Hemorrhoid Medicine 101

Witch hazel

Witch hazel is a common over-the-counter hemorrhoid treatment.^1,2,3 It is a plant-derived astringent, that can shrink body tissue. When applied topically (on the surface of the skin), witch hazel can help gently reduce the local discomfort and itching caused by hemorrhoids.^1,2,3 You can find hemorrhoid wipes that contain varying amounts of this active ingredient.

Lidocaine

Some hemorrhoid wipes, such Preparation H Rapid Relief Totables Wipes, may instead have lidocaine as an active ingredient. Found on the World Health Organization’s Model List of Essential Medicines⁴, lidocaine is a local anesthetic; it stops the nerves from signaling pain to the brain.⁵ Hemorrhoid wipes with lidocaine can help provide temporary local relief from soreness, burning, and pain, as well as local itching and discomfort.²

Phenylephrine HCI

You can purchase lidocaine wipes that also have other active ingredients such as phenylephrine. Phenylephrine is a vasoconstrictor that helps to temporarily reduce the swelling of hemorrhoidal tissue and make bowel movements easier.⁷

Glycerin and other soothers

Some hemorrhoid wipe products are infused with other ingredients like glycerin, aloe, or vitamin E. Glycerin is a hyperosmotic laxative that helps transfer water from body tissues into the bowel.⁸ It helps soften stool and can help increase bowel movement.⁸

Before using a wipe, be sure to read the full ingredient list to make sure that they are free from ingredients that you may be allergic to.

How to Use a Hemorrhoid Wipe

Hemorrhoid wipes with witch hazel may be used when the area needs to be cleansed, such as after a bowel movement, and can be used before applying other topical treatments like creams and ointments. To use a hemorrhoid wipe, follow these steps*:

1. Open the wipes container or peel back the seal.
2. Pull out a new wipe and unfold.
3. Gently cleanse the hemorrhoid area with the wipe by blotting, patting, and wiping.
4. Repeat this process as necessary.
5. Discard wipe. (Preparation H wipes are flushable, biodegradable and septic safe.)

*Use as directed on the product label.

You can also keep a folded wipe in place as a moist compress for up to 15 minutes to soothe the irritated area.

Creams

A second option when it comes to hemorrhoid medicine is a cream. Hemorrhoid creams may provide relief for a variety of symptoms, from itching to pain.^1,2,3 Like wipes for hemorrhoids, there are different types of hemorrhoid treatment creams that contain different active ingredients.

Hydrocortisone

The first common formulation is a cream with hydrocortisone. Hydrocortisone is a corticosteroid, an anti-inflammatory drug which helps to reduce topical itching and redness.⁶ Rectal hydrocortisone helps provide relief from the itching and discomfort that hemorrhoids cause.^3,6 Creams with higher concentrations of hydrocortisone are available by prescription while those with lower concentrations can be purchased over the counter. (We, of course, recommend Preparation H Soothing Relief Hydrocortisone Cream.)

Lidocaine

Another common ingredient in hemorrhoid creams is one that you’ll also find in wipes—lidocaine. As we mentioned, lidocaine is a local anesthetic and works to stop nerves from sending pain signals to the brain.⁵ Like hemorrhoid wipes with lidocaine, an over-the-counter cream with lidocaine can help provide temporary local relief from soreness, burning, pain, itching and the general discomfort caused by hemorrhoids.²

Pramoxine

Some hemorrhoid creams also include pramoxine as an ingredient. Pramoxine is a topical anesthetic that can relieve soreness, burning, itching and pain caused by hemorrhoids.⁹ It works by preventing the nerves from sending pain signals.⁹

How to Use Hemorrhoid Cream

Hemorrhoid creams are intended for topical use (that means you use them on the surface of your body—not internally). They are generally suitable for adults. Always consult a doctor before using hemorrhoid cream on a child. To use a hemorrhoid cream, follow these steps:

1. When practical, gently clean the area with a wipe or other method and pat or blot dry before applying a cream.
2. Apply the cream externally or to the lower portion of the anal canal. Follow the label to determine how many times per day it can be used.

Ointments

A third hemorrhoid medicine is ointment. What’s the difference between ointments and creams? The ratio of oil to water.

Generally, ointments contain a higher concentration of oil, creams tend to have a higher concentration of water. Because of the different oil-to-water ratio, creams and ointments differ in their texture. Your skin will typically absorb a water-based cream, faster than an oil-based ointment, which will remain on the surface of the skin for longer.

Ointments for hemorrhoids can contain ingredients which can offer different benefits. Some common ingredients that are found in ointments for hemorrhoids are mineral oil, petrolatum, phenylephrine, benzoic acid and glycerin.¹⁰

Protectorants

Many include protectants like mineral oil and petrolatum that help protect the anorectal area to make bowel movements more comfortable¹⁰. They can also help provide relief from local itching and discomfort.

How to Use Hemorrhoid Ointment

Hemorrhoid ointments are for use on adults. Consult a doctor before using a hemorrhoid ointment for a child. To use a hemorrhoid ointment, follow these steps*:

1. When practical, gently cleanse and dry the affected area.
2. For internal use, remove the ointment applicator cap and gently insert the applicator into the rectum.
3. For external use, squeeze a dime-size amount onto the tip of your finger.¹¹ Apply the cream externally or apply it to the lower portion of the anal canal to the area as needed.
4. Be sure to replace the cover and cleanse the applicator after use.

*Use as directed on the product label.

Gels

Another option for hemorrhoid relief are gels for hemorrhoids. You can use them like how you would use hemorrhoid creams. They can help relieve pain, burning and itching caused by hemorrhoids.

Suppositories

Suppositories have a common use for nighttime relief from hemorrhoids. You insert them in your rectum. They can help shrink swollen tissue and lessen further irritation caused by hemorrhoids.¹²

You have a lot of options when it comes to care for your derriere. While you’ve gained an understanding of available for over-the-counter hemorrhoid medicine, consider using our Relief Finder to help find the Preparation H that’s right for you. Always consult a doctor before trying any new hemorrhoid medications. Each hemorrhoid medication is different, so be sure to read the instruction label before use.