Treatments can include creams and ointments with ingredients like witch hazel, hydrocortisone, and phenylephrine, which can reduce swelling and calm itchy skin. Special pillows and bath salts can also provide relief. We researched dozens of over-the-counter hemorrhoid treatments and evaluated them for the following attributes: ingredients, price, and use.
Below, you’ll find the best over-the-counter hemorrhoid treatments on the market today.
We also like that Doctor Butler’s is formulated as an ointment to help moisturize and protect the painful fissures that often occur with hemorrhoids. Plus, the package includes “finger cots” for easy and mess-free applications.
Price at time of publication: $35
Zinc oxide (sometimes formulated as zinc sulfate, depending on the product) is a powerful mineral often used to treat diaper rash on babies. Zinc goes a long way when it comes to healing and protecting sensitive, damaged skin. Anusol Plus also includes pramoxine, an analgesic, to numb the pain. If you want the version that contains hydrocortisone (Anusol HC), your doctor can usually prescribe it.
Price at time of publication: $19
These ice packs, which include soft, skin-friendly covers, are made to stay flexible even when frozen, so they don’t cause further irritation. (Speaking of covers, these are also removable and machine washable.) Plus, the fact that you get two ice packs means you can constantly rotate and switch them out, if needed, rather than waiting for the same one to freeze all the time. Another bonus? They can double as heat packs.
Price at time of publication: $15
“During a sitz bath, you soak the rectal area in warm water for 10 to 15 minutes, two to three times daily,” says Dr. Arturo Bravo, a gastroenterologist at Houston Methodist Willowbrook Hospital. “Sitz baths work by improving blood flow and relaxing the muscle around the anus, called the internal anal sphincter.”
This sitz bath made by Thena, which includes Epsom salts and dead sea salt as well as nourishing coconut and magnesium oils, is both soothing and healing, reducing inflammation while repairing tissue damage. It can be dissolved into a special sitz device or simply blended into a warm bath within your tub.
Price at time of publication: $33
“The topical hemorrhoidal agents have not been fully assessed for safety in pregnancy,” says Matthew Bechtold, MD, a University of Missouri Health Care gastroenterologist. “Even though it’s unlikely that the ingredients in topical hemorrhoidal agents will harm the third-trimester infant, a discussion needs to be had between you and your obstetrician regarding therapy.”
Sitz baths are a pregnancy-safe treatment for hemorrhoids, but soaking your rectum three times a day isn’t always possible—and when you’re pregnant, you need hemorrhoid relief ASAP. Luckily, you can rely on good old-fashioned witch hazel to come through in a pinch, like this organic hemorrhoid balm by Motherlove. Made with witch hazel and yarrow, the balm can reduce inflammation and banish that frustrating hemorrhoid itch (in a totally baby-safe way).
Price at time of publication: $12
This ergonomic pillow is also massively portable, featuring a non-slip bottom for safety, a removable, washable cover, and non-deflating foam. You can use it at home, at work, in the car, or anywhere your inflamed bottom may need a little extra comfort.
Price at time of publication: $36
The Soothing Relief Anti-Itch Cream by Preparation H is our pick for best itch relief. While some other forms of Preparation H include phenylephrine or pramoxine, this one contains 1% hydrocortisone to provide instant and long-lasting itch relief, a maximum-strength percentage you don’t need a prescription for. We love that it can be used up to four times per day. But remember: Hydrocortisone hemorrhoid products should only be applied for one week unless otherwise instructed by a doctor.
Price at time of publication: $9
Once we narrowed down our options, we compared each hemorrhoid treatment’s benefits to its price tag. While some choices on our list may be more expensive than others, we wanted to give a wide range of options for buyers that would fit all needs and budgets. Based on all of these factors, we compiled this list of the best OTC hemorrhoid treatments.
What to Look for in an Over-the-Counter Hemorrhoid Treatment
Ingredients
There are several types of ingredients you may find in hemorrhoid treatments, and they’re generally designed to provide different kinds of relief.
According to Dr. Bechtold, you should consider products containing one or more of the following ingredients:
Witch hazel or zinc oxide, which can soothe, protect, and reduce itching and swelling Hydrocortisone, a topical steroid that can relieve swelling and itching Pramoxine or lidocaine, topical pain relievers that can numb the affected area Phenylephrine, which narrows blood vessels in the affected area
Creams vs. Ointments
The best approach may be one that doesn’t rely too heavily on any one ingredient but mixes and matches, as needed, to get the symptom relief you need. No matter what, don’t overuse any product containing hydrocortisone: “Limit use to one week if the product contains steroids,” Dr. Bechtold advises.
