If you’re feeling bum irritation or discomfort, you’re not alone. In fact, 75% of American men and women experience hemorrhoids at some point in their lifetime. Hemorrhoids are a painful condition which causes the veins and blood vessels inside the anus and rectum to swell up.
Also known as piles, hemorrhoids may be internal or external. Both varieties cause excruciating pain while passing stools. Frequent constipation, pregnancy, obesity, liver cirrhosis and some other health issues are the common causes of piles.
It is estimated that nearly 10 million Americans suffer from hemorrhoids annually. If statistics are to be believed, it is likely that half the population of the world will suffer from this malady by the age of 50.
The best way to cure hemorrhoids permanently is through proper diet, active lifestyle and some home remedies though a few people need surgical intervention. An important part of the treatment is the use of hemorrhoid creams and ointments.
Dramatic relief for most haemorrhoid symptoms can be found with simple, home remedies including over the counter haemorrhoid creams and ointments.
In this guide, I will talk about 10 best hemorrhoid creams to get rid of piles permanently. One of them is exceptionally effective as it contains several beneficial ingredients, rather then one of two that is typical to other products for hemorrhoids. Scroll down to find out which one it is.
How to Choose the Best over the Counter Hemorrhoid Cream?
Not everyone needs to see a doctor for hemorrhoids treatment. In mild cases, soaking in hot sitz bath, taking fibre supplements (or eating a fibre-rich diet), avoiding straining during bowel movement are some home remedies to treat piles.
If these do not show results, one can try applying a hemorrhoid cream before and after having a bowel movement. This helps numb the pain and gives much-needed best hemorrhoid relief from itching, burning and swelling.
There are many fantastic over the counter hemorrhoid ointments that work well for most people. But how does one choose a hemorrhoid product given the fact that there are so many varieties in the market?
What Are the Active Ingredients to Look For?
Below is a list of active ingredients to look out for in your hemorrhoid cream. It is a good idea to be informed about these ingredients and know how each one works. This way, you can choose a product that is specific to your needs.
Phenylephrine
Phenylephrine HCL is an active ingredient in Preparation H, a popular OTC hemorrhoid medicine. It works by soothing inflamed tissues and basically acts as a vasoconstrictor.
What this means is that Phenylephrine HCL shrinks the swollen hemorrhoid tissues which helps prevent pain during passing of stools. This over the counter hemorrhoid treatment can be used for external as well as internal piles and is available as suppositories or cream.
Hydrocortisone
1% hydrocortisone cream for hemorrhoids treatment can be purchased without a prescription. It relieves itchiness and inflammation of the anal tissue, so several over the counter hemorrhoid creams contain this ingredient.
For severe itchiness and inflammation caused by internal hemorrhoids, you can use 2.5% hydrocortisone suppositories.
Lidocaine
Lidocaine sold under brand name Xylocaine is a local topical anesthetic that is present in the best hemorrhoid relief suppositories. It works on inflamed anal tissues causing numbness which eases the severe burning and pain.
However, long-term use of such hemorrhoid creams should be avoided as, over time, it can increase irritation and dryness of rectum. Some patients also report burning sensation after using lidocaine. Having said that, lidocaine based creams can be very useful for managing severe anal pain caused by internal or external piles.
This ingredient is particularly beneficial to apply before having a bowel movement especially when dry, hard stools reopen the anal fissures and tears that aggravate burning.
Dibucaine
Nupercainal or Dibucaine, like lidocaine, works by numbing the rectal tissues. It acts as a topical painkiller to prevent itching, burning and pain. You can apply dibucaine cream, ointment or suppositories 3-4 times a day when symptoms are unbearable. These suppositories may be safely used up to 5 times a day.
Pramoxine Hydrochloride
This is sold under brand name Tronolane. It has a numbing, anesthetic action like Dibucaine and Lidocaine. Pramoxine HCL relieves pain, burning, itching and dryness. Its antipruritic action is particularly beneficial for preventing severe anal itching that occurs when anal tissues are dry and irritated.
Benzocaine
Many over-the-counter hemorrhoid preparations contain this numbing agent. Benzocaine numbs the anal tissues to provide much-needed relief from itching, inflammation and pain. It has a desensitising action. However, some people are allergic to benzocaine and the resulting symptoms can worsen the hemorrhoid pain.
Zinc Oxide
Unlike other ingredients above, zinc oxide works by forming a protective barrier on the anal tissues to prevent inflammation, irritation and burning. It is particularly beneficial for relieving pain caused by anal fissures.
