Best Hemorrhoid Cream: Buyer's Guide & Rankings (2026)

Reviewed by the HemRid Medical Team | Last updated: April 2026

With dozens of hemorrhoid creams on the market, choosing the right one can feel overwhelming. Some numb pain, others reduce swelling, and a few do both — but which hemorrhoid cream actually works best?

We evaluated the top hemorrhoid creams based on active ingredients, clinical evidence, user reviews, and value for money. Here's our definitive ranking for 2026.

Quick Picks: Best Hemorrhoid Creams at a Glance

HemRid Max StrengthThe #1 doctor-recommended hemorrhoid supplement. Clinically tested ingredients that work from the inside out.Shop Now — $33.99/mo →

Cream Best For Key Ingredient Price

Preparation H with Lidocaine Maximum pain relief Lidocaine 5% ~$15

Preparation H Ointment Shrinking hemorrhoids Phenylephrine 0.25% ~$10

Doctor Butler's Multi-symptom relief Lidocaine + phenylephrine ~$24

RectiCare Lidocaine cream (OTC) Lidocaine 5% ~$14

Tucks Ointment Natural/gentle option Pramoxine 1% ~$9

Important: Creams vs. Oral Supplements

Before we dive into creams, it's important to understand their limitation: hemorrhoid creams only treat symptoms topically. They provide temporary relief from pain, itching, and swelling, but they don't address the root cause — weakened vein walls and poor circulation.

For long-term relief, many doctors recommend combining a topical cream with an oral supplement like HemRid Max that works from the inside to support vein health. Think of it as treating the fire (cream) while also fixing the plumbing (supplement). Learn more: Hemorrhoid Pills vs Cream: Which Works Better?

1. Preparation H Maximum Strength Pain Relief Cream (Lidocaine)

Best for: Severe pain relief

The lidocaine version of Preparation H is the strongest OTC hemorrhoid cream available. The 5% lidocaine provides powerful numbing that kicks in within 5-10 minutes and lasts up to an hour.

Active Ingredients:

• Lidocaine 5% — topical anesthetic (numbs pain)
• Petrolatum — protective barrier

Pros:

• Strongest pain relief available OTC
• Fast-acting (5-10 minutes)
• Creates protective moisture barrier
• Trusted brand with decades of clinical use

Cons:

• Does NOT shrink hemorrhoids (no vasoconstrictor)
• Numbness only — doesn't treat underlying issue
• Can cause skin sensitivity with prolonged use
• Higher price point (~$15)

Best for: Thrombosed hemorrhoids, post-surgical pain, or any time you need maximum pain relief fast.

Read our full review: Preparation H Lidocaine Cream Review

2. Preparation H Ointment (Phenylephrine)

Best for: Actually shrinking hemorrhoids

The original Preparation H ointment is the only major OTC cream that contains a vasoconstrictor — an ingredient that actively narrows blood vessels to reduce swelling.

Active Ingredients:

• Phenylephrine HCl 0.25% — vasoconstrictor (shrinks tissue)
• Mineral oil 14% — lubricant/protectant
• Petrolatum 71.9% — protective barrier

Pros:

• Only OTC cream that actively shrinks hemorrhoids
• Creates strong moisture barrier
• Most widely recommended by pharmacists
• Affordable (~$10)

Cons:

• Limited pain relief (no anesthetic)
• Greasy texture
• Phenylephrine may affect blood pressure in rare cases
• Not recommended during pregnancy without doctor approval

Best for: Swollen external hemorrhoids where the primary goal is reducing size. Compare with: Preparation H vs Desitin

3. Doctor Butler's Advanced Hemorrhoid & Fissure Ointment

Best for: Multi-symptom relief

Doctor Butler's combines lidocaine AND vasoconstrictors in one formula, making it the most comprehensive single-product option. It also adds soothing botanicals.

