Hemorrhoid cream is often the first line of defense prescribed by doctors to treat painful, itchy hemorrhoids. These creams are readily available over-the-counter and generally considered safe for short-term use. However, some people wonder if hemorrhoid creams carry any potential side effects that should be considered before using them.
What Are Hemorrhoids?
Hemorrhoids are swollen, inflamed blood vessels located in and around the anus and lower rectum. They are extremely common, with about 75% of people experiencing them at some point. There are two types of hemorrhoids:
- Internal hemorrhoids occur inside the rectum and are usually painless.
- External hemorrhoids arise under the skin around the anus and can be extremely painful.
Hemorrhoids develop when there is increased pressure in the lower rectum, often from straining during bowel movements, childbirth, obesity, or heavy lifting. As the blood vessels swell and stretch, they can bleed and become irritated.
Common hemorrhoid symptoms include:
- Itching, burning, discomfort, and pain around the anus
- Bright red blood on toilet paper or in the toilet bowl after a bowel movement
- A hard, painful lump felt around the anus
- Leakage of feces
If hemorrhoid symptoms are mild, many people are able to find relief through simple at-home treatments like over-the-counter creams, ointments, suppositories, or medicated wipes. If symptoms persist or become severe, more intensive hemorrhoid treatments may be necessary, like prescription medications, minimally invasive procedures, or even surgery.
What’s in Hemorrhoid Cream?
Hemorrhoid creams typically contain a combination of active and inactive ingredients designed to provide multiple types of relief from hemorrhoid symptoms. Common active ingredients include:
- Vasoconstrictors – These tighten swollen hemorrhoidal blood vessels to relieve inflammation, itching, pain, and bleeding. Examples include phenylephrine HCl and epinephrine.
- Protectants – These coat hemorrhoidal tissues to prevent irritation from exposure to stool or moisture. Mineral oil, petrolatum, and zinc oxide are common protectants.
- Anesthetics – These temporarily numb hemorrhoid pain and itching. Lidocaine and benzocaine are two anesthetics in these creams.
- Corticosteroids – These help reduce inflammation and irritation. Hydrocortisone is a mild steroid often found in hemorrhoid creams.
- Antiseptics – These prevent infection in damaged tissues. Benzethonium chloride is a common antiseptic ingredient.
Inactive ingredients provide the cream base and improve absorption of the active ingredients into hemorrhoid tissues. These include ingredients like water, mineral oil, paraffin, and various waxes, thickening agents, and emulsifiers.
Are Hemorrhoid Creams Safe?
When used according to package label instructions, most experts consider hemorrhoid creams and ointments to be safe for short-term use of about a week or less. The risks associated with using these products incorrectly typically outweigh any potential side effects.
However, there are some potential side effects and safety concerns to be aware of with hemorrhoid cream ingredients:
- Vasoconstrictors – These can raise blood pressure if too much cream is used. They should be avoided in people with cardiovascular conditions.
- Corticosteroids – These can be absorbed into the bloodstream and cause side effects like skin thinning, irritation, and stretch marks when used long-term.
- Anesthetics – Some people may experience allergic reactions, rashes, or irritation from these ingredients.
- Petrolatum or mineral oil – These can block absorption of other medications if applied near the same time.
Additional safety tips when using hemorrhoid creams include:
- Carefully follow package directions for frequency of use and application.
- Avoid using for longer than 1 week unless directed by a doctor.
- Stop use and consult a doctor if symptoms worsen or do not improve within 7 days.
- See a doctor if excessive bleeding, infection, or anal fissures develop.
- Do not apply inside the anus with fingers or applicators due to risk of infection.
- Pregnant women should consult doctors before using as effects on pregnancy are unknown.
- Keep creams away from eyes and mucous membranes.