The sticky coat of zinc oxide forms a protective barrier around the anus. You can apply the cream before and after a bowel movement to stop the burning, itchiness and irritation.
If you’re feeling bum irritation or discomfort, you’re not alone. In fact, 75% of American men and women experience hemorrhoids at some point in their lifetime.
Go for zinc oxide based hemorrhoid creams if you are looking to form an anal protective barrier for all-day relief from hemorrhoid pain.
Note that zinc oxide based creams tend to have a sticky sensation which some people might find uncomfortable. The astringent action of zinc oxide is also beneficial in preventing bleeding.
Witch Hazel
Witch hazel, like zinc oxide, has an astringent action that stops bleeding. This herbal ingredient also acts as an analgesic and relieves pain, burning and itchiness. It causes the surface blood vessels to shrink and contract.
You can simply soak a cotton ball in witch hazel and refrigerate it for an hour. Insert the cool cotton wool in the anal area to relieve pain and burning. You can easily find many hemorrhoid creams on the market containing this soothing herbal ingredient.
Protectants
For mild hemorrhoids, a protectant cream is all you need for relief. These creams protect the inflamed anal tissues from stool, faeces, sweat and friction while walking. The zinc oxide based creams described above belong to the category of protectants.
Other ingredients that function similarly are lanolin, mineral oil, petrolatum/petroleum jelly, shark or cod liver oils, cocoa butter, glycerin, calamine, Aloe Vera extract, amino acids etc. Many of these ingredients also have antimicrobial action that kills germs.
Ingredients like cocoa, Shea and mango butters reduce friction and abrasion caused by underwear or hard stools. However, many of these ingredients do not always provide relief for severe itching, burning and pain.
So which ointment is best for piles?
Best Hemorrhoid Cream on the Market: Products Review
We will now discuss some of the best medicine for hemorrhoids you can buy but before we discuss 10 of the best medicines for over the counter hemorrhoid treatment, we must mention wipes.
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Wipes are No products found.. These make it very easy to apply the chose OTC hemorrhoid treatment without having to use hands. The wipes from Preparation H contain Aloe Vera and Witch Hazel and can even be used by people without piles. Here are its salient features:
Pros
- Preparation H flushable wipes contain hydrocortisone that relieves itch, burning and pain.
- They do not dry out quickly and retain their moistness for a long time.
- Preparation H wipes are flushable-so they won’t clog your toilet and are safe for your septic tank.
- Apart from anal area, you can also use these wipes for other body parts to freshen up.
- People who do not suffer from hemorrhoids also love No products found. They are much better than using dry, abrasive toilet paper.
- The added natural ingredients - aloe vera, and witch hazel soothe the anal tissues and give you complete cleaning to prevent germs and infections.
Cons
- Recent changes to the manufacturing process have rendered these wipes weak. They are made with plant materials which, while recyclable and biodegradable, also tear easily.
- The dispenser does not pull out the next wipe after you pull the previous one.
Top 10 Best Hemorrhoids Creams
Here are top 10 bestselling hemorrhoids creams in the market.
1. No products found. - Best Hemorrhoid Cream - FDA Approved Maximum Strength Pain Relief with Organic Healing Formula
More than forty five thousand users have benefited from Dr Butler’s hemorrhoids cream and over a thousand have rated it as the No products found. on the market. People are even stating that it is better than Preparation H cream!
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Pros
- This hemorrhoid cream has actually been developed by a Board-certified doctor/proctologist who is available to answer your questions.
- It protects, soothes and relieves irritated tissue.
- Amazon assures money back guarantee in the rare case that you aren’t satisfied with this best cream for piles. No wonder it is bestselling cream in this category.
- Dr Butler’s hemorrhoid cream takes care of pain, bleeding, itching, swelling, inflammation, irritation, dryness, fissures, internal and external piles etc. Still wondering what hemorrhoid cream works best?
- Safe and effective, this hemorrhoid treatment has undergone rigorous quality testing.
- Combines powerful healing herbs, amino acids, along with other pain relieving ingredients described above.
- It has ALL necessary ingredients including lidocaine (numbing analgesic), phenylephrine (vasoconstrictor), algae extracts, aloe vera, calendula oil, ginseng extract, gotu kola. Dr Butler’s hemorrhoid cream also has hydrocortisone for relieving pain, itch and swelling. Zinc oxide, mineral oil, pomegranate, horse chestnut and hyaluronic acid act as a protectant to prevent abrasive injuries to the already sensitive area.
