Best Hemorrhoid Ointments for Relief, Compared

What is the strongest hemorrhoid ointment?

It depends on the symptom you are treating. For pain, the strongest option is 5 percent lidocaine, the maximum anesthetic strength available without a prescription, which numbs within minutes. For swelling, the strongest choice is a phenylephrine ointment such as Preparation H, and for itching it is a hydrocortisone ointment used for no more than about a week. Combination products like Doctor Butler's carry both an anesthetic and a vasoconstrictor in one oil-based ointment. There is no single strongest ointment for every symptom, because these ingredients do different jobs; strength really means matching the active ingredient to what you feel.

Hemorrhoid ointment vs cream: which should you use?

The active ingredient decides what a product does, and the format decides how it feels. An ointment is oil-based, so it spreads into a longer-lasting protective layer that many people prefer overnight, though it is greasier. A cream is water-based, absorbs faster, and feels lighter under clothing during the day. The same active ingredient, phenylephrine or lidocaine, often comes in both. So choose the ingredient by symptom first, then pick the format by when you will use it: an ointment for overnight staying power, a cream like HemRid Lidocaine Cream for fast, less greasy daytime relief.

Best hemorrhoid ointment for swelling

When the hemorrhoid is swollen and protruding, look for phenylephrine, the vasoconstrictor in Preparation H original ointment. It narrows the local blood vessels and works over one to three days rather than in minutes, and the oil base keeps it in contact with the area. Because phenylephrine does little for pain by itself, combination ointments such as Doctor Butler's add an anesthetic. Whatever brings the swelling down in the moment, it stays down when the straining behind it stops, which is the job fiber, fluids and easier bowel movements do.

Best hemorrhoid ointment for pain

For pain, the active ingredient to look for is a topical anesthetic, and lidocaine at 5 percent is the strongest without a prescription. It numbs the nerve endings within about five to ten minutes. HemRid offers this as a 5 percent lidocaine cream; if you specifically want an oil-based ointment, a combination product such as Doctor Butler's pairs a lidocaine-class anesthetic with phenylephrine. An anesthetic relieves pain but does not shrink the hemorrhoid, so pair it with more fiber and water, and add a cold compress for the first day or two of a painful flare.

Best hemorrhoid ointment for itching

Itching responds best to an anti-inflammatory or a soothing astringent rather than to a numbing agent. Hydrocortisone 1 percent ointment calms the inflammation behind 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. Witch hazel and pramoxine-based products relieve the itch without a steroid. As with every symptom here, gentle hygiene does half the work: clean and dry the area fully after each bowel movement, and avoid scented or medicated wipes that can make irritation worse.

How to apply hemorrhoid ointment

Clean first. Gently wash the area with mild soap and warm water, or use an unscented wipe, then pat it fully dry. Apply a small amount to and around an external hemorrhoid, or use the applicator tip for internal use, and follow the Drug Facts label for how often to reapply. Because an ointment is oil-based, a thin layer goes a long way and lasts, which is why many people apply it before bed. Do not use any product longer than its label allows, do not layer two products with the same active ingredient, and if symptoms have not improved after one to two weeks, see a clinician.

When to see a doctor instead of an ointment

Ointments 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.

The main hemorrhoid ointment ingredients, and what they do

Whether it comes as an ointment or a cream, a hemorrhoid product is defined by its active ingredients. Four families cover almost everything on the shelf, and the ingredient, not the format, decides what it does.

Ointment or cream: the part most guides skip

Search results for hemorrhoid ointments and hemorrhoid creams overlap almost completely, because the two are the same medicines in a different base. The active ingredient, phenylephrine for swelling, lidocaine for pain, hydrocortisone for itching, is what decides the effect. The base decides the feel. An ointment is oil-based: it spreads into a longer-lasting, more protective layer that many people prefer applying before bed, at the cost of being greasier. A cream is water-based: it absorbs faster and feels lighter under clothing, which suits daytime use. Neither is stronger than the other at the same active-ingredient strength.

HemRid's topical is a 5 percent lidocaine cream rather than an ointment, so if pain is your main symptom and you want fast, less greasy relief, it is a direct option; if you specifically want overnight staying power, an oil-based ointment or a combination product may suit you better. Either way, a topical works on the surface, so pair it with more fiber, more water and less straining to keep flares from returning, and take rectal bleeding, severe pain, a hard lump, or symptoms lasting beyond one to two weeks to a clinician rather than another tube.

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