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Best hemorrhoid cream: what to look for

At a glance

Hemorrhoid creams are among the most commonly used treatments for hemorrhoid symptoms. They are available over the counter from pharmacies and can provide temporary relief from itching, burning, and mild pain. They do not cure hemorrhoids, but they can make flare-ups more comfortable while other measures take effect.

This guide explains what to look for in a hemorrhoid cream, what different ingredients do, and what to keep in mind.

What hemorrhoid creams do

Hemorrhoid creams work by addressing symptoms rather than the underlying cause. They may:

  • Soothe irritated tissue
  • Reduce itching through anti-itch ingredients
  • Decrease inflammation through steroids or other anti-inflammatory agents
  • Provide a barrier that protects the skin
  • Temporarily numb the area through local anaesthetics

What to look for

Key ingredients and what they do

Local anaesthetics (e.g., lidocaine): numb the area temporarily, providing relief from pain and itching. Useful during acute flare-ups. Should not be used long-term.

Steroids (e.g., hydrocortisone): reduce inflammation and itching. Effective but should not be used for more than seven days without medical guidance, as prolonged use can thin the perianal skin.

Protectants (e.g., zinc oxide, bismuth): create a barrier on the skin, protecting it from moisture and irritation. Soothing and low-risk for longer use.

Vasoconstrictors: reduce swelling by constricting blood vessels. Found in some formulations. Not suitable for everyone.

Soothing agents (e.g., witch hazel, aloe): provide a cooling or calming sensation. Generally gentle and well-tolerated.

Choosing between options

If your main symptom is…Look for…
ItchingHydrocortisone (short-term) or soothing agents
PainLocal anaesthetic (lidocaine)
BurningProtectant or soothing agent
SwellingAnti-inflammatory or vasoconstrictor
General discomfortA combination product

Practical considerations

  • Unscented products are generally better tolerated — fragrances can irritate
  • Check the instructions — some products are for external use only; others include an internal applicator
  • Ask a pharmacist if you are unsure which product is appropriate for your symptoms
  • Short-term use — most hemorrhoid creams are designed for up to seven days. If symptoms persist, see a clinician

What creams do not do

Hemorrhoid creams do not:

  • Shrink hemorrhoids permanently
  • Treat the underlying cause (constipation, straining, pressure)
  • Replace dietary and lifestyle changes
  • Substitute for medical treatment when symptoms are significant

They are one tool among many — useful for comfort, but most effective when combined with stool management, adequate hydration, and other measures.

When to see a clinician

If hemorrhoid symptoms persist despite cream use and self-care measures for more than two weeks, it is time to see a clinician. They can assess the hemorrhoids properly and discuss whether further treatment — banding, medication, or other interventions — is appropriate.

When to seek care

If you experience any of the following, seek urgent medical care:

  • Symptoms that do not improve after two weeks of treatment
  • Heavy or persistent bleeding
  • Severe pain or a new, rapidly growing lump
  • Signs of allergic reaction to any product

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