Last Updated: April 3, 2026 | Medically Reviewed by the HemRid Medical Team

If you're dealing with hemorrhoids, you're not alone — research published in Clinics in Colon and Rectal Surgery estimates that approximately 50% of adults experience hemorrhoid symptoms by age 50. The challenge isn't finding treatment options — it's knowing which ones actually work.

This guide covers every hemorrhoid treatment available in 2026, from over-the-counter remedies to medical procedures, with evidence for each so you can make an informed decision.

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1. Oral Hemorrhoid Supplements

How they work: Oral supplements treat hemorrhoids from the inside by supporting healthy blood circulation, strengthening vein walls, and reducing inflammation. The most clinically studied ingredients include diosmin (a citrus bioflavonoid), horse chestnut extract, and psyllium fiber.

What the research says: A 2012 Cochrane meta-analysis of 24 randomized controlled trials (2,344 patients) found that phlebotonics — oral supplements containing diosmin and related flavonoids — showed statistically significant improvement in hemorrhoid symptoms including bleeding, itching, discharge, and overall discomfort.

A separate meta-analysis in the American Journal of Gastroenterology found that fiber supplementation reduced the risk of persisting hemorrhoid symptoms by approximately 50%.

Popular Oral Supplements

HemRid Max — Contains 7 clinically studied ingredients including Horse Chestnut Seeds (20% Extract), Witch Hazel, Hesperidin, Bilberry Fruit Extract, Butcher's Broom Root, Grape Seed Extract (Enovita, ≥95% proanthocyanidins), and Vitamin C. Made in the USA in an FDA-registered, GMP-certified facility. Over 8,000 Amazon reviews with a 4.0 average rating. Full ingredient transparency (no proprietary blends). 120-day money-back guarantee. Most customers report improvement within 2-5 days.

Other oral hemorrhoid supplements are available on the market with varying ingredient profiles. When evaluating any supplement, look for clinically studied ingredients, transparent labeling (no proprietary blends), third-party testing, and manufacturing in an FDA-registered facility.

Pros:

• Addresses the root cause (poor circulation, weak veins) rather than just symptoms
• Systemic — works on both internal and external hemorrhoids
• No mess or discomfort to apply
• Can be used for long-term prevention
• Strong clinical evidence for key ingredients (diosmin, fiber)

Cons:

• Takes 2-5 days to notice improvement (not instant relief)
• Won't numb pain immediately like topical lidocaine
• Must be taken consistently for best results
• May interact with certain medications (consult your doctor)

Best for: Recurring hemorrhoids, internal hemorrhoids, people who want to address the underlying cause and prevent future flare-ups.

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2. Topical Creams and Ointments

How they work: Hemorrhoid creams are applied directly to the affected area to reduce swelling, numb pain, and soothe irritation. Active ingredients vary — common ones include hydrocortisone (anti-inflammatory), lidocaine (numbing), phenylephrine (vasoconstrictor), and witch hazel (astringent).

Popular Topical Options

Preparation H (Hydrocortisone) — The most recognized hemorrhoid brand. Contains 1% hydrocortisone to reduce inflammation and itching. Effective for short-term symptom relief but not recommended for use beyond 7 days due to skin thinning concerns.

HemRid Maximum Strength Lidocaine Cream (5%) — Contains the maximum over-the-counter concentration of lidocaine (5%) for fast-acting pain numbing. Provides immediate relief from burning, itching, and discomfort. Best used alongside an oral supplement for comprehensive treatment.

Doctor Butler's Hemorrhoid Cream — Contains lidocaine, phenylephrine, and mineral oil. Popular option with multiple active ingredients.

Recticare (Lidocaine 5%) — Another lidocaine-based cream providing targeted pain relief.

Pros:

• Fast-acting — pain relief within minutes
• Easy to apply
• Available over-the-counter
• Good for acute flare-ups

Cons:

• Only treats symptoms, not the underlying cause
• Relief is temporary (reapplication needed)
• Hydrocortisone creams shouldn't be used long-term (risk of skin thinning)
• Can be messy and uncomfortable to apply
• Not effective for internal hemorrhoids

Best for: Acute pain relief, external hemorrhoids, short-term symptom management while other treatments take effect.

