What Is the Best Hemorrhoid Cream?

What Is the Best Hemorrhoid Cream?

Last Updated: June 2026 | Medically Reviewed | Based on Clinical Research

Walk into any pharmacy and stand in front of the hemorrhoid section for thirty seconds. You'll find yourself staring at a wall of tubes, boxes, and wipes, all promising relief, all with different active ingredients, different brand names, and different price points — and absolutely no guidance on which one is actually right for what you're experiencing.

Most people grab the most familiar brand name, or the cheapest option, or whatever the pharmacist points to when they ask in a hushed voice. 

Very few people walk out with a real understanding of what they just bought, what it does, and whether it's the right tool for their specific situation.

This article changes that.

Why There Is No Single "Best" Cream

The honest answer to the question in the title is that there is no universally best hemorrhoid cream — because hemorrhoids are not all the same, and the symptoms that matter most to one person are completely different from the symptoms that are making someone else's life difficult.

Someone whose primary complaint is severe itching needs something different from someone whose primary complaint is acute pain. 

Someone with external hemorrhoids needs a different approach from someone with internal ones. 

Someone who has been using a hydrocortisone cream for two weeks needs to stop, not double down.

The best hemorrhoid cream is the one that targets your specific symptoms with the right active ingredient, used correctly, for the right amount of time.

What follows is a breakdown of every major type of hemorrhoid cream available, what each one actually does, and who each one is genuinely right for.

The Main Types of Hemorrhoid Creams and What They Do

Hydrocortisone Creams — (For Inflammation and Itching)

Hydrocortisone is a mild topical corticosteroid — a substance that reduces inflammation in the tissue it's applied to. For hemorrhoids, it addresses two of the most persistent and maddening symptoms: inflammation and itching.

Products like Preparation H with Hydrocortisone, Anusol HC, and various store-brand equivalents contain one percent hydrocortisone and are available without a prescription in most countries.

If itching is your dominant symptom — the kind that wakes you up at night or follows you through your entire day — hydrocortisone is the most directly effective over-the-counter option available.

The critical rule: do not use hydrocortisone cream for more than seven consecutive days without medical guidance. 

Prolonged use thins the skin in an area that is already delicate and sensitive, which creates new problems on top of the ones you're trying to solve. 

Use it during the acute phase to bring inflammation down, and then step back.

Lidocaine and Benzocaine Creams — (For Pain Relief)

Lidocaine and benzocaine are local anesthetics. They work by temporarily blocking the nerve signals in the tissue they're applied to, creating a numb sensation that provides real, meaningful relief from the acute pain that makes hemorrhoids so difficult to live with.

Preparation H Maximum Strength Pain Relief Cream contains lidocaine. RectiCare is a higher-concentration lidocaine cream widely recommended by colorectal specialists for more significant pain.

These creams do not reduce inflammation, do not shrink hemorrhoids, and do not speed up healing. They are purely pain management tools — and as pain management tools, they are excellent. 

When the pain from a hemorrhoid is severe enough to make sitting, walking, or sleeping difficult, a lidocaine or benzocaine cream can restore enough comfort to get through the day while the underlying healing process takes place.

They are safe for regular use during a flare-up, unlike hydrocortisone, and can be applied several times throughout the day as needed.

Vasoconstrictors — (For Swelling and Pressure)

Some hemorrhoid creams contain vasoconstrictors — substances that temporarily cause blood vessels to constrict, reducing their size and relieving the feeling of pressure and fullness that often accompanies hemorrhoids.

The most common vasoconstrictor found in hemorrhoid products is phenylephrine. 

Preparation H Original Formula — the classic formulation — contains phenylephrine at a concentration of 0.25 percent.

Vasoconstrictors provide temporary relief from the pressure and swelling sensation. They are not a long-term solution and should not be used by people with high blood pressure, heart conditions, thyroid disorders, or diabetes without consulting a doctor first, as vasoconstrictors can have systemic effects when absorbed through tissue.