Key Ingredients:

• Lidocaine — pain relief
• Phenylephrine — shrinks hemorrhoids
• Aloe, amino acids, mineral oil — soothing agents

Pros:

• Combines pain relief + shrinkage in one tube
• Good for both hemorrhoids and fissures
• Added soothing botanicals
• Strong customer reviews

Cons:

• Most expensive option (~$24)
• Only available on Amazon/online (not in most stores)
• Smaller tube for the price

Read our full review: Doctor Butler's Review

4. RectiCare Anorectal Cream

Best for: Strong lidocaine alternative

RectiCare is a focused lidocaine cream without the Preparation H brand premium. It delivers the same 5% lidocaine concentration at a slightly lower price.

Active Ingredient: Lidocaine 5%

Pros:

• Same strength as Preparation H Lidocaine
• Clean, non-greasy formula
• Often cheaper than Prep H

Cons:

• No vasoconstrictor (doesn't shrink)
• Less widely available in stores

5. Tucks Hemorrhoidal Ointment

Best for: Gentle, pregnancy-safe option

Tucks ointment uses pramoxine 1% instead of lidocaine — a gentler anesthetic that's better tolerated by sensitive skin.

Active Ingredients:

• Pramoxine HCl 1% — gentle topical anesthetic
• Zinc oxide 12.5% — skin protectant and mild astringent

Pros:

• Gentle enough for sensitive skin
• Zinc oxide provides protective barrier
• Generally considered safe during pregnancy
• Affordable (~$9)

Cons:

• Weaker pain relief than lidocaine products
• Doesn't shrink hemorrhoids

For the pads comparison: Preparation H vs Tucks

How to Choose the Right Hemorrhoid Cream

Your Main Symptom Best Cream Why

Severe pain Prep H Lidocaine or RectiCare 5% lidocaine provides maximum numbing

Swelling Prep H Ointment Phenylephrine actively shrinks tissue

Pain + swelling Doctor Butler's Both lidocaine and vasoconstrictor

Itching Hydrocortisone 1% + Tucks pads Anti-itch + soothing witch hazel

Pregnancy Tucks Ointment Gentle pramoxine + zinc oxide

Post-surgery Prep H Lidocaine Maximum pain relief during recovery

Beyond Creams: Complete Hemorrhoid Relief

Creams are great for immediate symptom relief, but for lasting results, consider a comprehensive approach:

HemRid Max — Oral supplement that works from the inside to support vein health and reduce hemorrhoid symptoms. Over 8,000 reviews and a 120-day money-back guarantee.

High-fiber diet — Prevents the straining that causes hemorrhoids

Sitz baths — Warm water therapy for healing

Witch hazel pads — Natural astringent for soothing

Frequently Asked Questions

What is the best hemorrhoid cream for pain?

Preparation H Maximum Strength with Lidocaine or RectiCare — both contain 5% lidocaine, the strongest OTC anesthetic available for hemorrhoids. For combined pain and swelling, Doctor Butler's ointment offers both lidocaine and a vasoconstrictor.

What cream shrinks hemorrhoids the fastest?

Preparation H Ointment with phenylephrine is the only widely available OTC cream that contains a vasoconstrictor to actively shrink hemorrhoidal tissue. Most people notice reduced swelling within 1-3 days of regular use.

Can I use hemorrhoid cream every day?

Most hemorrhoid creams are safe for short-term daily use (up to 7 days). Hydrocortisone-based creams should NOT be used for more than 7 days without medical supervision, as prolonged use can thin the skin. If symptoms persist beyond a week, see a doctor.

What works better: hemorrhoid cream or pills?

They work differently and are most effective together. Creams provide fast topical relief, while oral supplements like HemRid Max address the root cause from the inside. Think of cream as the quick fix and supplements as the long-term solution.

Is there a prescription hemorrhoid cream?

Yes. Prescription options include higher-strength hydrocortisone (2.5%), nitroglycerin ointment (for anal fissures), and nifedipine cream. These require a doctor's prescription and are typically reserved for more severe cases.

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