What is the Best Prescription Medicine for Hemorrhoids?

A man in a flannel shirt with his hands on his buttocks.
  • Hemorrhoids are swollen blood vessels that develop around or inside the rectum, causing pain and discomfort.
  • This condition may also cause irritation and itching around the affected area. In some cases, hemorrhoids may even burst and bleed.
  • While there is no known cause for hemorrhoids, most experts agree that daily habits and some factors — like obesity, sedentary lifestyles, and low-fiber diets — are to blame.
  • Hemorrhoids can be treated in a number of different ways, including topical creams, non-invasive procedures, and surgery.

Hemorrhoids are a common condition that usually affects 1 in 20 Americans in their lifetime. About half of the population will have had hemorrhoids by the time they turn 50.

Although hemorrhoids are common, they often make people uncomfortable or reluctant to seek treatment.

There are plenty of home remedies that can help you manage your symptoms, but it’s often necessary to use a prescription-strength treatment to fully heal hemorrhoids.

This article takes a closer look at how hemorrhoids can occur and what the best treatment options are to help you manage your condition.

What Are Hemorrhoids?

Hemorrhoids — which are sometimes called piles — are swollen veins or blood vessels that develop in the anus or lower rectum. They may also prolapse, which means they may extend out of the anus.

There are two kinds of hemorrhoids:

  • Internal hemorrhoids that occur inside the rectum and are often less painful, but they may start to protrude. This can lead to an infection and irritation if the protrusion collects mucus and stool particles (pruritus).

  • External hemorrhoids develop on or around the anus and may cause discomfort. Blood clots may form inside external hemorrhoids, which can lead to sudden and severe pain. When the clot dissolves, the excess skin left behind becomes itchy and irritated.

How do I know if I have hemorrhoids?

The signs and symptoms of hemorrhoids will largely depend on the type of hemorrhoid that develops. Common signs and symptoms include:

  • Pain or itching around or inside the lower anal area
  • Swelling or bumps around the area
  • Bright red bowel movement immediately afterward
  • Blood in the stools that may color them maroon or tarry
  • Bulging tissue in the anal area
  • Irritated or inflamed skin
  • Poor control over urine or bowel movements (incontinence)

It’s recommended that you speak to your healthcare provider if you start experiencing any of the symptoms mentioned above.

What Causes Hemorrhoids?

There isn’t always a cause for hemorrhoids, and they often develop for no reason. However, they are commonly associated with:

  • Chronic and frequent bouts of constipation or diarrhea
  • Straining during bowel movements
  • Sitting for long periods of time
Key Point: What Increases My Risk of Developing Hemorrhoids?

A few factors may put you at a higher risk of developing hemorrhoids. These include:

  • Obesity
  • Pregnancy
  • Weak anal muscles caused by advanced age, surgery, or intercourse
  • Lack of physical activity
  • Having a diet that’s low in fiber

How Are Hemorrhoids Diagnosed?

Hemorrhoids should be diagnosed by a medical professional.

Although it may be uncomfortable to talk about, you should reach out to your doctor if you suspect that you have symptomatic hemorrhoids.

Your doctor will likely perform a physical examination. They will ask you questions about your symptoms, medical history, and any medication you’re currently taking.

They will take a look at the affected area to help determine the severity of your condition and whether you have internal or external hemorrhoids.

A physical examination of the lower rectum is necessary for doctors to determine if there are any unnatural growths, like polyps or tumors, that need to be removed or treated.

Another way to diagnose hemorrhoids is with an anoscopy. This procedure involves an endoscopic device that’s inserted into the rectum.

Your doctor may use this device to examine the interior wall of the rectum and anal canal. This is usually relatively painless but may be uncomfortable for some people.

How Are Hemorrhoids Treated?

There are a number of ways to treat hemorrhoids at home and with different types of medicine.

Your treatment will depend on the type of hemorrhoids you have and the severity of your diagnosis. Over-the-counter (OTC) and prescription treatments

There are a number of ways to treat hemorrhoids with topical OTC and prescription products.

These products are usually topical pain relievers like creams, gels, or lotions that can alleviate symptoms and heal hemorrhoids.

Two common ingredients to look for are hydrocortisone and pramoxine. These popular ingredients for treating hemorrhoids are available in prescription or OTC formulas.

