Hemorrhoid Treatment Level Two: Topical Medications

January 29th, 2013 by Eduardo Krajewski, MD, FACS, FASCRS

Symptomatic hemorrhoids can cause itching, burning or pain. Sometimes these symptoms do not respond completely to the diet and lifestyle modifications that are recommended in Treatment Level One. When we move up to Treatment Level Two, we find topical medications for the treatment of hemorrhoid symptoms.

These remedies are mostly available without a prescription. They can come in various forms, such as:

  • Ointments
  • Creams
  • Suppositories
  • Foams
  • Medicated wipes

Combination of Ingredients

For the treatment of hemorrhoid symptoms, topical medications typically contain a combination of ingredients. First of all, there is usually some kind of barrier protectant such as aluminum hydroxide, cocoa butter or lanolin. There is often a pain relieving ingredient included as well, such as lidocaine or pramoxine, to give immediate relief to burning or pain.


Another common ingredient found in topical treatments, corticosteroids are very effective in decreasing inflammation. It is important, however, not to use steroid containing medications for more than 2 or 3 weeks. This is because the steroids can cause thinning of the skin making it susceptible to breakdown.

Other Ingredients

Some topical hemorrhoid remedies contain vasoconstricting agents, such as ephedrine, that tighten up blood vessels and can help reduce inflammation. Astringents are another type of additive sometimes used to tighten and dry up swollen and inflamed hemorrhoids. Calamine and zinc oxide are common examples of astringents.

Herbal Remedies

Many herbal or alternative medications have been shown to be useful in the topical treatment of hemorrhoid problems. One popular herb is Witch Hazel which is derived from the leaves of a plant indigenous to North America. Witch Hazel is an astringent and can be found in pre-medicated wipes for hemorrhoids.

Horse Chestnut is another example of an herbal remedy. Horse Chestnut seed extract contains a substance called aescin. Hemorrhoids are vascular structures that cause symptoms when they get inflamed and swollen. Aescin has venotonic effects which makes it is good for tightening up swollen veins, and this makes aescin effective for hemorrhoid treatment.


When hemorrhoid symptoms do not respond to diet and lifestyle modifications, you might need to use topical medications. These medicines come in various forms and can contain different ingredients, including herbal remedies.

Check out The H Doctor website. You will find many articles and videos that contain the latest information about hemorrhoid treatment and other important GI health topics.

Take charge of your health today.


Leave a Reply