What Is the Best Cream to Get Rid of Hemorrhoids?

Why you should trust this guide

I have spent years covering health and wellness products, and hemorrhoid relief is one of the most common yet under-discussed categories I research. The market is flooded with creams, wipes, and ointments that make bold claims, but very few deliver consistent, reliable results. My approach is to focus on the active ingredients that have the strongest clinical backing, like phenylephrine, lidocaine, hydrocortisone, and witch hazel, and to evaluate how each product’s formulation actually addresses the specific symptoms it targets. I do not rely on marketing hype; I look at the pharmacology and the real-world feedback from thousands of verified purchasers.

For this guide, I examined the five most prominent products in the OTC hemorrhoid category, each representing a different strategy for relief. I cross-referenced each product’s stated active ingredients with published medical guidelines from sources like the American Society of Colon and Rectal Surgeons. I also analyzed patterns in owner feedback to identify common strengths and honest limitations that might not appear in the product description. This guide is built on that research, not on personal trial, so you can make an informed choice based on what each product is actually designed to do.

How we researched

To evaluate these products, I established a set of criteria that matter most for hemorrhoid relief: speed of symptom reduction, duration of effect, ease of application, and suitability for different symptom types (internal vs. external, itching vs. pain vs. swelling). I weighed the strength and mechanism of each active ingredient. For example, a vasoconstrictor like phenylephrine works quickly to shrink tissue, while hydrocortisone takes longer but is more powerful against inflammation. I also considered the formulation base, because a thick ointment can provide longer-lasting protection than a thin cream, and whether the product includes a delivery applicator for internal use.

I then compared each product against these criteria using the manufacturer’s stated features and the collective experience of many verified buyers. I did not test these products myself. Instead, I looked for consistent patterns: products that earned praise for fast relief were weighted heavily, but I also flagged any recurring complaints about staining, greasiness, or inadequate relief for severe symptoms. I prioritized products that offer a clear, targeted benefit rather than a vague promise of relief. The result is a ranking based on how well each product’s design matches the specific hemorrhoid problem it claims to solve.

Preparation H Maximum Strength Cream – Best Fast Multi-Symptom Relief

Preparation H Maximum Strength Cream is the gold standard for a reason. Its active ingredient, phenylephrine HCl at 0.25 percent, is a vasoconstrictor that works by narrowing blood vessels in the swollen hemorrhoidal tissue. This reduces the size of the hemorrhoid and alleviates the sensation of pressure and fullness. The cream also contains petrolatum and white petrolatum, which form a protective barrier over the irritated skin. This barrier is critical because raw, inflamed tissue is easily aggravated by friction from clothing or further wiping. Many formulations of this cream also include pramoxine, a local anesthetic that numbs nerve endings to stop pain and itching on contact. This triple-action approach makes it the most versatile single product for people who have multiple symptoms at once.

One of the strongest advantages of this cream is its speed. The vasoconstrictor begins working within minutes, and the barrier effect lasts for hours. It is designed for both internal and external use, though it does not come with a long applicator for deep internal delivery. The cream is white and non-staining, which is a practical benefit for daily use. It is widely available at most drugstores and online, and it is the product most often recommended by general practitioners for first-line treatment. The brand’s reputation is built on decades of consistent formulation, so you are getting a reliable product with predictable results.

However, there is an honest limitation. Some users find that the relief from Preparation H is temporary and requires reapplication every few hours, especially for severe hemorrhoids. The vasoconstrictor effect can also cause a mild burning or tingling sensation in some people, particularly if the skin is already broken or fissured. Additionally, while it is excellent for general symptoms, it may not be strong enough for cases of extreme inflammation where a corticosteroid like hydrocortisone would be more appropriate. If your primary symptom is relentless itching rather than swelling, you might need a different approach.

Tucks Medicated Cooling Pads – Best for Soothing Relief and Post-Bowel Hygiene

Tucks Medicated Cooling Pads are not a cream, but they are an essential part of any comprehensive hemorrhoid care routine. Each pad is saturated with 50 percent witch hazel, a natural astringent that has documented anti-inflammatory and vasoconstrictive properties. When you apply a Tucks pad to the anal area, the witch hazel immediately cools the skin and reduces swelling by constricting tiny blood vessels. This provides instant relief from the burning and itching that often accompany hemorrhoids. The pads are also designed to replace harsh toilet paper, which can aggravate already tender tissue. Using a Tucks pad after a bowel movement cleans the area gently and leaves a soothing layer of witch hazel behind.

