How long does it take for hemorrhoid cream to kick in?

Affecting about 1 in 20 Americans, hemorrhoids are a common issue [1.6.5]. When seeking relief, many wonder: how long does it take for hemorrhoid cream to kick in? The answer depends on the cream's active ingredients, which work in different ways to soothe symptoms.

Quick Summary

The time it takes for hemorrhoid cream to provide relief varies by its active ingredients. Anesthetics like lidocaine can work in 30-60 minutes, while vasoconstrictors and steroids may take longer to reduce swelling and inflammation.

Key Points

• Speed Varies by Ingredient: How long a hemorrhoid cream takes to work depends on its active ingredients; anesthetics are fastest for pain.

• Anesthetics for Fast Pain Relief: Ingredients like lidocaine can numb the area and relieve pain in as little as 30-60 minutes [1.4.1].

• Steroids for Inflammation: Hydrocortisone reduces swelling and itching but takes a few days of consistent use to show results [1.5.2].

• Vasoconstrictors Shrink Tissue: Phenylephrine starts working within hours to shrink swollen hemorrhoidal tissue, easing discomfort [1.2.1, 1.3.1].

• Proper Application is Key: Clean the area and apply the cream as directed (externally or with an applicator) to ensure maximum effectiveness [1.7.1].

• Short-Term Use Only: Most OTC creams should not be used for more than one week without a doctor's advice [1.5.2].

• Consult a Doctor: If symptoms persist for more than 7 days or if you experience heavy bleeding, see a healthcare provider [1.9.2].

Understanding Hemorrhoids and How Creams Help

Hemorrhoids, also known as piles, are swollen and inflamed veins located in the lower rectum or around the anus [1.6.5]. They can cause symptoms like pain, itching, swelling, and sometimes bleeding [1.9.1]. Hemorrhoid creams are topical treatments designed to alleviate these symptoms, but they don't cure the underlying condition [1.2.1]. The effectiveness and speed of relief depend entirely on the active ingredients in the formula. These ingredients fall into several categories: local anesthetics, vasoconstrictors, corticosteroids, and protectants [1.8.3, 1.8.4].

The Speed of Relief: An Ingredient-by-Ingredient Breakdown

The onset of action for hemorrhoid creams is not uniform. Some ingredients provide rapid numbing, while others work over several days to reduce inflammation.

• Local Anesthetics (Lidocaine, Pramoxine, Benzocaine): These ingredients work by numbing the nerve signals in the affected area, providing rapid relief from pain and itching [1.8.3]. Creams containing lidocaine typically start working within 30 to 60 minutes [1.4.1, 1.4.2]. The numbing effect can last for about one to three hours [1.4.1].
• Vasoconstrictors (Phenylephrine): Phenylephrine works by temporarily shrinking the swollen hemorrhoidal blood vessels [1.8.4]. This action helps to soothe itching and reduce discomfort. When administered rectally, phenylephrine reaches peak concentration in about 30 to 60 minutes [1.3.1, 1.3.2]. Some products containing this ingredient claim to provide relief within a few hours [1.2.1].
• Corticosteroids (Hydrocortisone): Hydrocortisone is a low-potency steroid that reduces inflammation, redness, swelling, and itching associated with hemorrhoids [1.2.2, 1.5.2]. However, it does not work as quickly as anesthetics. It generally takes a few days of consistent application for hydrocortisone cream to relieve symptoms [1.2.2, 1.5.4]. These creams should not be used for more than seven days unless directed by a doctor, as long-term use can thin the skin [1.5.2, 1.5.4].
• Protectants (Glycerin, Petrolatum, Mineral Oil): These ingredients create a physical barrier over the irritated tissue [1.2.3]. This barrier helps to make bowel movements less painful and protects the area from further irritation [1.2.3]. Their effect is immediate upon application in terms of protection and lubrication, but they do not actively shrink hemorrhoids or numb pain.
• Astringents (Witch Hazel): Witch hazel is a natural ingredient that can help cool and soothe irritated skin, acting as an astringent to shrink swollen tissues [1.8.3, 1.10.2]. Its primary function is to provide symptomatic relief from itching and irritation.

Comparison of Common Hemorrhoid Cream Ingredients

Active Ingredient	Type	Primary Action	Estimated Onset of Action
Lidocaine, Pramoxine	Local Anesthetic	Numbs the area to relieve pain and itching [1.8.3]	30–60 minutes [1.4.1]
Phenylephrine	Vasoconstrictor	Shrinks swollen blood vessels [1.8.4]	30-60 minutes to reach peak concentration [1.3.1]
Hydrocortisone	Corticosteroid	Reduces inflammation, swelling, and itching [1.2.2]	A few days of consistent use [1.5.2, 1.5.4]
Glycerin, Petrolatum	Protectant	Forms a protective barrier, lubricates [1.2.3]	Immediate protective effect
Witch Hazel	Astringent	Soothes and helps shrink tissue [1.8.3]	Provides immediate cooling sensation [1.10.2]

