PlanetRx - Learn More - Product Advice - Hemorrhoid Relief

Don't live with discomfort

Millions of people suffer from hemorrhoids, and they're not laughing. Hemorrhoids, also known as piles, are swollen bunches of blood vessels, tissue, membrane, and skin that develop within the anal canal (internally) or just at the rectum (externally). Hemorrhoids cause mild to major burning, itching, inflammation, and swelling. For many individuals, the symptoms are severe enough to interfere with everyday living.

If you are one of the unfortunate few with very painful hemorrhoids, talk with a doctor. Medical treatments (even surgery) are different than those available over-the-counter. For simple, uncomplicated hemorrhoids, however, there are a whole host of treatments to ease your minor discomfort.

Hemorrhoids Are No Fun

There's no doubt about it, hemorrhoids are painful. They burn, they itch, they swell. And you want to make them disappear as soon as possible. A wide variety of products are available to treat all of these symptoms.

Sometimes other such other conditions as anal cracks, sores, pinworms, benign or malignant tumors, and poor anal hygiene can be confused with hemorrhoidal symptoms. Check to make sure you truly have hemorrhoids; if you are in doubt, have your doctor examine you.

Medical advice is also warranted if your symptoms last longer than a week after nonprescription treatment, or if you are experiencing bleeding, mucus discharge, bowel movement seepage, or a prolapsed hemorrhoid (it protrudes out of the anus).

Your Arsenal Against Hemorrhoids

Over-the-counter ointments, suppositories, and foams may relieve hemorrhoids. Be sure to follow instructions regarding whether they can used externally only or can be applied intrarectally (into the rectum). Many products contain a combination of the following types of ingredients:

Vasoconstrictors: shrink the swollen blood vessels.
Astringents: decrease mucus production and dry the rectal tissue.
Skin-peeling agents: exfoliate dead skin and reduce itching.
Local anesthetics: temporarily desensitize the painful area.
Protectants: coat irritated and raw tissues.
Itch-pain relievers: also called counterirritants, block the sting and itch of hemorrhoids by creating some of their own stinging-cooling-soothing distraction.
Corticosteroids: relieve anal itching.

Hemorrhoids Don't Just Appear

Nobody likes to talk about the anus, but understanding it is important in the prevention and treatment of hemorrhoids. Inadequate blood flow and pooling of the blood in the veins surrounding the anorectal area can lead to pressure build-up and the formation of hemorrhoids. Some of the causes of hemorrhoids include:

Straining during bowel movements or childbirth. Normal bowel movements will prevent straining and reduce the chance of developing or worsening hemorrhoidal symptoms. Eating a high-fiber diet and drinking adequate amounts of fluids are important to maintain normal bowel health.
Passing a sharp object in the stool.
Accumulation of fecal "pockets" within the anal canal. These may be cleaned out by adding more fiber to your diet.

Antiseptics

Often components of hemorrhoidal products employed to prevent anorectal infection, though they are not FDA-approved for this indication. Prevent the growth of bacteria, but may not be effective against the very large number of bacteria present in the anorectal region. Common antiseptics are benzalkonium chloride, benzyl benzoate, and cetylpyridinium chloride.

Astringents

Agents which tighten anorectal tissue and dry it out to temporarily relieve irritation and burning. Also able to bind proteins, they may be able to reduce irritation by binding and holding feces. Astringents provide soothing comfort, but if you are experiencing swelling, try a vasoconstrictor.

Itch-pain relievers

Itch-pain relievers stimulate the sensory nerve endings to produce cooling or warming sensations. The theory is that by producing this smaller irritation, you will be distracted from the greater pain. They may also briefly block the pain receptors in the skin. Useful in relieving itch and pain associated with hemorrhoids when used externally.

Keratolytic agents

Skin-peeling agents which increase the turnover of epithelial cells. It is thought that they may reduce irritation by sloughing off dead skin cells and exposing new skin to medication. Should only be used externally.

Protectants

Protectants do just what their name says -- they protect. By providing a physical barrier that coats the irritated skin's surface, they can help the hemorrhoidal area stay moist and offer protection as a barrier to further irritation from bowel movements. May be used externally or intrarectally (except glycerin) for temporary soothing relief of hemorrhoidal pain.

Topical anesthetics

Temporarily relieve pain, burning, itching, and discomfort by suppressing transmission of nerve impulses. Their use in hemorrhoid treatments is debated, however, because of the lack of evidence of pain-receiving nerve endings inside the rectum. Be aware that these drugs may be absorbed into the bloodstream and cause toxic reactions when applied inside the rectum. Take care to use these products sparingly and externally only.

Vasoconstrictors

Agents which temporarily narrow blood vessels to reduce swelling. They also have a slight anesthetic effect, mediated by an unknown mechanism or action, which helps reduce itching, discomfort, and irritation. Should not be used by people with diabetes, heart disease, hyperthyroidism, hypertension, or prostate enlargement. If you are taking blood pressure medication or antidepressants, consult a doctor before using vasoconstrictors.