There are usually creams and ointments available for the OTC treatment of hemorrhoids, and there isn’t much difference in the ingredients between the two formulations, says Dr. Bechtold. Instead, the difference is found in the consistency or texture.
“Creams and ointments [have a different] ratio of oil and water,” he explains. “Creams have about the same amount of oil and water, [making them] good for treating wet or oozing skin conditions, [while] ointments have more oil than water, making them thicker and greasier.”
Ointments: In general, ointments add moisture to the skin and can stay on the skin surface longer, so if you need intense hydration and skin protection, an ointment may be the better choice. Creams: If you want something that absorbs more quickly into the skin and doesn’t leave any residue behind, a cream is your best bet.
Stool Softeners and Fiber
Since hemorrhoids usually develop as a result of constipation and straining to have bowel movements, Dr. Bravo says stool softeners actually play an important role in treatment.
“One of the most important steps in treating hemorrhoids is avoiding constipation—hard or infrequent stools—and stool softeners are a good option if you have chronic constipation,” he says. Increasing the amount of fiber in your diet by eating more fruits and vegetables is another good way to soften your stools, he says, adding that the recommended amount of dietary fiber is around 20 to 35 grams per day.
You can try an OTC stool softener like Colace (docusate), which doesn’t force you to have a bowel movement but simply makes it easier to pass stool. You can also try a natural stool softener with ingredients like psyllium, which is helpful if you can’t get enough fiber in your diet through the foods you eat.
Lifestyle Changes
No, you can’t buy a one-size-fits-all dietary supplement to prevent constipation and simplify your bowel movements. However, you can create a lifestyle that helps keep you regular (thereby relieving and, in many cases, avoiding constipation).
“The first step in the treatment of hemorrhoids is to eliminate constipation and restore regular, daily bowel movements with soft stool and without any straining,” says Dr. Kantsevoy. “Increase your fiber and fluid intake [and] if diet alone does not eliminate constipation, you should start taking bulking agents like Metamucil and Miralax.”
Make sure you also refrain from straining or lingering on the toilet, sitting for prolonged periods of time, and—if possible—taking medications that cause diarrhea or constipation, says Dr. Bechtold.
Why Trust Verywell Health
“After dietary and lifestyle modifications, you can try some medications for relief of symptoms,” Dr. Bechtold explains. “These include topical analgesics and steroids, venoactive agents, antispasmodic agents, and sitz baths.”
Dr. Bravo advises his patients not to overuse OTC treatments since some can weaken and irritate the skin with prolonged use. “You should not use hemorrhoid creams and suppositories, particularly hydrocortisone, for longer than one week unless your health care provider approves.”
The actual healing process can take longer, though, depending on the type of hemorrhoid you have. Internal hemorrhoids are treated with sitz baths, diet modifications, and OTC products. Dr. Govekar usually waits four to six weeks, and many patients see symptoms disappear in about a month. External hemorrhoids can take a few weeks to a month to go down in size.
“After that, I recommend warm—but not hot—sitz baths,” he says, “sitting in about 3 to 4 inches of water for about 15 minutes.”
If that doesn’t work, you can try medicated wipes containing witch hazel, which are considered safe in pregnancy and are a treatment recommended by the American College of Obstetricians and Gynecologists.
Fissures are tears in the skin around the hemorrhoid, and a thrombosed hemorrhoid is one that contains a blood clot. If your hemorrhoids bleed, you may need medical treatment. This might include rubber band ligation or other surgical procedures designed to cut off the hemorrhoid’s blood supply (causing it to shrink).
“Fissures are extremely painful and usually happen in patients who have constipation and have strained [during bowel movements],” he explains. “Acute fissures happen in many people, and if constipation is corrected, they usually heal in seven to 10 days.”
However, fissures can quickly become chronic and difficult to treat if constipation persists (unlike hemorrhoids, which are more easily treated and may go away without treatment). Some cases of chronic fissures may eventually require surgery, says Dr. Kantsevoy.
“Bleeding could be caused by something other than hemorrhoids, so you should have it checked out by a physician,” says Dr. Bravo, “[and] if you continue to have symptoms from hemorrhoids despite medical therapies or office-based procedures, you may require surgery.”
