Understanding the Relief: What Does Hemorrhoid Cream Do?

Hemorrhoidal disease is a common condition, with a self-reported incidence of 10 million cases per year in the United States [1.13.2]. So, what does hemorrhoid cream do? These topical treatments are designed to temporarily relieve the primary symptoms like swelling, burning, pain, and itching [1.2.1].

Quick Summary

Hemorrhoid cream works by using active ingredients to shrink swollen tissue, numb the affected area to relieve pain and itching, and provide a protective barrier to reduce irritation [1.2.1, 1.2.3].

Key Points

• Symptom Relief: Hemorrhoid creams temporarily relieve symptoms like swelling, burning, pain, and itching caused by hemorrhoids [1.2.1].

• Vasoconstriction: They often contain ingredients like phenylephrine that narrow blood vessels to shrink swollen hemorrhoidal tissue [1.5.2].

• Pain and Itch Blocking: Local anesthetics such as lidocaine and pramoxine are used to numb the area and block pain signals [1.4.3].

• Protective Barrier: Ingredients like zinc oxide, glycerin, and mineral oil form a protective layer to prevent irritation from contact with stool [1.2.1, 1.2.4].

• Anti-Inflammatory Action: Some creams include hydrocortisone, a steroid that reduces inflammation and swelling, but should be used for less than a week [1.2.2].

• Astringent Properties: Witch hazel acts as an astringent to tighten tissues and relieve burning and irritation [1.8.1, 1.8.2].

• Usage Limitation: If symptoms do not improve within 7 days, or if bleeding occurs, it is important to stop use and consult a doctor [1.12.2].

The Burden of Hemorrhoids

Hemorrhoids, also known as piles, are swollen veins in the lower rectum and anus. This common condition can cause significant discomfort, affecting daily life with symptoms like pain, itching, swelling, and sometimes bleeding [1.2.1, 1.12.3]. Affecting millions of people, it is the fourth leading outpatient gastrointestinal diagnosis in the U.S. [1.13.2]. While lifestyle changes like increasing fiber intake are crucial for long-term prevention, over-the-counter (OTC) hemorrhoid creams offer targeted, temporary relief from these disruptive symptoms [1.2.2]. These creams are applied topically to the affected area and contain a combination of active ingredients designed to tackle specific symptoms.

How Do Hemorrhoid Creams Provide Relief?

Hemorrhoid creams are multi-action formulas designed to address the various symptoms of hemorrhoids through specific pharmacological agents. Their primary goals are to reduce swelling, alleviate pain and itching, and protect the irritated tissue [1.2.1]. This is achieved through several classes of active ingredients that work in different ways to bring comfort.

The Role of Active Ingredients

Understanding the label of a hemorrhoid cream is key to choosing the right product for your symptoms. Most creams are a cocktail of ingredients, each with a distinct function.

• Vasoconstrictors: Ingredients like phenylephrine are a mainstay in many hemorrhoid creams [1.4.2]. They work by temporarily narrowing, or constricting, the blood vessels in the anal area. This action directly reduces the swelling of hemorrhoidal tissue, which in turn helps to relieve the discomfort and pressure [1.5.2, 1.5.3].
• Local Anesthetics: To combat the often-intense pain and itching, creams include local anesthetics such as lidocaine, pramoxine, or benzocaine [1.4.3, 1.6.2]. These ingredients work by blocking the nerve signals in the skin that transmit sensations of pain and itchiness, providing a temporary numbing effect and immediate relief [1.3.2]. Lidocaine is noted for having a faster onset, while pramoxine may be associated with fewer allergic reactions [1.6.2].
• Protectants: Ingredients like glycerin, zinc oxide, mineral oil, petrolatum, and cocoa butter act as protectants [1.2.1, 1.7.4]. They form a soothing, protective barrier over the inflamed and irritated tissue [1.2.3]. This coating serves two purposes: it prevents the sensitive area from having painful contact with stool, making bowel movements less uncomfortable, and it helps to retain moisture, preventing further drying and irritation [1.7.1].
• Astringents: Witch hazel is a common astringent found in many hemorrhoid preparations, including creams and medicated pads [1.8.1]. Astringents work by causing the skin and other tissues to tighten and shrink. This helps to dry out the affected area, reduce swelling in the blood vessels, and relieve burning and itching [1.8.2].
• Corticosteroids: Some hemorrhoid creams contain a low-dose steroid like hydrocortisone [1.2.2]. Hydrocortisone is an anti-inflammatory agent that is very effective at reducing swelling, redness, and itching [1.9.1]. However, steroid-containing creams should be used for a limited time, typically no more than a week unless directed by a doctor, as prolonged use can cause the skin to thin [1.2.2, 1.11.2].