- It is colourless and odourless.
- It's inexpensive
- Best hemorrhoid treatment over the counter. Most effective hemorrhoid treatment
- This OTC hemorrhoid treatment is known to even work on thrombosed hemorrhoids. People who have been recommended surgery for piles removal have gotten immense relief with this cream and many have been able to avoid surgery as well.
- For hundreds of users, No products found..
There are no negatives about this product! For the few users who felt that this cream did not work, Dr Butler has taken the time to respond to each query. He has assured money back guarantee and also promises that the ingredients are especially formulated to reduce pain with the strongest analgesic action on the market.
2. No products found.
This is the strongest Preparation H hemorrhoids treatment in the market. But is this the best medicine for hemorrhoids?
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Pros
- Maximum strength offers maximum relief for severest of cases.
- This medicine is steroid free. It contains Phenylephrine (vasoconstrictor), Glycerin and Petrolatum (protectants) and Pramoxine HCL (local anesthetic).
- It also has soothing Aloe Vera extracts
- Useful for external pile characterised by pain, burning, swelling, itching and discomfort.
Cons
- The cap design is a bit inconvenient for application owing to child safety lock.
- Preparation H is good over the counter medication for hemorrhoids but comparing with Dr Butler’s Hemorrhoids Cream it does not contain all beneficial ingredients.
- This hemorrhoid cream could cause intense burning in the few minutes after application.
3. No products found.
This popular cream for hemorrhoids and piles contains 5% Lidocaine.
Pros
- Relieves pain, itching and burning
- The numbing effect lasts for over 12 hours so you need to apply only twice a day
- Works even better than many prescription based Lidocaine based external hemorrhoid creams which contain only 3% anesthetic.
- Many use this cream for tattoos and waxing as well.
Cons
- It burns and stings after application
- Cap design causes wastage of cream
- Does not contain instructions for application
- Expensive product compared to other similar over the counter products for hemorrhoids in the category
4. No products found. - Best Ointment for Hemorrhoids
This hemorrhoid treatment medicine is like Reticare but it contains Dibucaine instead of Lidocaine.
Pros
- Hundreds of positive reviewers call Nupercainal the best OTC hemorrhoid treatment on the market.
- It is useful for relieving pain, burning, itchiness and swelling
- You can even use it for treating burns, before and after wax removal or tattoos.
- Works great on fever blisters, cold sores and mouth ulcers
- Very effective for treating insect bites and stings too.
Cons
- The original formula has been changed so the colour and texture of the new product are different. Some users were dissatisfied with this new formula.
- Nupercainal melts and becomes messy after application leaving stains and a slick, slippery feeling.
5. No products found.
Anusol belongs to the category of ‘protectant’ OTC hemorrhoid creams. This means that it will not shrink your hemorrhoids but it will certainly give you relief while protecting the inflamed tissues from friction and abrasion.
Pros
- ANUSOL contains an anesthetic and protectant. The zinc sulfate monohydrate protects from further inflammation and anesthetic provides maximum and long lasting pain relief.
- Works effectively to stop burning. One of the best hemorrhoid creams on the market
Cons
- The product is made in Canada and may not be available readily in the United States. In fact; FDA has discontinued this product in the USA.
6. No products found.
Tronolane like ANUSOL contains Pramoxine HCL an aesthetic and Zinc oxide a protectant. Thus, it provides dual action of pain relief and protective barrier from the further tear, abrasion and friction.
Pros
- Hundreds of satisfied customers have rated this one of the best ointment for hemorrhoids like Prep H.
- If you have suffered for years from piles, you have to try this piles cream for fast relief from severe itching, burning and pain.
Cons
- Tronolane is available on Amazon but not in local drugstores.
- It is loose and runny unlike other external hemorrhoid creams.
- Did not work for some people as effectively as other medicines in the category.
7. No products found.
This is a lesser known brand of OTC hemorrhoids cream but it contains three kinds of hemorrhoids relief medicines - an anesthetic pramoxine H which gives external relief, a vasoconstrictor Phenylephrine which shrinks the hemorrhoidal tissues and protectant glycerin which prevents frictional wear and tear. Additionally, it has soothing aloe vera extracts for long lasting relief.
Pros
- Equate gives rapid relief from pain, burning, swelling and itching. It not just gives symptomatic relief but also treats hemorrhoids.