Your doctor will be able to recommend the best option to manage your condition.


Creams containing topical preparations of steroids — like hydrocortisone or Anusol-HC — are popular for helping to reduce swelling, redness, and irritation.


Some OTC treatments may also contain ingredients that can help protect the skin against further irritation. Protectants may also prevent dryness and help to soothe the affected area.

Most protectants are formulated with ingredients like mineral oil or petrolatum. You can also use petroleum jelly, commonly known as Vaseline.


Another OTC option is decongestant products — also known as rectal phenylephrine — that shrink blood vessels to heal hemorrhoids.

This can also help relieve burning and swelling around the affected area.


Astringent products like witch hazel can be used to protect and soothe irritated areas around the rectum. It may also help to relieve discomfort and burning.

Local anesthetics

Many OTC treatment options for hemorrhoids may contain local anesthetics to help alleviate pain and soreness. They usually create a numbing effect that reduces discomfort.

These products are normally only used for external hemorrhoids and should not be used inside the anal area.

Common anesthetics include:

  • Pramoxine (Proctofoam HC)
  • Lidocaine (Ana-Lex)
  • Benzocaine
Cream from a tube being dispensed onto a woman's finger.


For more severe cases of hemorrhoids, your healthcare provider may recommend a surgical procedure to remove the growth.

Hemorrhoid surgery — also called an excisional hemorrhoidectomy — involves a colon and rectal surgeon cutting the growth from the body using a sharp instrument.

This may also be the best option if your doctor has found tumors or protrusions around the affected area, or if the hemorrhoids haven’t responded to other treatments.

It’s also one of the best treatments for providing hemorrhoid relief and ensuring that they don’t occur again.

Key Point: Are There Non-Surgical Ways to Treat Hemorrhoids?

If your symptoms persist and surgery isn’t an option, there are a couple of nonsurgical procedures that your healthcare provider may recommend.

These may include:

  • Rubber band ligation: This is the most widely used nonsurgical procedure for treating hemorrhoids.

It involves a small elastic band that is inserted into the anal canal and tied around the base, cutting off the hemorrhoid’s blood supply. The hemorrhoid and elastic will fall off within a couple of weeks.

After the procedure, you’ll need to rest for two to three days and avoid carrying heavy items or straining.

Bleeding may also occur, but this is a normal part of the procedure.

  • Coagulation therapy: This procedure involves using heat, laser, or electric currents to cut off blood supply to the hemorrhoid. Once the hemorrhoids shrink and die, scar tissue forms on the anal wall to hold nearby veins in place and prevent bulging.

You can treat one hemorrhoid at a time with coagulation therapy, with a 10-14 day period between sessions.

  • Sclerotherapy: This treatment option involves injecting a chemical solution into the blood vessels or hemorrhoid tissue. The chemicals cause a reaction that interferes with the blood flow inside the hemorrhoid, causing it to wither and die. It falls off naturally.

Although these are nonsurgical procedures, they must still be performed by a licensed medical professional.

What Are the Best Prescription Medications for Hemorrhoids?

It can be difficult to know what the right kind of hemorrhoid medication for your condition is. The most effective hemorrhoid treatments often contain hydrocortisone, pramoxine, or nitroglycerin.

Common brand names for these are:

  • Analpram
  • Pramasone
  • Mezparox
  • Proctocream HC
  • Anusol-AC (suppository)
  • Protocort (suppository)
  • Rectiv
  • Nifedipine ointment

You can also try a combination of hydrocortisone and lidocaine — also called Ana-Lex — for a more potent treatment.

Although these products are available as OTC options, your doctor may recommend a prescription-strength formula.

Home remedies

Some home remedies can be effective for treating hemorrhoids and helping you to manage your symptoms. You can also give home remedies a try if you’d first like a more conservative approach and want to stay away from medication.

The following are common things you can do or use at home that may help alleviate hemorrhoid symptoms.

  • Take regular sitz baths: Sitz baths are warm, shallow baths that people often use to clean the anal area. It can also be an effective way to soothe and reduce pain, irritation, and itching.

Ensure that you sit in the bath for at least 10 to 15 minutes and pat yourself dry with a towel. Avoid rubbing the anal area since this can worsen the irritation.