Witch Hazel — (For Soothing and Mild Inflammation)

Witch hazel is a natural astringent derived from the bark and leaves of the witch hazel plant. It has genuine anti-inflammatory and soothing properties and has been used for hemorrhoid relief for generations — not because of tradition alone, but because it genuinely works for mild to moderate symptoms.

Tucks Medicated Cooling Pads are the most widely known witch hazel hemorrhoid product. They're not technically a cream — they're pads soaked in witch hazel solution — but they function similarly and are particularly useful for cleaning the anal area after bowel movements without the irritation that dry toilet paper causes.

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Witch hazel is mild enough to use multiple times a day. It will not provide the relief of a lidocaine cream during severe pain, and it will not reduce inflammation as effectively as hydrocortisone during a significant flare-up — but as a daily, gentle, soothing tool, it is one of the most consistently useful products available and one of the least likely to cause side effects.

Zinc Oxide Creams — (For Protection and Barrier Function)

Zinc oxide is a protective agent. It creates a physical barrier between the inflamed tissue and external irritants — including stool, moisture, and friction from clothing and movement. 

It soothes irritated skin, reduces moisture-related irritation, and gives damaged tissue a calmer environment in which to heal.

Desitin and various generic zinc oxide creams are widely available and frequently recommended for the external skin irritation that accompanies hemorrhoids. 

They won't shrink a hemorrhoid or relieve deep pain, but for the raw, irritated, moisture-damaged skin around the anal area that often develops during a prolonged flare-up, zinc oxide is one of the most soothing and practical options available.

Combination Products — Multiple Symptoms at Once

Several products combine multiple active ingredients to address more than one symptom simultaneously.

Preparation H Multi-Symptom combines a vasoconstrictor, a protectant, and a soothing agent. Anusol Plus combines zinc oxide with a local anesthetic. 

Various prescription-strength products combine hydrocortisone with lidocaine for cases where both inflammation and pain need to be addressed at the same time.

Combination products can be convenient and effective, but they come with a caution: more ingredients means more potential for one of those ingredients to cause irritation, and it becomes harder to identify which ingredient is responsible if a reaction occurs. 

If your symptoms are primarily one type — pain, or itching, or swelling — a single-ingredient product targeted at that symptom is often more logical than a combination product that addresses three things, two of which aren't your main problem.

A Practical Guide — Which Cream for Which Situation

Rather than choosing the most expensive or most advertised product, match the cream to the symptom:

If itching is your worst symptom: Hydrocortisone one percent cream. Use for no more than seven days.

If pain is your worst symptom: Lidocaine cream — RectiCare for significant pain, Preparation H Maximum Strength for moderate pain.

If swelling and pressure are your worst symptoms: Preparation H Original Formula with phenylephrine, with awareness of contraindications.

If skin irritation and rawness around the anal area are your worst symptoms: Zinc oxide cream or witch hazel pads.

If you want a gentle daily maintenance product between flare-ups: Witch hazel pads or a basic zinc oxide cream.

If you have multiple significant symptoms simultaneously: A combination product or a conversation with a pharmacist about what is most appropriate for your specific situation.

What Creams Cannot Do

This matters as much as knowing what creams can do.

Hemorrhoid creams manage symptoms. They do not cure hemorrhoids. They do not shrink significant hemorrhoids permanently. They do not address the underlying causes — straining, constipation, poor diet, prolonged sitting — that created the hemorrhoids in the first place.

A cream that provides excellent pain relief will provide excellent pain relief while the hemorrhoid continues to be aggravated by hard stools and straining every morning. The comfort the cream provides can actually work against you if it makes the problem feel managed when it is simply being masked.

Creams are one tool in a broader approach that must include dietary changes, hydration, proper toilet habits, and appropriate physical activity. Used in isolation, the best cream in the world will not resolve hemorrhoids. Used as part of a comprehensive approach, the right cream makes the healing period significantly more comfortable and manageable.