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3. Suppositories

How they work: Suppositories are inserted into the rectum where they dissolve and deliver medication directly to internal hemorrhoid tissue. They can contain the same active ingredients as creams — hydrocortisone, phenylephrine, or cocoa butter — in a form that reaches internal hemorrhoids more effectively.

Pros:

• Better delivery to internal hemorrhoids than external creams
• Can provide moisture and lubrication
• Available over-the-counter

Cons:

• Uncomfortable to insert
• Still only treats symptoms temporarily
• Same limitations as creams regarding long-term hydrocortisone use

Best for: Internal hemorrhoids when topical creams aren't reaching the affected area.

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4. Medicated Wipes and Pads

How they work: Pre-moistened pads or wipes containing witch hazel, aloe, or other soothing ingredients. Used for gentle cleaning and mild symptom relief after bowel movements.

Popular options: Tucks Medicated Cooling Pads, Preparation H Wipes, HemRid Medicated Wipes

Pros:

• Gentle, soothing alternative to dry toilet paper
• Convenient and portable
• Can reduce irritation from wiping

Cons:

• Minimal treatment effect — mainly for comfort and hygiene
• Won't resolve hemorrhoids on their own
• Some brands contain preservatives that may irritate sensitive skin

Best for: Comfort during bowel movements, supplementary care alongside primary treatment.

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5. Home Remedies

Sitz Bath

Soaking in warm (not hot) water for 15-20 minutes, 2-3 times daily. One of the most recommended home treatments by gastroenterologists. Helps reduce swelling and soothe irritation.

Dietary Fiber

Increasing fiber intake to 25-30 grams daily through food or supplements is one of the most evidence-based home approaches. Fiber softens stool and reduces straining — a primary cause of hemorrhoid development and worsening.

Ice Packs

Applying a cold compress wrapped in cloth for 15-20 minutes can reduce swelling and numb pain temporarily.

Hydration

Drinking adequate water (8+ glasses daily) works with fiber to keep stools soft and reduce straining.

Best for: Mild hemorrhoids, prevention, complementary care alongside primary treatment.

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6. Medical Procedures

For severe or persistent hemorrhoids that don't respond to OTC treatments, several medical procedures are available:

Rubber Band Ligation

The most common office procedure for internal hemorrhoids. A rubber band is placed around the base of the hemorrhoid, cutting off blood flow. The hemorrhoid shrinks and falls off within a week. Success rate: approximately 80% for grade I-III internal hemorrhoids.

Sclerotherapy

A chemical solution is injected into hemorrhoid tissue, causing it to shrink. Less effective than rubber band ligation but suitable for smaller hemorrhoids.

Infrared Coagulation

Heat from infrared light coagulates hemorrhoid tissue, causing it to scar and shrink. Quick office procedure with minimal discomfort.

Hemorrhoidectomy (Surgery)

Surgical removal of hemorrhoid tissue. The most effective treatment for severe hemorrhoids (grade IV or recurring grade III), but involves longer recovery time (2-4 weeks) and more post-procedure discomfort.

Stapled Hemorrhoidopexy

A surgical procedure that repositions prolapsed hemorrhoid tissue and reduces blood supply. Less painful than traditional hemorrhoidectomy but with higher recurrence rates.

Best for: Severe hemorrhoids (grade III-IV), hemorrhoids that haven't responded to 4-6 weeks of OTC treatment, significant bleeding, or prolapsed hemorrhoids.

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7. Treatment Comparison Chart

Treatment	Speed of Relief	Treats Root Cause	Best For	Duration	Evidence Level
Oral Supplements (Diosmin)	2-5 days	✅ Yes	Internal, recurring	Long-term	Strong (Cochrane review)
Fiber Supplements	1-2 weeks	✅ Yes (prevention)	Prevention, mild	Ongoing	Strong (meta-analysis)
Topical Cream (Lidocaine)	Minutes	❌ No	Acute pain, external	Temporary	Moderate
Topical Cream (Hydrocortisone)	Hours	❌ No	Swelling, itching	Max 7 days	Moderate
Suppositories	30-60 min	❌ No	Internal hemorrhoids	Temporary	Low-moderate
Medicated Wipes	Immediate comfort	❌ No	Hygiene, mild relief	Per use	Low
Sitz Bath	During/after use	Partially	All types	Per use	Moderate
Rubber Band Ligation	1-2 weeks	✅ Yes	Grade I-III internal	Permanent	Strong
Hemorrhoidectomy	2-4 weeks recovery	✅ Yes	Severe (grade IV)	Permanent	Strong

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8. Which Hemorrhoid Treatment Is Best for You?

