Preparation H Cream vs Ointment: Which Form Works Better? (2026)

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

Preparation H cream or ointment — which one should you buy? They're both on the same shelf, both say "Preparation H," but they're actually different formulations designed for different situations.

This guide breaks down the real differences so you can pick the right one for your specific symptoms.

Quick Answer

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Preparation H Ointment is better for shrinking hemorrhoids and creating a protective barrier (contains phenylephrine vasoconstrictor). Preparation H Cream absorbs faster and is less greasy, better for daytime use. The Lidocaine Cream version is best for severe pain.

All Preparation H Formulations Compared

Product Active Ingredients Best For Price

Ointment Phenylephrine 0.25%, Mineral Oil 14%, Petrolatum 71.9% Shrinking + protection ~$10

Cream Phenylephrine 0.25%, Glycerin 12%, White Petrolatum 18% Daytime use, less greasy ~$10

Suppositories Phenylephrine 0.25%, Cocoa Butter 85.5% Internal hemorrhoids ~$10

Lidocaine Cream Lidocaine 5%, Petrolatum Maximum pain relief ~$15

Cooling Gel Phenylephrine 0.25%, Witch Hazel 50% Itching + cooling relief ~$10

Medicated Wipes Witch Hazel 50% Gentle cleansing ~$8

Ointment vs Cream: Key Differences

Feature Ointment Cream

Base 71.9% petrolatum (thick, greasy) 18% petrolatum (lighter)

Absorption Sits on surface, slow absorption Absorbs faster into skin

Moisture barrier Excellent — heavy petroleum coat Moderate

Shrinkage Yes (phenylephrine) Yes (phenylephrine)

Texture Thick, sticky, greasy Smoother, lighter

Best time to use Nighttime / before bed Daytime / at work

Staining More likely (oily base) Less likely

Duration Longer-lasting barrier Needs more frequent reapplication

When to Choose the Ointment

• You need a strong protective barrier (during bowel movements)

Nighttime use — the greasy texture doesn't matter when sleeping

• Your hemorrhoids are dry, cracked, or raw — the petroleum base seals in moisture
• You have external hemorrhoids that need surface-level protection
• You want the longest-lasting single application

When to Choose the Cream

Daytime use — absorbs without leaving greasy residue

• You're active or at work and don't want to deal with staining
• You prefer a lighter, less messy application
• You're using it under clothing

When to Choose the Lidocaine Version

• You have severe pain — 5% lidocaine provides maximum numbing

Thrombosed hemorrhoids — the most painful type

• Post-surgery recovery
• Note: The lidocaine version does NOT contain phenylephrine, so it won't shrink hemorrhoids

Pro Tip: Combine for Best Results

Many experienced hemorrhoid sufferers use a two-product strategy:

Morning: Preparation H Cream (absorbs fast, no grease for daytime)

Night: Preparation H Ointment (heavy barrier protection while sleeping)

As needed: Lidocaine Cream for pain flare-ups

And for root cause treatment, combine any topical with HemRid Max — an oral supplement that works from the inside to support vein health. Cream treats the symptom; HemRid Max treats the cause. Learn more about pills vs cream.

Frequently Asked Questions

Is Preparation H cream or ointment better?

Neither is objectively better — they serve different purposes. Ointment provides a thicker, longer-lasting protective barrier and is ideal for nighttime use. Cream absorbs faster and is better for daytime use under clothing. Both contain the same active ingredient (phenylephrine 0.25%) for shrinking hemorrhoids.

Can I use Preparation H ointment and cream together?

Yes. Many people use cream during the day for convenience and ointment at night for maximum protection. Don't apply both at the same time — alternate between them.

Which Preparation H is strongest?

For pain: Preparation H Maximum Strength with Lidocaine (5% lidocaine). For shrinkage: all phenylephrine-based products (ointment, cream, suppositories, cooling gel) have the same 0.25% concentration.

Does Preparation H ointment stain underwear?

Yes, the petroleum-based ointment can stain fabric. Use a panty liner or old underwear when using the ointment. The cream formula is much less likely to stain.

How often should I apply Preparation H?

Apply up to 4 times daily, especially after bowel movements and before bed. Clean the area gently before each application.

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