Common Brands of Hemorrhoid Creams
There are dozens of hemorrhoid cream products available over-the-counter and by prescription. Some of the most common brand names include:
| Brand Name | Active Ingredients |
|---|---|
| Preparation H | Phenylephrine HCl, mineral oil, petrolatum, shark liver oil |
| Tucks | Mineral oil, petrolatum |
| Americaine | Benzocaine |
| Anusol HC | Hydrocortisone |
| Proctofoam HC | Hydrocortisone, pramoxine |
| Recticare | Lidocaine, hydrocortisone |
Generic store brands are also available containing similar ingredients. Prescription brands with higher potencies of active ingredients may be prescribed if over-the-counter brands are not effective.
When to See a Doctor About Hemorrhoids
While hemorrhoid creams can help manage symptoms, they aren’t a cure for the underlying cause of hemorrhoids. If home treatments don’t provide relief within about a week, or if hemorrhoid symptoms are severe, it is a good idea to make an appointment to see a doctor.
A doctor can examine the affected area and determine if hemorrhoids are present. They may prescribe stronger topical treatments or provide recommendations for minimizing hemorrhoid flare ups through diet, hydration, fiber intake, and bathroom hygiene. If necessary, they can also suggest minimally invasive office procedures or surgical options to permanently remove hemorrhoids.
You should seek medical advice right away if you experience any of the following more severe symptoms:
- Excessive rectal bleeding for more than a week
- Severe pain not relieved by over-the-counter creams
- Fever, chills, or other signs of infection
- Lumps around the anus that don’t go away
- Bowel changes lasting longer than two weeks
Using Hemorrhoid Cream Properly
To get the most relief from hemorrhoid cream while avoiding potential side effects or complications, it’s important to use it correctly:
- Clean the area – Gently wash with warm water and pat dry before each application.
- Apply a small amount – Use only enough cream to lightly cover the affected area.
- Use externally only – Unless advised by a doctor, only apply to the outer anal area.
- Follow instructions – Don’t exceed dosage amounts or frequency in the label.
- Reapply as needed – You can reapply cream after each bowel movement.
- Contact doctor if needed – Seek medical help if symptoms persist beyond 1 week of cream use.
Avoid inserting hemorrhoid creams internally or applying to mucus membranes or broken skin. Only use each product for the duration specified on the label, usually no more than 7 days. See a doctor right away if your symptoms worsen or if excessive bleeding occurs.
Hemorrhoid Cream Side Effects
Most people can use hemorrhoid creams safely, but side effects are possible, especially with prolonged use. Potential side effects include:
- Skin irritation or rash at the application site
- Allergic reaction – itching, hives, swelling, trouble breathing
- Thinning of rectal tissues with long-term use
- Absorbtion into bloodstream leading to side effects when overused
- Infection when used improperly
Stop using any product that causes increased burning, stinging, pain, or itching. Seek emergency care if you experience signs of an allergic reaction like swelling, hives, or difficulty breathing after using hemorrhoid cream.
Interactions with Other Medications
Some of the active and inactive ingredients in hemorrhoid creams can interact with other medications if absorbed into the bloodstream in high enough amounts. Potential interactions include:
- Vasoconstrictors – These can have interactions with heart/blood pressure medications.
- Steroids – These can potentially cause interactions with other steroid medications.
- Numbing agents – These can increase sedation when combined with anti-anxiety medications or sleeping pills.
- Protectants like mineral oil can reduce absorption of other topical or oral medications.
Check with a pharmacist or doctor about potential interactions if you regularly use any prescription or over-the-counter medications, supplements, or herbal products. It’s best to avoid applying hemorrhoid creams near the time you take other medicines by mouth.
Home Remedies for Hemorrhoids
In addition to using OTC hemorrhoid creams or those prescribed by a doctor, some natural home remedies can help provide relief from hemorrhoid symptoms and prevent flare ups.
Warm Sitz Baths
Sitting in a warm bath can help soothe hemorrhoid pain and irritation. Try sitting in warm water for 10-15 minutes, 2-3 times per day, ideally after a bowel movement.
Cold Compresses
Applying cold compresses or ice packs can constrict blood vessels and reduce inflammation associated with hemorrhoids. Use for up to 20 minutes at a time, several times per day.
