Best Hemorrhoid Creams for Relief, Compared

Best hemorrhoid cream for pain

For sharp, stinging or burning pain, the fastest relief comes from a topical anesthetic. Lidocaine at 5 percent is the strongest concentration available without a prescription, and it numbs the nerve endings within about five to ten minutes. HemRid Lidocaine Cream and RectiCare Advanced both use that 5 percent strength, while Preparation H Rapid Relief pairs a lower dose of lidocaine with phenylephrine so it eases pain and swelling at the same time. An anesthetic cream quiets the pain you feel right now, but it does not reduce the size of the hemorrhoid, so pair it with more fiber and water to take the pressure off the vein. A cold compress held against the area for the first day or two adds numbing relief on top of the cream, which many people find helps most with a painful external or thrombosed hemorrhoid.

Best hemorrhoid cream for swelling

When the main problem is a swollen, protruding hemorrhoid rather than pain, look for phenylephrine, a vasoconstrictor that narrows the local blood vessels. It is the active ingredient in Preparation H original ointment, and it works over one to three days of regular use rather than in minutes. Because phenylephrine does little for pain on its own, combination products such as Preparation H Rapid Relief with Lidocaine or Doctor Butler's add an anesthetic in the same tube so you are not choosing between the two. Phenylephrine is usually the ingredient people mean when they ask what shrinks a hemorrhoid fastest among creams. Even so, the swelling truly comes down when the straining behind it stops, which is why fiber, fluids and unhurried bathroom habits do the lasting work a cream cannot.

Best hemorrhoid cream for itching

Itching and irritation respond best to an anti-inflammatory or a soothing astringent rather than to an anesthetic. Hydrocortisone 1 percent calms the inflammation that drives the itch, but it is a mild steroid and should not be used for more than about seven days, because longer use can thin the delicate skin around the anus. Witch hazel pads are a gentler, steroid-free option for cleansing and calming irritation, and pramoxine-based products such as some Anusol creams numb the itch without lidocaine. Whatever you choose, keeping the area clean and fully dry after each bowel movement does as much for itching as any cream, so make gentle hygiene part of the routine and skip scented or medicated wipes that can irritate the skin further.

Best hemorrhoid cream for bleeding

No over-the-counter cream is designed to stop rectal bleeding, and bleeding is the one symptom you should not try to manage on your own with a cream. Bright red blood on the paper or in the bowl is common with hemorrhoids, but it can also come from an anal fissure or from more serious conditions, so it should be looked at by a clinician rather than assumed to be a hemorrhoid. If a doctor confirms the bleeding is from a hemorrhoid, gentle care helps the irritated tissue settle: a soothing witch hazel or barrier product, warm sitz baths, softer stools from more fiber and water, and no straining on the toilet. Seek care promptly for heavy bleeding, bleeding that keeps returning, or bleeding with dizziness or weakness.

Internal or external: will the cream even reach it?

Match the format to where the hemorrhoid actually sits. External hemorrhoids form under the skin around the anus, so a standard cream applied to the surface reaches them directly. Internal hemorrhoids form higher up inside the rectum, where an external cream cannot make contact; for those, use a product with an applicator tip made for internal use, or a suppository, and follow the label. Many creams are sold in both formats for exactly this reason. If you are not sure which type you have, the symptoms are a clue: external hemorrhoids tend to be painful and you can feel a lump, while internal ones are often painless but may bleed or slip out during a bowel movement. When in doubt, a quick look from a clinician settles it.

How to apply hemorrhoid cream for the best results

Clean first. Gently wash the area with mild soap and warm water, or use an unscented wipe, then pat it fully dry before applying anything. Use a small amount on and around an external hemorrhoid, or the applicator tip for internal use, and follow the Drug Facts label for how often to reapply. Most anesthetic and phenylephrine creams can be used up to a few times a day; the HemRid Lidocaine Cream label, for example, allows application up to six times a day. Do not use any product longer than its label allows, and do not layer two creams that share the same active ingredient. If your symptoms have not improved after one to two weeks, or they are getting worse, stop reaching for another tube and see a clinician.

When to see a doctor instead of reaching for a cream

Creams are for mild, short-lived symptoms. See a doctor promptly if you have any of these:

• Rectal bleeding, or blood in the toilet or on the paper
• Severe or sudden pain
• A hard, painful lump at the anus
• Symptoms that keep getting worse, or last more than one to two weeks

Do not assume bleeding is from a hemorrhoid. Rectal bleeding should always be evaluated.

How to read a hemorrhoid cream label

Every over-the-counter hemorrhoid cream is built around one or two active ingredients, and those ingredients, not the marketing on the front of the box, decide what the cream does. Four families cover almost everything on the shelf.

Where a cream fits, and where it does not

A cream works on the surface. It is the fastest way to take the edge off pain, swelling or itching, and for a short flare that is often all you need. What a cream cannot do is change the pressure and straining that produced the swollen veins in the first place. That is why most people who get lasting relief pair a topical with more fiber, more water and less time straining on the toilet, and why some add a daily oral option such as HemRid Max for ongoing vein support from the inside. Think of the cream as the fast relief and the daily habits as the reason the flare does not keep coming back.

If your symptoms are internal, an external cream will not reach them, and you should choose an applicator product or a suppository. And if a cream is not helping after one to two weeks, or your symptoms are getting worse, that is the point to stop guessing at the pharmacy and see a clinician.

Related product pages

Related comparisons

Related reading