Can You Use Hemorrhoid Cream on the Inside? A Guide to Internal vs. External Products

October 11, 2025 •

4 min read

According to the American College of Gastroenterology, approximately 50% of the population will experience hemorrhoids by age 50. For those with symptoms of internal hemorrhoids, a common and critical question arises: Can you use hemorrhoid cream on the inside? The short answer is yes, but only with specific products designed for that purpose and equipped with an applicator.

Quick Summary

The ability to use hemorrhoid cream internally depends on the product's formulation and whether it includes a designated applicator. Internal hemorrhoids require specialized products, often suppositories or creams with applicators, while external creams are not meant for internal use and can contain inappropriate ingredients. Always follow packaging instructions to ensure safe and effective treatment.

Key Points

Check the Label: Always use a hemorrhoid cream specifically indicated and labeled for internal (intrarectal) use and containing an applicator.
External Creams Aren't for Internal Use: Creams formulated solely for external hemorrhoids contain ingredients, like some local anesthetics, that are not intended for the less-sensitive internal rectal tissue and may cause irritation.
Use the Applicator Correctly: Follow the packaging instructions for the internal applicator, ensuring it is properly lubricated and inserted gently to avoid injury.
Alternatives Exist: For internal hemorrhoids, suppositories can be an effective alternative to creams, providing longer-lasting relief by releasing medication over time.
Consult a Doctor for Worsening Symptoms: If you experience severe pain, persistent bleeding, or if symptoms do not improve after seven days of self-treatment, contact a healthcare provider for an evaluation.
Combine with Lifestyle Changes: The most effective treatment involves medication combined with lifestyle changes, such as increasing fiber and water intake and avoiding straining.

Understanding Internal vs. External Hemorrhoids

Before determining how to apply a product, it's essential to understand the difference between internal and external hemorrhoids. The key distinction lies in their location relative to the dentate line, a midpoint in the anal canal.

Internal hemorrhoids form inside the rectum, above the dentate line. Because this tissue lacks nerve endings for pain, these hemorrhoids are often painless but can cause bleeding and, if severe, prolapse or bulge outside the anus.
External hemorrhoids develop under the skin around the anus, below the dentate line. This area has numerous nerve endings, making external hemorrhoids more prone to causing pain, itching, burning, and swelling.

Due to this physiological difference, the medication used for each type can differ. Creams intended for external use are formulated for the sensitive skin around the anus, while internal treatments deliver medication to the affected area inside the rectum.

The Proper Way to Use Cream Internally

For internal hemorrhoids, you should only use a product that explicitly states it is safe for intrarectal use. These products typically come with a round-tipped applicator that can be screwed onto the tube. Following the directions carefully is crucial for both safety and effectiveness.

Here are the general steps for internal application:

Use the bathroom first: Try to have a bowel movement before application to ensure the medicine remains in place as long as possible.
Clean the area: Wash your hands and the affected anal area gently with mild soap and warm water, then pat dry with a soft cloth or pad.
Prepare the applicator: Attach the applicator to the cream tube. Squeeze the tube slightly to fill the applicator and lubricate its tip with a small amount of the cream.
Insert gently: Gently insert the rounded applicator tip into the rectum, about 1 to 2 inches. Do not force it.
Apply the cream: Squeeze the tube to dispense the cream inside. A pea-sized amount is usually sufficient.
Withdraw and clean: Carefully remove the applicator. Thoroughly wash the applicator with soap and warm water after each use and replace the cover.
Wash your hands: Wash your hands again with soap and warm water to prevent spreading bacteria.
Wait before a bowel movement: Avoid having a bowel movement for at least an hour or two after applying the cream to allow the medication to work effectively.

Why External Creams Aren't for Internal Use

Using a cream not designed for internal application poses several risks. The primary reason is the difference in ingredients and their intended target tissue. Creams specifically labeled for external hemorrhoids often contain topical anesthetics, such as lidocaine or pramoxine. While effective for external pain, these ingredients are not needed for internal hemorrhoids, which have few pain-sensing nerves, and may even cause irritation to the delicate internal rectal lining. For instance, a cream with local anesthetics should not be used inside the rectum without a healthcare professional's guidance.

