Best OTC Hemorrhoid Relief, Compared
The best over-the-counter hemorrhoid product depends on what is bothering you most. For pain, a 5 percent lidocaine cream numbs the fastest. For swelling, a phenylephrine cream or suppository narrows the blood vessels. For itching, a short course of hydrocortisone or some witch hazel calms the skin. And to keep flares from returning, more fiber, more fluids and a daily oral option work on the straining behind them. Below we compare the leading over-the-counter options, including HemRid, Preparation H, Anusol and RectiCare, by what each one actually does, so you can match the product to your symptom instead of guessing in the pharmacy aisle.
Shop HemRid OTC relief
HemRid Lidocaine Cream is an over-the-counter drug; use it only as directed by its Drug Facts label. HemRid Max is a dietary supplement, not a drug.
How the leading OTC hemorrhoid products compare
Compared by what each product does, not ranked. Over-the-counter drugs and dietary supplements do different jobs, so the right pick depends on your symptom.
| Product | Active ingredient | Best for | Price |
|---|---|---|---|
| HemRid Lidocaine Cream (sold here) | OTC drug, lidocaine 5% | Fast relief of sharp external pain | $15.95 |
| HemRid Max (sold here) | Supplement, diosmin, horse chestnut, hesperidin | Daily vein support and recurring flares | $34.95 |
| Preparation H Ointment | OTC drug, phenylephrine 0.25% | Reducing swelling | ~$10 |
| Preparation H Rapid Relief w/ Lidocaine | OTC drug, lidocaine + phenylephrine | Pain and swelling together | ~$13 |
| Anusol / Anusol-HC | OTC drug, pramoxine + zinc oxide, or hydrocortisone | Itching and a protective barrier | ~$9 |
| Hydrocortisone 1% | OTC drug, hydrocortisone | Itching and inflammation, up to 7 days | ~$8 |
| Psyllium fiber (e.g. Metamucil) | Supplement, soluble fiber | Softer stool and less straining | ~$15 |
How to choose the right OTC product for your symptom
A topical anesthetic numbs the area within minutes. HemRid Lidocaine Cream and RectiCare Advanced use the maximum over-the-counter strength.
Phenylephrine narrows the blood vessels to bring swelling down over one to three days. Preparation H is the common choice.
Hydrocortisone calms inflammation but should not be used beyond about a week. Witch hazel and pramoxine products soothe without a steroid.
A surface cream cannot reach an internal hemorrhoid. Use a product made for internal use and follow the label.
Topicals relieve symptoms on the surface. Fiber and an oral option such as HemRid Max work on the straining and vein tone behind repeat flares.
What is the best OTC hemorrhoid treatment overall?
There is no single best over-the-counter treatment, because the products do different jobs. The most effective approach for most people is a pair rather than one product: a topical for fast symptom relief now, plus fiber and fluids to reduce the straining that caused the flare. If pain is the problem, that topical is a 5 percent lidocaine cream; if swelling is the problem, it is a phenylephrine product; if itching is the problem, it is hydrocortisone or witch hazel. People with flares that keep coming back often add a daily oral option for vein support. Matching the product to the symptom, and combining relief with prevention, beats hunting for one miracle tube.
Best OTC treatment for hemorrhoid pain
For pain, reach for a topical anesthetic. Lidocaine at 5 percent is the strongest concentration sold without a prescription and numbs the nerve endings within about five to ten minutes; HemRid Lidocaine Cream and RectiCare Advanced both use it. Preparation H Rapid Relief pairs a lower dose of lidocaine with phenylephrine so it covers pain and swelling at once. An anesthetic 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 or thrombosed hemorrhoid.
Best OTC treatment for swelling
When the hemorrhoid is swollen and protruding rather than simply painful, 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. Because it does little for pain by itself, combination products add an anesthetic. Suppositories carry the same ingredient higher up for an internal hemorrhoid. Whatever brings the swelling down in the moment, it stays down when the straining stops, which is the job fiber and fluids do.
Best OTC treatment for itching
Itching responds to an anti-inflammatory or a soothing astringent rather than to a numbing agent. Hydrocortisone 1 percent calms the inflammation behind the itch but is a mild steroid that should not be used for more than about seven days. Witch hazel pads and pramoxine-based products such as some Anusol creams relieve the itch without a steroid. As with the other symptoms, hygiene does half the work: clean gently and dry fully after each bowel movement, and skip scented or medicated wipes that can make irritation worse.
OTC creams, ointments or suppositories: which format?