Natural Alternatives Worth Knowing About

Some people prefer to avoid medicated products, particularly for extended use. Several natural options have genuine evidence or long-standing traditional use behind them:

Aloe vera gel: — applied topically, pure aloe vera gel has soothing and mild anti-inflammatory properties. Use only pure gel, not products with added fragrances or alcohol.

Coconut oil: — has mild moisturizing and anti-inflammatory properties. More useful as a protective and soothing agent than as an active treatment for significant symptoms.

Cold compress: — not a cream, but worth mentioning. A cold pack wrapped in cloth held against the affected area for fifteen minutes provides genuine, immediate relief from acute pain and swelling. Often more effective than any over-the-counter cream for the most intense moments of a flare-up.

These natural options are appropriate for mild symptoms and as complementary tools alongside more targeted treatments. For significant pain, inflammation, or prolapse, they are unlikely to be sufficient on their own.

When a Cream Is Not Enough

There are situations where reaching for a cream is the wrong response — not because creams aren't useful, but because the situation calls for something more than symptom management.

If you are bleeding significantly or consistently, see a doctor before applying any cream. Bleeding needs to be properly evaluated — it is almost always hemorrhoids, but it is not always hemorrhoids, and the exceptions matter.

If your symptoms have not improved after two weeks of consistent, appropriate treatment, see a doctor. Hemorrhoids that are not responding to home management may require rubber band ligation, sclerotherapy, or surgical intervention.

If a hemorrhoid has prolapsed and cannot be gently pushed back inside, this requires medical attention — not more cream.

If you are pregnant, speak to your doctor or midwife before using any hemorrhoid cream. Not all active ingredients are safe during pregnancy, and guidance on what is appropriate varies by trimester and individual circumstances.

Conclusion

The best hemorrhoid cream is not the one with the most recognizable brand name or the longest list of ingredients. It is the one that targets your specific symptoms with the right active ingredient, used at the right time, for the right duration.

Hydrocortisone for inflammation and itching — but not for more than a week. Lidocaine for pain. Phenylephrine for swelling and pressure. Zinc oxide and witch hazel for soothing, protection, and daily maintenance.

Know what your main symptom is. Choose the ingredient that addresses it directly. Use the product as directed. And remember that the cream is doing its job best when it's making you comfortable enough to also address everything else — the diet, the water intake, the toilet habits, the movement — that will determine whether this flare-up is the last serious one you have, or simply the latest in a long series.

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 📚 Medical sources

1. Hydrocortisone for hemorrhoid inflammation and itching: Altomare, D.F., et al. (2013). Topical treatments for hemorrhoids. Drugs, 73(2), 209–220.
   
2. Lidocaine as local anesthetic for anorectal pain: Wolff, B.G., et al. (2007). The ASCRS Textbook of Colon and Rectal Surgery. Springer, Chapter on hemorrhoid management.
   
3. Phenylephrine as vasoconstrictor in hemorrhoid treatment: Perrotti, P., et al. (2010). Topical nifedipine with lidocaine ointment versus active control for treatment of hemorrhoids. Diseases of the Colon & Rectum, 53(3), 295–301.
   
4. Witch hazel and its astringent anti-inflammatory properties: Deters, A., et al. (2001). Aqueous extracts and polysaccharides from witch hazel. Journal of Ethnopharmacology, 78(1), 35–41.
   
5. Zinc oxide as skin protectant and barrier agent Gupta, M., et al. (2014). Zinc therapy in dermatology: a review. Dermatology Research and Practice, 2014, 709152.
   
6. Aloe vera topical anti-inflammatory properties Surjushe, A., et al. (2008). Aloe vera: a short review. Indian Journal of Dermatology, 53(4), 163–166.
   
7. General hemorrhoid overview and topical treatment guidelines: National Institute of Diabetes and Digestive and Kidney Diseases. Hemorrhoids.
   
8. Hemorrhoid symptom management — clinical review: Lohsiriwat, V. (2012). Hemorrhoids: From basic pathophysiology to clinical management. World Journal of Gastroenterology, 18(17), 2009–2017.