Prolonged use, especially with corticosteroid creams, can lead to thinning and damage of the rectal skin. An incorrect applicator or using your finger can also introduce bacteria, potentially leading to infection. Always check the product label to ensure it is suitable for intrarectal use.

Comparison of Internal and External Treatments


Feature	External Cream/Ointment	Internal Cream/Suppository
Intended Use	External hemorrhoids and perianal symptoms	Internal hemorrhoids and intrarectal symptoms
Applicator Included?	No, typically for fingertip application	Yes, typically comes with a disposable or reusable applicator
Common Active Ingredients	Protectants (petrolatum), Astringents (witch hazel), Local Anesthetics (pramoxine, lidocaine)	Protectants (mineral oil, petrolatum), Vasoconstrictors (phenylephrine), Steroids (hydrocortisone)
Primary Function	Relieves external pain, itching, burning, and swelling	Shrinks swollen tissue and forms a protective coating on internal tissues
Pain Relief	Provides external numbing relief for pain and soreness	Less focused on pain, as internal tissues are not as sensitive

Alternative Treatments and When to See a Doctor

For internal hemorrhoid symptoms, another common and effective option is a suppository. These are solid, cone-shaped medications that melt inside the rectum, releasing medicine over a longer period. They can often provide longer-lasting relief than a cream application.

Lifestyle changes are also a cornerstone of treatment. Increasing fiber intake, drinking more water, and avoiding prolonged toilet time can significantly help. Sitz baths, or warm shallow baths, can also soothe the area.

If you experience persistent bleeding, severe pain, or a worsening of your condition after a week of over-the-counter treatment, it is important to consult a healthcare professional. They can provide an accurate diagnosis and recommend more advanced treatment options, such as rubber band ligation or sclerotherapy, if necessary. The American Academy of Family Physicians offers additional guidance on hemorrhoid management.

Conclusion

While it is possible to use hemorrhoid cream on the inside, it is imperative to use a product specifically designed and labeled for intrarectal use. Applying an external-only cream can be ineffective for internal symptoms and may cause irritation. The proper use of an internal applicator, alongside lifestyle adjustments, can offer significant relief. Always follow the product's instructions and seek medical advice if your symptoms do not improve or if you experience unusual side effects. Your health and comfort depend on using the right medication in the right way.

Frequently Asked Questions

No, you should not insert a hemorrhoid cream meant for external use with your finger. Products for internal use come with a special applicator designed for safe, gentle insertion. Using a finger increases the risk of bacterial introduction and can cause injury or irritation.

Internal hemorrhoids are typically painless but may cause bleeding, as the tissue lacks nerve endings. External hemorrhoids form under the skin around the anus and are known for causing pain, itching, and swelling due to the numerous nerve endings in that area.

Suppositories are often considered better for internal hemorrhoids because they melt slowly inside the rectum, providing longer-lasting relief than a cream might. It is a matter of personal preference, but they are both effective options for internal issues.

Using external cream internally can be harmful because some external formulations contain local anesthetics that can irritate the sensitive internal rectal lining. Moreover, the lack of an applicator makes manual insertion risky and unsanitary.

You should not use over-the-counter hemorrhoid products for more than seven days without consulting a doctor. Prolonged use, especially with corticosteroids, can thin the skin and lead to other complications.

If your symptoms do not improve after a week of using an over-the-counter cream or if you experience bleeding or worsening pain, you should stop use and contact a doctor for a proper diagnosis and potentially a different treatment plan.

Creams with local anesthetics like lidocaine or pramoxine are generally intended for external use to numb pain on the skin's surface. They are not recommended for internal application without a healthcare professional's guidance, as the internal rectal lining does not have pain-sensing nerves that would benefit from this ingredient.