The real strength of Tucks is their versatility. They can be used on their own for mild symptoms, or they can be applied after a hemorrhoid cream to extend relief and reduce irritation. Many people keep a box in the bathroom for post-bowel care and another in the refrigerator for an extra cooling effect. The pads are soft, pre-moistened, and individually wrapped, making them convenient for travel. They are also fragrance-free and contain no dyes, which reduces the risk of allergic reactions on sensitive skin. For anyone who experiences pain or irritation from wiping, Tucks are a simple, effective solution that addresses the root cause of mechanical irritation.

The limitation of Tucks is that they provide only temporary, surface-level relief. They do not shrink hemorrhoidal tissue the way a vasoconstrictor cream does, nor do they numb pain like lidocaine. For moderate to severe hemorrhoids, Tucks are best used as a complement to a stronger topical treatment, not as a standalone cure. Some users also report that the witch hazel can cause a mild stinging sensation if applied to broken skin, though this usually fades quickly. If you have a fissure or an open wound, you may want to test a small area first.

Doctor Butler’s Hemorrhoid and Fissure Ointment – Best Natural-Clinical Blend

Doctor Butler’s Hemorrhoid and Fissure Ointment takes a unique approach by combining pharmaceutical-grade lidocaine with natural actives like arnica montana, horse chestnut, and essential oils. Lidocaine is a powerful local anesthetic that blocks nerve signals in the skin, providing rapid relief from pain and itching. Arnica montana is a plant extract traditionally used to reduce bruising and inflammation, while horse chestnut contains aescin, a compound that strengthens blood vessel walls and reduces swelling. This blend is formulated by a gastroenterologist, which gives it a level of clinical credibility that many natural products lack. The ointment is designed to treat both hemorrhoids and anal fissures, which often occur together because the same straining that causes hemorrhoids can tear the anal lining.

The thick ointment base is another key feature. Unlike thin creams that can rub off quickly, this ointment adheres to the tissue and provides sustained coverage. This is especially beneficial for fissures, where prolonged contact with the medication is needed for healing. The ointment is free of parabens, petroleum, and artificial fragrances, which appeals to people with sensitive skin or those who prefer cleaner ingredients. The manufacturer also includes a narrow rectal applicator for internal delivery, which is a nice addition for treating internal hemorrhoids. The lidocaine concentration is high enough to provide noticeable numbing within minutes, and the natural ingredients work synergistically to reduce inflammation over time.

The limitation here is that the natural ingredients, while promising, have less robust clinical evidence compared to synthetic drugs like phenylephrine or hydrocortisone. Arnica and horse chestnut are well-studied for topical use, but they are not as fast-acting or as powerful as a vasoconstrictor for shrinking swollen tissue. Some users also find the ointment to be greasier than creams, which can be uncomfortable for daytime use. Additionally, the lidocaine can cause a temporary numbing sensation that may feel odd or unsettling for some people, especially if applied too liberally. If you need immediate, dramatic shrinkage of a large hemorrhoid, this may not be the fastest option.

Proctozone-HC 2.5% (Hydrocortisone Cream) – Best for Severe Inflammation and Itching

Proctozone-HC 2.5 percent is the strongest over-the-counter hydrocortisone cream available for rectal use. Hydrocortisone is a corticosteroid that works by suppressing the inflammatory response in the tissue. This directly reduces the redness, swelling, and intense itching that often accompany hemorrhoids, especially during flare-ups. The 2.5 percent concentration is significantly stronger than the typical 1 percent hydrocortisone creams found in general first-aid sections. It is specifically formulated for the sensitive anal area and is designed to be used for short-term relief of severe symptoms. For people who have tried basic creams and found them inadequate, this is the logical next step.

This cream is particularly effective for hemorrhoids that are driven by inflammation rather than by vascular swelling alone. Itching is often caused by histamine release and inflammatory cytokines, and hydrocortisone directly blocks those pathways. Many users report that the itching stops within a day or two of consistent use. The cream is also useful for reducing the inflammation that can make bowel movements painful. It is a white, non-staining cream that absorbs reasonably well, though it can leave a slight residue. It is typically applied two to four times daily, and it is important to follow the dosage instructions because prolonged use of corticosteroids can thin the skin.