Witch Hazel
Witch hazel contains tannins and oils that may help reduce swelling, pain, itching from hemorrhoids. Apply witch hazel pads or mix witch hazel extract with warm water and apply topically several times per day.
Aloe Vera
The anti-inflammatory properties of aloe vera gel can help soothe irritated hemorrhoidal tissues. Apply pure aloe vera gel directly to the affected area up to 3 times per day.
High Fiber Diet
Eating more high fiber fruits, vegetables, beans, bran cereals, and whole grains can help prevent constipation and reduce pressure on hemorrhoids. Gradually increase fiber intake and stay well hydrated when increasing fiber consumption.
Over-the-Counter Pain Relievers
Oral pain relievers like acetaminophen or ibuprofen can help temporarily relieve hemorrhoid pain and discomfort in between applying topical creams.
When to See a Doctor
While hemorrhoid creams and home remedies can help manage symptoms, it’s important to see a doctor if:
- Symptoms don’t improve with at-home treatment after a week
- You experience severe pain or rectal bleeding
- You have hemorrhoid symptoms along with changes in bowel habits or stool consistency
- You have signs of infection like fever, increased pain, swelling or pus
A doctor can rule out other conditions causing rectal bleeding or pain, examine your symptoms, and determine if prescription-strength topical treatments or other hemorrhoid removal options may be warranted.
Precautions When Using Hemorrhoid Creams
When using over-the-counter hemorrhoid creams, keep the following precautions in mind:
- Avoid using for longer than 1 week unless advised by your doctor
- Don’t exceed dosage amounts recommended on the packaging
- Only apply creams externally and avoid inserting them inside the rectum
- Wash hands thoroughly after each use
- Don’t use hemorrhoid creams if you have an allergy to any of the ingredients
- Don’t share hemorrhoid cream with others as they’re meant for individual use
Speak to your pharmacist or doctor if you have any other health conditions, take prescription medications, or are pregnant or breastfeeding. If your symptoms don’t improve within 7-10 days or worsen at any point, seek medical evaluation by a doctor.
Frequently Asked Questions
Can you use hemorrhoid cream while pregnant?
Some creams containing hydrocortisone are considered safe for pregnant women to use temporarily, but check with your OB-GYN first. Avoid other creams containing ingredients like phenylephrine or witch hazel without approval from a doctor when pregnant.
Should hemorrhoid cream burn?
It’s normal to feel a temporary warm, tingling sensation after applying hemorrhoid cream, but it should reduce discomfort and pain – not increase burning. Stop using any hemorrhoid cream that causes increased burning or stinging and contact your doctor.
How long does hemorrhoid cream take to work?
Most people experience some symptom relief from hemorrhoid creams within 3-5 days, but maximum relief may take up to 7 days. If symptoms haven’t improved after a week or get worse at any point, see your doctor for evaluation.
Can you use hemorrhoid cream on skin tags?
Skin tags around the anus are harmless but can become irritated. Hemorrhoid creams can help soothe skin tag irritation, but avoid using hemorrhoid cream on skin tags long-term without medical guidance.
How often can you use hemorrhoid suppositories?
Hemorrhoid suppositories are generally safe for use up to twice per day for around a week. Follow package directions and see a doctor if symptoms don’t improve within 7 days.
The Bottom Line
Hemorrhoid creams are medicated ointments, creams, gels, and suppositories containing ingredients like hydrocortisone, lidocaine, witch hazel, or phenylephrine designed to temporarily relieve painful hemorrhoid symptoms like itching, swelling, and burning around the anus. When used exactly according to package directions for up to a week, hemorrhoid creams are generally safe and effective.
However, using them incorrectly or long-term can increase the risk of side effects like skin irritation, thinning of rectal tissues, allergic reactions, and absorption of ingredients into the bloodstream potentially causing interactions with other medications. See a doctor right away if hemorrhoid cream causes increased burning or pain or if symptoms don’t improve after a week of at-home treatment.