  • Take fiber supplements: Incorporating fiber supplements into your daily routine can help reduce the risk of hemorrhoid bleeding and inflammation.

It also makes bowel movements a bit easier and less strenuous, minimizing the risk of developing hemorrhoids in the future.

  • Apply aloe vera: Aloe vera is a well-known soothing ingredient because of its anti-inflammatory properties.

Given how delicate and sensitive the anal area is, it’s recommended that you only use pure aloe vera after having performed a patch test on your inner wrist first. Wait 24-48 hours to determine if you have a reaction.

  • Use a cold compress: If you don’t want to use aloe vera, you can also try a cold compress. This can help reduce swelling and discomfort. For best results, apply a cloth-wrapped ice pack to the anal area for 10-15 minutes.

It’s important to always take note of your symptoms and monitor whether they’re improving or not. If they don’t improve, or they worsen within a week, make an appointment with your doctor.

Key Point: Can Hemorrhoids Go Away on Their Own?

In most cases, hemorrhoids can resolve without invasive treatments if you make lifestyle changes.

These may include eating more high-fiber foods, drinking plenty of fluids, and getting regular exercise.

Although they can go away on their own, hemorrhoids should always be monitored to see if they worsen.

Untreated hemorrhoids can cause significant irritation, pain, and discomfort. They may also burst and cause bleeding.

Prolapsed hemorrhoids may also require a surgical procedure to be pushed back into the body if left untreated for too long.

Do Hemorrhoid Treatments Have Any Side Effects?

Although most hemorrhoid treatments are considered safe, side effects and adverse reactions may occur.

Let’s take a look at what those are:

  • Skin irritation where creams, gels, or ointments are applied
  • Rectal bleeding and severe irritation
  • Allergic reaction (rash, swelling, or hives)
  • Increase in blood pressure
  • Headaches
  • Nausea
  • Dizziness

If you’re using a steroid-based treatment, it’s recommended to stop using it after one week. Prolonged use can lead to skin damage.

You should also reach out to your doctor as soon as possible if you experience any of the symptoms listed in this section.

Key Point: What Are The Long-Term Effects of Hemorrhoids?

Long-term effects or complications occurring as a result of hemorrhoids are rare but may occur in some cases. These may include:

  • Anemia: This is a condition where the body doesn’t have enough healthy red blood cells to carry oxygen to other cells. Chronic blood loss from hemorrhoids may cause anemia to develop.

  • Blood clots: Clots may occasionally form in existing hemorrhoids. Although this isn’t dangerous, it can be painful and will require manual drainage.

  • Strangulated hemorrhoids: This condition occurs when the blood supply to an internal hemorrhoid is cut off, causing bouts of extreme pain.

How Can I Avoid Getting Hemorrhoids?

Although the causes of hemorrhoids aren't fully clear, there are a number of things you can do to avoid getting them in the first place.

These mainly include making lifestyle changes and incorporating healthier habits into your daily routine. It could also include:

  • Going to the bathroom when you need to, instead of delaying your bowel movements. Waiting can cause chronic constipation, which can contribute to hemorrhoids.

  • Not spending too much time on the toilet. This can cause you to strain during your bowel movements which put extra stress on your blood vessels.

  • Following a healthier diet that includes drinking plenty of water, eating more fiber, and avoiding lactose products like milk and cheese.

  • Exercising more regularly to avoid becoming sedentary and increasing the risk of developing hemorrhoids.

Incorporating these habits and changes into your daily routine may help reduce the risk of developing hemorrhoids and improve the quality of your life in general.

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Are You Concerned That You Might Have Hemorrhoids?

Although hemorrhoids can be uncomfortable, know that you’re not alone. Many people will have hemorrhoids at some point in their lives.

If you’re experiencing any of the symptoms listed in this article, head over to LifeMD to make a telehealth appointment with a board-certified doctor or nurse practitioner.

Dr. Banita Sehgal

Dr. Sehgal received her medical degree from Western University in Los Angeles and trained as Chief Resident at White Memorial Medical Center, also in Los Angeles. She’s been practicing medicine for 20+ years and has a specific interest in women’s health.

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This article is intended for informational purposes only and should not be considered medical advice. Consult a healthcare professional or call a doctor in the case of a medical emergency.

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