- Has dual function- also works on under eye bags to relieve puffiness and swelling.
Cons
- It may contain ingredients that are actually banned by FDA.
8. No products found.
This is a Chinese formula containing protectant based of calamine on zinc oxide along with petrolatum. Other inactive ingredients include:
- Moschus- Derived from musk deer. It is a homeopathic remedy.
- Bovis calculus- ox bezoars or dried gallstones of cattle, a potent Chinese herbal remedy
- Margarita- The proteins in this help reduce heat and swelling of hemorrhoids
- Syntheticum-shrinks tissues and prevents pain
- Succinum- shrinks swelling, relieves pain and burning.
- Borax-Protectant
- Lanolin- Protectant
Pros
- Thousands of users have called this the best OTC hemorrhoid medicine
- It has a cooling sensation that relieves pain, burning and itch.
- Has a rejuvenating, menthol-like smell
- Each tube comes with three applicators.
- The product is also available in Chinese alongside English instructions. Both products are the same.
- Mayinglong external hemorrhoid cream is a gentle herbal and ancient formula with ancient wisdom from Traditional Chinese Medicine. The product has a rich history-legend says that the cream was developed by a Chinese woman named Mayinglong who made it for her Emperor.
- Many people are calling this best piles cream a ‘miracle’!
Cons
- May cause intense burning and stinging after use.
9. No products found.
The best part about HemoTreat is that it has no pharmaceutical ingredients but contains only natural gentle ingredients.
Pros
- Best selling formula that works fast to give instant pain relief
- Effective, safe and clinically tested formula that not only treats pain, burning, itching and irritation but also gets rid of swollen internal and external piles.
- Does not stain clothing
- Contains FDA approved ingredients like camphor, eucalyptus oil, petrolatum and lanolin.
- Has helped colon cancer patients with bowel issues
- Cooling sensation and fresh herbal fragrance
Cons
- Smell may be strong for some users
- Could cause soreness and irritation upon application.
10. No products found.
This is another gentle, all natural best OTC hemorrhoids cream. It contains all natural ingredients like Olive oil, Horse chestnut, beeswax, calendula, witch hazel, arnica, marshmallow root, butcher’s broom, Uva ursi, Vitamin E, Chickweed, Yarrow, Feverfew etc.
Pros
- This best natural hemorrhoids cream has been developed by a naturopathic doctor. It is best suited for those who do not like to use chemicals
- Dr. Cole’s hemorrhoids cream is not treated on animals and is GMO-free and 100% organic.
- Comes with a money back guarantee.
- The OTC piles cream comes with a free sample of constipation balm along with an instruction booklet of ways to treat piles naturally.
- Why use convention hemorrhoids medicines which can destroy delicate anal tissues? Use this gentle herbal formula which can be used several times a day without worrying about pain, burning and itching.
- Users have called it magical and miraculous product
- Portable easy to use tin container
Cons
- Did not help some users.
Apart from these ten bestselling hemorrhoids creams, I would like to recommend a Sitz bath salt to soak in for additional relief from pain, itch and burning.
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This bath salt is complete chemical free. It contains USP grade Epsom salts and 100% certified essential oils. The Sitz bath soak is also made in the United States.
Pros
- Contains Vitamin C crystals that increase immunity and improves circulation.
- The magnesium in the salts relieves tension and aches and pains.
- Soaking in Sitz bath mixed with these salts can relieve tightness, pain and irritation.
- Use the bath before or after having a bowel movement to reduce pain, burning, germs and soothe the irritation, and stop bleeding.
- The essential oils smell fantastic and relieve tension, stress and anxiety.
Cons
- Product caused burning sensation in some users
- In few people, it did not bring any change in the condition.
The best way to treat hemorrhoids is to prevent them in the first place. You can do so by eating a fibre-rich diet, exercising and practising other healthy lifestyle habits.
The medical treatment of piles or hemorrhoids is also aimed at relieving symptoms and a big part of symptomatic relief is the use of hemorrhoid creams.
I have reviewed 10 of the best hemorrhoid creams available readily in the market and I hope that this guide helps you make an informed choice so you can buy an effective OTC hemorrhoid cream that best suits your needs.
Last update on 2025-04-02 at 06:40 / Affiliate links / Images from Amazon Product Advertising API
For me I’ve been using Tronolane. It does provide relief. I’ve tried almost all otc in the past, neosporin is the king. I haven’t tried this Ma Ying Long Musk hemorrhoids ointment yet. I might give it a try.