Comparison of Common Hemorrhoid Treatments

Treatment Type	Primary Use	Active Ingredients	How it Works
Creams/Ointments	External & Internal (with applicator)	Phenylephrine, Lidocaine, Hydrocortisone, Zinc Oxide	Applied topically to shrink tissue, numb pain, reduce inflammation, and protect skin [1.2.1, 1.3.3].
Suppositories	Internal Hemorrhoids	Same as creams (e.g., Phenylephrine, Cocoa Butter)	Inserted into the rectum, where it dissolves to deliver medication directly to internal hemorrhoids [1.14.1, 1.14.2].
Medicated Wipes	External Cleansing & Soothing	Witch Hazel, Aloe Vera	Used for gentle cleansing after bowel movements to reduce irritation and apply a soothing astringent [1.8.2].

Proper Application for Maximum Efficacy

Using hemorrhoid cream correctly is essential for getting the most relief. Always follow the product's specific directions.

For External Use:

1. Cleanse the affected area with mild soap and warm water, then rinse thoroughly [1.10.3].
2. Gently dry the area by patting with a soft cloth or toilet tissue.
3. Apply a small amount of cream to your finger and rub it gently onto the external anal area [1.10.1].
4. Repeat up to 4 times daily, especially in the morning, at night, and after each bowel movement [1.2.1].

For Internal Use:

1. Cleanse and dry the external area as described above.
2. Attach the provided applicator nozzle to the tube [1.10.1].
3. Squeeze the tube to fill the applicator with cream.
4. Lubricate the tip of the applicator.
5. Gently insert the applicator into the rectum, about 1/2 to 1 inch deep [1.9.1].
6. Squeeze the tube gently to dispense the medication inside the rectum [1.10.1].
7. Clean the applicator thoroughly with soap and warm water after each use [1.10.1].

When to See a Doctor

Over-the-counter hemorrhoid creams are intended for temporary relief of mild symptoms. It is important to consult a healthcare provider if your symptoms do not improve after one week of home treatment [1.12.2]. You should also 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 [1.12.1, 1.12.2].

Conclusion

Hemorrhoid cream serves as a valuable first-line defense against the uncomfortable symptoms of hemorrhoids. By combining vasoconstrictors to shrink swelling, anesthetics to numb pain, and protectants to shield irritated skin, these widely available treatments provide significant temporary relief [1.2.1, 1.2.3]. While they do not cure the underlying condition, they effectively manage the discomfort, allowing individuals to go about their day more comfortably. For persistent or severe symptoms, consulting a doctor is crucial for proper diagnosis and a comprehensive treatment plan.

For more information on hemorrhoid diagnosis and treatment, you can visit the Mayo Clinic.

Frequently Asked Questions

How quickly does hemorrhoid cream work?

Hemorrhoid cream can provide immediate relief from symptoms like itching and burning, especially formulas containing local anesthetics like lidocaine, which can start working in 30 to 60 minutes [1.8.2, 1.4.3].

Can I use hemorrhoid cream for internal hemorrhoids?

Yes, many hemorrhoid creams are suitable for both internal and external use and come with a special applicator nozzle for applying the cream inside the rectum [1.10.1, 1.9.1].

What is the difference between hemorrhoid cream and ointment?

Creams and ointments are very similar. Ointments typically have a higher oil concentration, giving them a greasier consistency which can provide a more robust protective barrier [1.5.1]. The choice between them is often a matter of personal preference.

What's the main active ingredient in Preparation H?

One of the main active ingredients in many Preparation H products is phenylephrine, a vasoconstrictor that shrinks swollen hemorrhoidal tissues. Some formulations also contain pramoxine for pain relief or hydrocortisone for inflammation [1.5.4, 1.9.2].

Are there side effects to using hemorrhoid cream?

Side effects are not common when used as directed but can include mild stinging or pain at the application site. Creams with vasoconstrictors can, in rare cases, cause nervousness or an irregular heartbeat. Steroid creams can cause skin thinning if used for more than a week [1.11.1, 1.11.2].

How often can I apply hemorrhoid cream?

Most hemorrhoid creams can be applied up to 4 times daily, typically in the morning, at bedtime, and after each bowel movement, unless otherwise directed by a doctor [1.2.1].

When should I see a doctor for my hemorrhoids?

You should see a doctor if your symptoms do not improve after one week of using over-the-counter treatments, if you have severe pain, or if you experience rectal bleeding [1.12.2].