The limitation of Proctozone-HC is that it is not a pain reliever. It does not contain any anesthetic, so it will not numb the area or stop sharp pain from a fissure or a thrombosed hemorrhoid. It also does not shrink hemorrhoidal tissue directly; it only reduces the inflammation around it. This means that for people whose primary symptom is a large, swollen lump, a vasoconstrictor like phenylephrine may be more effective. Additionally, corticosteroids should not be used for more than seven to ten days without a doctor’s supervision, as long-term use can lead to skin atrophy and other side effects. If you have an infection or a fissure that is not healing, you should see a doctor before using this product.

AnuMed International Hemorrhoid Cream – Best for External Swollen Hemorrhoids

AnuMed International Hemorrhoid Cream is designed with a lidocaine-based formula that rapidly numbs the anal area to eliminate pain and itching. Lidocaine is one of the most effective topical anesthetics available over the counter, and it works within minutes of application. The cream also contains other ingredients that work to reduce tissue swelling, though the manufacturer emphasizes the numbing effect as the primary benefit. This product is specifically optimized for external hemorrhoids that are significantly swollen or prolapsed, where the pain and discomfort are most intense. The cream is non-staining and odorless, which makes it suitable for discreet use during the day.

A notable feature of AnuMed is the inclusion of a narrow rectal applicator for precise internal delivery. While the cream is optimized for external use, the applicator allows you to treat internal hemorrhoids as well if needed. The formula is thick enough to stay in place without dripping, which is important for external hemorrhoids that are exposed to friction from clothing. Many users appreciate that it does not have a strong medicinal smell, unlike some other hemorrhoid treatments. The lidocaine concentration is high enough to provide meaningful relief for sharp, stabbing pain, which is common with thrombosed external hemorrhoids.

The limitation of AnuMed is that the numbing effect, while fast, is temporary and may require frequent reapplication. Lidocaine typically lasts for one to two hours before the numbness fades, so you may need to apply it several times a day for continuous relief. The cream also does not contain a vasoconstrictor, so it will not shrink the hemorrhoid itself; it only masks the pain. For people who need both pain relief and tissue shrinkage, this cream works best when paired with a product like Preparation H. Additionally, some users find the applicator to be somewhat rigid and uncomfortable for internal use, so it may not be ideal for everyone.

What to look for

• Active ingredient match: Choose a vasoconstrictor (phenylephrine) for swelling, a corticosteroid (hydrocortisone) for inflammation and itching, or an anesthetic (lidocaine, pramoxine) for pain. No single product covers all symptoms equally.
• Formulation type: Creams absorb faster and are less greasy for daytime use. Ointments provide longer-lasting protection and are better for fissures or raw skin. Pads are best for hygiene and gentle cleansing.
• Application method: Look for a product with a narrow rectal applicator if you need to treat internal hemorrhoids. For external use only, a simple tube or pad is sufficient.
• Skin sensitivity: If you have sensitive skin, choose a product free of fragrances, dyes, and parabens. Witch hazel and natural ingredients can be gentler but may still cause stinging on broken skin.
• Duration of relief: Fast-acting anesthetics and vasoconstrictors provide relief in minutes but may need reapplication every few hours. Corticosteroids take longer to work but offer longer-lasting anti-inflammatory effects.
• Safety for short-term use: Corticosteroids like hydrocortisone should not be used for more than 7-10 days without medical supervision. Vasoconstrictors are safer for longer use but can cause rebound swelling if overused.

The verdict

For most people dealing with hemorrhoids, Preparation H Maximum Strength Cream is the best all-around choice because it addresses the three most common symptoms: swelling, pain, and irritation. Its vasoconstrictor provides fast shrinkage, the barrier protects raw tissue, and the anesthetic numbs discomfort. If your primary issue is severe itching and inflammation that does not respond to basic creams, Proctozone-HC 2.5 percent is the stronger option. For those who want a natural-leaning formula with clinical backing, Doctor Butler’s offers a smart blend of lidocaine and plant extracts. Tucks pads are a must-have for anyone who experiences pain from wiping, and AnuMed is the go-to for numbing large, painful external hemorrhoids. No single product is perfect, but understanding which symptom matters most to you will guide you to the right choice.