The format should match where the hemorrhoid sits. Creams and ointments are for external hemorrhoids you can reach and feel; ointments are greasier and last longer, creams absorb faster and are less messy. Suppositories and applicator products are for internal hemorrhoids a surface cream cannot touch. Many brands sell the same active ingredient in more than one format for exactly this reason, so choose the delivery that reaches your symptom rather than assuming a cream is always the answer.
Where oral support and fiber fit
Every topical on this page works on the surface, which is why symptoms often return once the tube is empty. Fiber and fluids reduce the straining that produces the swollen veins, and an oral option such as HemRid Max, with diosmin and horse chestnut, is taken daily to support vein tone from the inside. HemRid Max is a dietary supplement, not a drug, and it is meant to sit alongside a topical rather than replace it. Think of the cream or ointment as the fast relief and the daily habits as the reason the next flare is milder or does not come at all.
What is the strongest over-the-counter medicine for hemorrhoids?
For pain, the strongest over-the-counter option is a 5 percent lidocaine cream, the maximum non-prescription anesthetic strength. For swelling, the strongest choice is a phenylephrine product, and for itching it is a hydrocortisone cream. There is no single strongest product for every symptom, because these ingredients do different things; strength really means matching the active ingredient to what you are feeling.
What shrinks a hemorrhoid the fastest?
Among over-the-counter products, a phenylephrine cream or ointment acts on swelling the fastest by narrowing the blood vessels, usually over one to three days. Anesthetic creams relieve pain within minutes but do not reduce size. The swelling comes down for good when the straining behind it stops, which is why fiber, fluids and unhurried bathroom habits matter as much as any cream.
How to get rid of a hemorrhoid without a doctor?
Most mild hemorrhoids settle within a week or two with self-care: a symptom-matched over-the-counter product, warm sitz baths, gentle hygiene, more fiber and fluids, and no straining on the toilet. See a doctor if there is rectal bleeding, severe pain, a hard lump, or symptoms that last beyond one to two weeks or keep returning. Do not assume bleeding is from a hemorrhoid.
What is the best over-the-counter treatment for hemorrhoids?
The best over-the-counter approach pairs a topical for fast relief with fiber and fluids to reduce straining. Choose the topical by symptom: lidocaine for pain, phenylephrine for swelling, hydrocortisone or witch hazel for itching. Many people also add a daily oral option for vein support. Product choice matters less than matching the ingredient to the symptom and combining relief with prevention.
When over-the-counter care is not enough
Over-the-counter products 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.
Frequently asked questions
The main OTC hemorrhoid ingredients, and what they do
Over-the-counter hemorrhoid products come down to a handful of active ingredients plus the fiber and oral options that work on the cause. Knowing the ingredient tells you what a product will actually do.
Numb the nerve endings so pain and burning fade within minutes. Lidocaine at 5 percent is the strongest non-prescription strength. They relieve pain but do not reduce swelling.
Narrow the blood vessels to bring down swelling over one to three days. The classic Preparation H mechanism, often paired with an anesthetic for pain.
Calm the itching and inflammation of a flare, but the steroid should not be used more than about seven days because it can thin the skin.
Soothe irritation and shield raw skin. Gentle, good for mild symptoms and for cleansing after a bowel movement.
Work on the cause rather than the surface. Fiber softens stool to reduce straining; oral phlebotonics are taken daily to support vein tone. These are supplements, not drugs.
Where over-the-counter care fits, and where it stops
Over-the-counter products are the right first move for most hemorrhoid flares. They are inexpensive, they work within minutes to days depending on the ingredient, and for a short flare they are often all you need. The trick is to stop treating them as interchangeable. A numbing cream will not bring down swelling, a vasoconstrictor will not quiet pain, and a steroid is only for a short course. Match the active ingredient to your main symptom and you get relief; grab the wrong tube and you conclude, wrongly, that nothing works.
What no topical can do is change the pressure and straining that produced the swollen veins. That is why lasting relief pairs a topical with more fiber, more water and less time straining, and why some people add a daily oral option for vein support. And it is why bleeding, severe pain, a hard lump, or symptoms that drag past one to two weeks belong with a clinician rather than another trip down the pharmacy aisle.
Related reading
Best OTC Hemorrhoid Treatment Guide →Best Hemorrhoid Medicine →Best Hemorrhoid Supplements →*This page is for general information and is not a substitute for professional medical advice. Over-the-counter drug products should be used only as directed by their Drug Facts label. If you are experiencing severe pain or rectal bleeding, seek medical care.