How long do you leave hemorrhoid cream on? A Pharmacological Guide

Approximately 10 million people in the United States report experiencing hemorrhoids, a prevalence rate of 4.4% [1.2.1, 1.2.3]. A common question is, how long do you leave hemorrhoid cream on for effective treatment? The answer depends on the product and application type.

Quick Summary

Hemorrhoid cream is not meant to be wiped off; it's absorbed by the skin. After application, avoid bowel movements for 1-3 hours. Do not use most OTC treatments for more than 7 days without consulting a doctor.

Key Points

• Leave it On: Hemorrhoid cream is designed to be absorbed by the skin and should not be wiped off after application [1.3.1].

• Duration Limit: Do not use over-the-counter hemorrhoid treatments for more than 7 consecutive days without consulting a doctor [1.3.3].

• Application Frequency: Most creams can be applied up to 4 times a day, particularly after bowel movements and before bed [1.4.2].

• Wait After Application: Avoid having a bowel movement for at least 1-3 hours after applying the cream to ensure it's effective [1.4.1].

• Hydrocortisone Caution: Creams containing hydrocortisone should not be used for more than one week due to the risk of skin thinning [1.7.1].

• Internal vs. External: Use a finger for external application and the provided nozzle for internal application, inserting it no more than 1 inch [1.5.3].

• Consult a Doctor: If symptoms persist beyond a week, or if you experience severe pain or bleeding, seek medical advice immediately [1.9.2].

Understanding Hemorrhoid Cream Application

Hemorrhoid creams are topical treatments designed to be absorbed into the skin to relieve symptoms like itching, pain, and swelling. Unlike a cleansing product, you do not wipe the cream off after applying it [1.3.1]. The primary goal is to allow the active ingredients time to work. For both internal and external applications, it's recommended to avoid having a bowel movement for at least one to three hours after use, as this can wash away the medication and reduce its effectiveness [1.4.1, 1.5.5].

Most over-the-counter (OTC) hemorrhoid treatments are intended for short-term use, typically up to four times per day [1.3.3]. It is critical to stop use and consult a doctor if your symptoms do not improve within seven days [1.3.3, 1.4.2]. Products containing hydrocortisone, a steroid, should not be used for more than one week to avoid side effects like skin thinning [1.7.1, 1.7.2].

How to Apply External Hemorrhoid Cream

Proper application ensures the medication is effective and minimizes contamination.

1. Cleanse the Area: Gently wash the anal area with mild soap and warm water, then pat dry with a soft cloth or tissue [1.4.2]. A sitz bath can also be beneficial [1.10.3].
2. Wash Your Hands: Thoroughly wash your hands with soap and water before and after application [1.4.1].
3. Apply a Small Amount: Squeeze a pea-sized amount of cream onto your fingertip [1.5.1].
4. Gently Rub In: Apply the cream to the affected area around the outside of the anus [1.4.1].
5. Frequency: Apply up to 2-4 times daily, especially in the morning, at night, and after bowel movements, unless the product label directs otherwise [1.4.2].

How to Use Internal Hemorrhoid Cream Applicators

Many creams come with a special nozzle or applicator for treating internal hemorrhoids.

1. Empty Bowels if Possible: Try to have a bowel movement before internal application [1.5.2].
2. Prepare the Applicator: Puncture the tube's foil seal and attach the applicator nozzle [1.4.2]. Squeeze the tube to fill the applicator.
3. Lubricate: Apply a small amount of the cream or petroleum jelly to the tip of the applicator for easier insertion [1.5.2].
4. Insert Gently: Carefully insert the applicator about a half-inch to one inch into the rectum [1.5.3, 1.5.5]. Do not force it.
5. Apply the Cream: Squeeze the tube gently to release the medication inside the rectum [1.5.2].
6. Clean Up: Remove the applicator and wash it thoroughly with soap and warm water. Wash your hands again [1.4.1].
7. Rest: Try to sit or lie still for about 15 minutes to allow the medicine to melt and be absorbed [1.3.2].

Comparison of Common Active Ingredients

Hemorrhoid creams contain different active ingredients that target specific symptoms. Understanding these can help you choose the right product.

