator may be needed

• To use an applicator, lubricate the applicator tip by spreading the cream around it

• Insert the applicator gently into the anal area and apply to hemorrhoids

Hemorrhoid Cream alternatives

While hemorrhoid cream can be helpful for hemorrhoids, other treatments can also work. If your symptoms get worse or don’t go away in a few days, you should talk to your healthcare provider.

1.  Fiber supplementation. Getting enough  fiber has been shown to improve symptoms of hemorrhoids like bleeding. This is because fiber helps you have soft bulky stools that can be passed without straining. You should strongly consider adding fiber-rich foods to your diet, no matter what else you do for hemorrhoids. If you can’t get enough fiber in your diet OTC supplements like psyllium (Metamucil) can help you get enough fiber. The recommended amount is about 25 g per day for women and 38 g per day for men.

2.  Sitz baths. A sitz bath is a warm, shallow bath taken two to three times a day for about 20 minutes. It’s often recommended to help soothe pain from hemorrhoids. But, a review of studies found no benefit for hemorrhoids. So, while sitz baths are likely safe, there’s no guarantee they’ll be helpful.

3.  Surgery. One of the most common surgical treatments is rubber band ligation. Another is excisional hemorrhoidectomy (cutting the hemorrhoid out). A review comparing excisional hemorrhoidectomy to rubber band ligation showed that ligation resulted in less postoperative pain. It also allowed patients to return to work and to their previous level of functioning faster. For patients with severe hemorrhoids though, excisional hemorrhoidectomy has less chance of recurrence.

The bottom line

Hemorrhoid products can treat hemorrhoids by relieving symptoms of burning, itching, and pain. OTC products to treat hemorrhoids often include more than one ingredient. This may include steroids and local anesthetics. Your healthcare provider can help you select a hemorrhoid product that can help treat your most bothersome symptoms.

Prescription products to treat hemorrhoids include stronger steroid creams, nifedipine, and nitroglycerin. Surgery may be recommended if your hemorrhoids are more severe. Talk to your healthcare provider if you experience bleeding or have bothersome symptoms for more than 7 days.

Cleveland Clinic. (n.d.). Phenylephrine rectal cream or ointment.

Dolgencorp, LLC. (2022). DG HEALTH HEMORRHOIDAL- mineral oil, petrolatum, phenylephrine hcl ointment.

GlaxoSmithKline Consumer Healthcare Holdings (US) LLC. (2020). PREPARATION H COOLING GEL- phenylephrine hcl, witch hazel gel.

GlaxoSmithKline Consumer Healthcare Holdings (US) LLC. (2021). PREPARATION H- mineral oil, petrolatum, phenylephrine hcl ointment.

GlaxoSmithKline Consumer Healthcare Holdings (US) LLC. (2021). PREPARATION H SOOTHING RELIEF ANTI-ITCH- hydrocortisone cream.

Insight Pharmaceuticals LLC. (2020). AMERICAINE- benzocaine ointment. 

Johnson & Johnson Consumer Inc. (2022). LABEL: DESITIN MULTI-PURPOSE HEALING- petrolatum ointment.

Katsinelos, P., et al. (2006). Aggressive treatment of acute anal fissure with 0.5% nifedipine ointment prevents its evolution to chronicity. World Journal of Gastroenterology.

Mott, T., et al. (2018). Hemorrhoids: Diagnosis and treatment options. American Family Physician.

Richards, E. et al. (2021). Phenylephrine.

Schubert, M.C., et al. (2009). What every gastroenterologist needs to know about common anorectal disorders. World Journal of Gastroenterology.

Shanmugam, V., et al. (2005). Rubber band ligation versus excisional haemorrhoidectomy for hemorrhoids. Cochrane Database of Systematic Reviews.

Tejirian, T., et al. (2005). Sitz bath: where is the evidence? Scientific basis of a common practice. Diseases of the Colon & Rectum.

GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.

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