How to Maximize Effectiveness and Speed

Proper application is crucial for getting the fastest relief possible from your hemorrhoid cream. Following these steps can improve the cream's effectiveness:

1. Clean the Area: Before application, gently clean the affected area with mild soap and warm water, then pat dry with a soft cloth [1.7.2]. A sitz bath can also be beneficial [1.10.3].
2. Wash Your Hands: Always wash your hands thoroughly before and after applying the cream to prevent the spread of bacteria [1.7.3].
3. Apply as Directed: For external hemorrhoids, apply a small, pea-sized amount of cream to the area with your finger [1.7.3]. For internal use, many products come with a special applicator nozzle. Lubricate the tip, gently insert it into the rectum, and squeeze the tube as directed [1.7.1]. Do not use fingers for internal application [1.8.1].
4. Be Consistent: Apply the cream as frequently as the package directs, which is often in the morning, at night, and after each bowel movement [1.2.4, 1.7.2].
5. Don't Overuse: Most over-the-counter hemorrhoid creams are intended for short-term use, typically no more than 7 days [1.2.1, 1.5.2]. If symptoms persist or worsen, it's essential to consult a healthcare provider [1.9.2].

Complementary Home Remedies for Faster Healing

In addition to using creams, certain lifestyle adjustments and home remedies can help speed up the healing process:

• Increase Fiber and Water Intake: A high-fiber diet and plenty of fluids soften stool, making it easier to pass and reducing straining [1.11.4].
• Sitz Baths: Soaking the affected area in a few inches of warm water for 15-20 minutes several times a day can relieve pain and swelling [1.10.1, 1.10.4].
• Cold Compresses: Applying a cold pack to the anus for a few minutes can help numb the area and reduce swelling [1.10.3].
• Avoid Straining: Do not sit on the toilet for extended periods or strain during bowel movements, as this increases pressure on the veins [1.11.2].

When to See a Doctor

You should consult a doctor if your symptoms do not improve after one week of using over-the-counter treatments [1.9.2]. It is also crucial to seek medical attention if you experience severe pain, excessive or persistent rectal bleeding, or if your stool appears black or tarry, as these could be signs of a more serious condition [1.9.1, 1.9.2].

Conclusion

The time it takes for hemorrhoid cream to kick in varies from under an hour to several days, depending on the active ingredients. Local anesthetics like lidocaine offer the fastest relief from pain and itching, often within 30-60 minutes [1.4.1]. Vasoconstrictors like phenylephrine also work relatively quickly to reduce swelling [1.3.1]. In contrast, corticosteroids such as hydrocortisone take a few days to effectively decrease inflammation [1.5.2]. For best results, combine the use of an appropriate cream with proper application techniques and supportive home remedies. If symptoms don't resolve within a week, medical consultation is necessary [1.9.4].

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

Frequently Asked Questions

Which hemorrhoid cream works the fastest?

Creams with local anesthetics like lidocaine or pramoxine typically work the fastest for relieving pain and itching, often providing a numbing effect within 30 to 60 minutes [1.4.1, 1.4.2].

How long does it take for hydrocortisone to shrink hemorrhoids?

Hydrocortisone cream does not actually shrink or remove hemorrhoids, but it reduces the inflammation, swelling, and itching associated with them [1.2.2]. It generally takes a few days of regular use to notice an improvement in these symptoms [1.5.2, 1.5.4].

Can I use hemorrhoid cream every day?

Yes, you can use hemorrhoid cream every day, but it is intended for short-term relief. Most over-the-counter products recommend use for no longer than 7 days. If your symptoms persist beyond a week, you should consult a doctor [1.9.2, 1.11.3].

What's the difference between a cream with phenylephrine and one with lidocaine?

Phenylephrine is a vasoconstrictor that shrinks swollen blood vessels to reduce the size of the hemorrhoid [1.8.4]. Lidocaine is a local anesthetic that numbs the area to provide temporary relief from pain and itching [1.8.3]. Some creams contain both for dual action [1.8.2].

How often should I apply hemorrhoid cream?

You should apply hemorrhoid cream up to four times daily, especially in the morning, at night, and after each bowel movement, or as directed by the product's instructions or your doctor [1.7.2].

Do I need a prescription for strong hemorrhoid cream?

While many effective creams are available over-the-counter, stronger formulations, such as higher-concentration hydrocortisone (e.g., 2.5%) or lidocaine creams, may require a prescription from a doctor [1.5.1, 1.8.3].

What should I do if my hemorrhoids don't get better after using cream for a week?

If your symptoms do not improve or they get worse after one week of using an over-the-counter cream, you should stop using it and see a doctor. You may need a different treatment or have an underlying issue that needs to be diagnosed [1.9.2, 1.9.4].