Active Ingredient	Type	Primary Function	Common Brands	Cautions
Phenylephrine HCl	Vasoconstrictor	Shrinks swollen hemorrhoidal tissue by temporarily restricting blood vessels [1.6.3, 1.6.5].	Preparation H	May cause temporary stinging. Can increase blood pressure; use with caution if you have heart problems or high blood pressure [1.8.2].
Hydrocortisone	Corticosteroid	Reduces inflammation, redness, swelling, and itching [1.7.2, 1.6.4].	Anusol-HC, Proctofoam HC	Do not use for more than 7 days. Prolonged use can cause skin thinning [1.7.1].
Lidocaine / Pramoxine	Local Anesthetic	Numbs the area to provide rapid relief from pain, soreness, and burning [1.6.3, 1.6.4].	Preparation H Rapid Relief, Germoloids	May cause slight burning upon application. Stop use if irritation worsens [1.6.3].
Witch Hazel	Astringent	A natural ingredient that cools, soothes, and calms irritated skin [1.6.3].	Tucks Medicated Pads	Generally gentle, but can dry out skin if overused [1.6.3].
Glycerin / Petrolatum	Protectant	Forms a protective barrier over the skin to make bowel movements less painful and prevent further irritation [1.6.1, 1.6.2].	Preparation H Ointment	Generally well-tolerated with minimal side effects [1.4.2].

Lifestyle Changes for Long-Term Relief

While creams provide symptomatic relief, lifestyle adjustments are crucial for preventing hemorrhoids from recurring.

• Increase Fiber Intake: Aim for 25-35 grams of fiber daily from fruits, vegetables, and whole grains to soften stool and prevent straining [1.10.1, 1.10.2].
• Stay Hydrated: Drink 6-8 glasses of water daily to help fiber work effectively and keep stools soft [1.10.2].
• Don't Strain: Avoid straining or holding your breath during bowel movements. Don't sit on the toilet for prolonged periods [1.10.2].
• Exercise Regularly: Physical activity like walking promotes healthy bowel function and can help you maintain a healthy weight, reducing pressure on rectal veins [1.10.1].
• Respond to Urges: Go to the bathroom as soon as you feel the urge to prevent stool from becoming hard and dry [1.10.3].

When to See a Doctor

It is important to seek medical advice if your condition doesn't improve or worsens. Consult a healthcare provider if you experience:

• Symptoms that persist for more than one week despite using OTC remedies [1.9.2, 1.9.5].
• Significant rectal bleeding [1.9.5].
• Severe pain or discomfort [1.9.2].
• A lump that doesn't go away or is very painful [1.9.4].
• Changes in your bowel habits or stool color (maroon or tar-like), which could indicate a more serious condition [1.9.2, 1.9.3].

Conclusion

Hemorrhoid cream should be left on to be absorbed and should not be wiped away. Adhering to the recommended application frequency, typically up to four times a day, and not exceeding a one-week treatment course without medical advice, is key for safety and efficacy [1.3.3, 1.7.4]. Combining topical treatments with positive lifestyle changes, such as a high-fiber diet and regular exercise, offers the best strategy for managing and preventing hemorrhoids long-term [1.10.2]. If symptoms are severe or persistent, a doctor can provide a proper diagnosis and more advanced treatment options.

For more information on hemorrhoid treatment, you can visit the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

Frequently Asked Questions

Do you wipe off hemorrhoid cream?

No, you do not wipe off hemorrhoid cream. It is intended to be absorbed into the affected area to provide relief. You should try to avoid bowel movements for 1 to 3 hours after application [1.3.1, 1.4.1].

How many times a day should you apply hemorrhoid cream?

You can typically apply hemorrhoid cream up to 4 times daily. It's often recommended to use it in the morning, at bedtime, and after each bowel movement [1.3.3].

How long does it take for hemorrhoid cream to work?

While some ingredients like lidocaine can provide immediate numbing relief, it may take a few days of consistent use for symptoms like swelling and irritation to improve. If there is no improvement after 7 days, you should see a doctor [1.4.2, 1.7.2].

Can I use hemorrhoid cream every day?

You can use most hemorrhoid creams every day, but not for more than 7 consecutive days. Long-term use, especially of steroid creams like hydrocortisone, can lead to side effects such as skin thinning [1.7.1].

What happens if you use too much hemorrhoid cream?

Overusing hemorrhoid cream, particularly those with steroids or vasoconstrictors, can lead to side effects like skin irritation, thinning, increased blood pressure, or nervousness. Always follow the product's directions [1.8.1, 1.8.2].

Is it better to use cream or a suppository for internal hemorrhoids?

Both creams with an applicator and suppositories are effective for internal hemorrhoids. A suppository is a solid plug of medicine that melts inside the rectum, while a cream is applied via a nozzle. The choice often comes down to personal preference [1.3.2, 1.4.3].

When should I see a doctor for my hemorrhoids?

You should see a doctor if your symptoms don't improve after one week of at-home treatment, if you have severe pain, or if you experience significant rectal bleeding. These could be signs of a more serious condition [1.9.2].