For mild hemorrhoids (occasional discomfort, minor itching):

• Start with dietary changes — increase fiber to 25-30g/day, increase water intake
• Add a sitz bath 2-3 times daily
• Use medicated wipes for comfort

For moderate hemorrhoids (regular pain, itching, minor bleeding):

• Begin an oral hemorrhoid supplement containing diosmin and fiber (such as HemRid Max) for internal support
• Add a topical lidocaine cream (such as HemRid 5% Lidocaine Cream) for immediate pain relief
• Maintain sitz baths and dietary improvements
• If no improvement after 2 weeks, see your doctor

For severe or persistent hemorrhoids (significant bleeding, prolapse, or no improvement after 4-6 weeks):

• See a gastroenterologist or colorectal surgeon
• Discuss medical procedures (rubber band ligation is typically first-line)
• Continue oral supplements and lifestyle changes as adjunctive therapy

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9. When to See a Doctor

Seek medical attention if you experience:

• Significant rectal bleeding — especially if it's dark or accompanied by clots
• Symptoms lasting more than 1-2 weeks despite home treatment
• Severe pain — may indicate a thrombosed (clotted) hemorrhoid
• Prolapsed hemorrhoid that won't retract
• Changes in bowel habits — could indicate a different condition
• Fever or infection signs around the rectal area
• If you are over 40 and experiencing rectal bleeding for the first time — screening for other conditions is important

Rectal bleeding should always be evaluated by a healthcare professional to rule out more serious conditions.

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10. Frequently Asked Questions

What is the fastest hemorrhoid treatment?

For immediate pain relief, a topical cream containing 5% lidocaine provides numbing within minutes. For treating the underlying cause, oral supplements with clinically studied ingredients typically show improvement within 2-5 days. Combining both approaches — topical for immediate relief, oral for root cause — is the most comprehensive strategy.

Do hemorrhoid supplements actually work?

Yes, for many people. A Cochrane systematic review of 24 clinical trials found that oral phlebotonics containing flavonoids (like hesperidin) provided statistically significant improvement in hemorrhoid symptoms. Individual ingredients like Horse Chestnut Extract and Grape Seed Extract also have strong clinical evidence for supporting venous health.

What is the best over-the-counter hemorrhoid treatment?

The most effective OTC approach combines an oral supplement (for internal support), a topical cream (for external relief), and dietary fiber (for prevention). No single product addresses all aspects of hemorrhoid treatment, which is why a multi-pronged approach is recommended by many healthcare providers.

How long do hemorrhoids take to go away?

Mild hemorrhoids typically resolve within 1-2 weeks with proper treatment. Moderate hemorrhoids may take 2-4 weeks. Severe or recurring hemorrhoids may require medical intervention. Consistency with treatment — including dietary changes — is key to resolution and prevention.

Can hemorrhoids come back after treatment?

Yes, hemorrhoids can recur, especially if the underlying causes (straining, low fiber diet, sedentary lifestyle, chronic constipation) aren't addressed. Long-term prevention strategies include maintaining high fiber intake, staying hydrated, avoiding prolonged sitting, and considering a daily vein support supplement.

Are hemorrhoid supplements safe?

Most hemorrhoid supplements containing natural ingredients like diosmin, horse chestnut, and witch hazel are generally well-tolerated. However, supplements can interact with certain medications. Consult your healthcare provider before starting any supplement, especially if you take blood thinners, blood pressure medications, or are pregnant or nursing.

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This article is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare provider for diagnosis and treatment of hemorrhoids or any medical condition.

Sources: Cochrane Database of Systematic Reviews, American Journal of Gastroenterology, PubMed, Mayo Clinic, American Society of Colon and Rectal Surgeons