Ingredient		Description
Astringents
Calamine		Absorbs moisture and irritants. Safe and effective in protecting skin from further irritation. For external and intrarectal use.
Hamamelis Water (Witch Hazel)		Safe and effective to relieve burning and itching in the anorectal area. Recommended in concentrations less than 50% for anorectal use. For external use only.
Zinc Oxide		Absorbs moisture and irritating proteins. Main ingredient in calamine. Safe and effective for soothing irritated skin. For external and intrarectal use.
Itch-Pain Relievers
Ingredient		Description
Camphor		Safe and effective in relieving itching when used in concentrations of less than 3%. Has a mild numbing effect. Deadly when taken orally.
Juniper Tar		Safe and effective in relieving minor itching and skin irritation. Not commonly found in nonprescription products.
Menthol		Safe and effective in low concentrations of 0.1% to 1% for relieving itching and pain.
Keratolytic Agents
Ingredient		Description
Alcloxa		Form of allantoin. Safe and effective in relieving itching and softening irritated skin. Not commonly found in nonprescription products.
Resorcinol		Safe and effective in softening and peeling skin in the anorectal area. Not commonly found in nonprescription products.
Protectants
Ingredient		Description
Aluminum Hydroxide Gel		Binds and holds fecal bacteria to reduce irritation and itching in the anorectal area. Very safe and widely used. Not effective when used in conjunction with petrolatum. Not commonly found in nonprescription products.
Calamine		Absorbs moisture and irritants. Safe and effective in protecting skin from further irritation. Not commonly found in nonprescription products.
Cocoa Butter		Lubricates skin and anal canal. Safe and effective in soothing irritated skin.
Cod Liver Oil		Safe and effective for softening skin when part of a combination product with another skin protectant. Not commonly found in nonprescription products.
Glycerin		Should not be used intrarectally because it has a laxative effect. Safe and effective for external use to soften and moisturize skin.
Hard Fat		Hard fat (cocoa butter substitutes, hydrogenated coco-glycerides, and hydrogenated palm kernel glycerides) soothes and moistens the skin. It also significantly reduces water loss from the skin. Safe and effective.
Kaolin		Absorbs moisture and binds and neutralizes fecal bacteria. Very effective in reducing itching when combined with aluminum hydroxide. Not effective when used with petrolatum.
Lanolin		Safe and effective for softening skin.
Mineral Oil		Soothes and lubricates skin. Safe and effective.
Petrolatum		A petroleum-derived product used to coat and soothe irritated tissues. Safe and effective.
White Petrolatum		A petroleum-derived product similar to petrolatum used to coat and soothe irritated tissues. Safe and effective.
Shark Liver Oil		Soothes and softens irritated skin. Safe and effective. Must be in combination product with other skin protectants.
Starch Powder		Absorbs moisture and smooths skin. Safe and effective.
Zinc Oxide		Absorbs moisture and irritating proteins. Main ingredient in calamine. Safe and effective for soothing irritated skin.
Topical Anesthetics
Ingredient		Description
Benzocaine		Safe and effective in relieving anorectal pain when used in a 5% to 20% concentration. Pain relief lasts 4 to 6 hours.
Benzyl Alcohol		Safe and effective in relieving burning and itching of irritated skin. Fast-acting but not very long-lasting relief. Has a slight antibacterial action.
Dibucaine		Safe and effective in relieving minor pain when used in a 0.25% to 1% concentration. Very fast-acting. Should not be applied to large areas of irritated skin.
Dibucaine Hydrochloride		Safe and effective in relieving minor pain when used in a 0.25% to 1% concentration. Works much more slowly than dibucaine. Should not be applied to large areas of irritated skin.
Dyclonine		Safe and effective in relieving pain of irritated skin when used in a 0.5% to 1% concentration. Very fast-acting (two to three minutes) but not very long-lasting (30 minutes). Not commonly found in nonprescription products.
Hydrocortisone		One of the most effective and widely tested anesthetics. Very effective in relieving itching and pain of irritated skin when used externally. Very safe with minimal irritation and sensitivity found.
Lidocaine		Commonly used pain and itch reliever. Safe and effective for treating hemorrhoid pain. Fast-acting and long-lasting. Should not use large amounts on broken skin due to toxic reactions.
Pramoxine		Very effective in relieving anal pain. Very few adverse effects and little sensitivity exhibited in most people.
Tetracaine		Safe and effective in relieving minor pain and itching when used in a 0.5% to 1% concentration.
Vasoconstrictors
Ingredient		Description
Ephedrine		Safe for treatment of anal-rectal swelling. Has not been tested specifically for its action on hemorrhoidal swelling, however, its ability to constrict blood vessels is well-known. Very fast-acting, and effect may last for two to three hours. May be used intrarectally or externally. Not commonly found in nonprescription products.
Epinephrine		Very similar to epinephrine hydrochloride. Effective in reducing swelling and itching. For external use only. Not commonly found in nonprescription products.
Epinephrine Hydrochloride		Has a short-term effect on reducing swelling and itching. Effect similar to ephedrine. For external use only. Not commonly found in nonprescription products.
Phenylephrine Hydrochloride		Potent vasoconstrictor effective at relieving hemorrhoidal swelling and itching. Less likely to cause irritation than other vasoconstrictors. Safer than epinephrine. May be used intrarectally or externally.

FDA-Approved Uses

General hemorrhoidal products

For the temporary relief of local discomfort and itching associated with hemorrhoids, anorectal disorders, inflamed hemorrhoidal tissues, anorectal inflammation, hemorrhoidal tissues, or piles.

Topical anesthetics

For the temporary relief of pain, soreness, and burning.

Astringents

Aids in protecting irritated anorectal areas and offers temporary relief of irritation and burning.

Counterirritants

For the temporary relief of pain and burning.

Can help distract from pain; may provide a cooling sensation.

Hydrocortisone

For the temporary relief of itching associated with minor skin irritations and rashes.

Protectants

Forms a temporary protective coating over inflamed and irritated tissues to help prevent drying.
Protects the anorectal surface from irritation and abrasion during bowel movements.

Temporarily relieves burning and discomfort.

Aluminum hydroxide gel & kaolin

For the temporary relief of itching associated with moist anorectal conditions.

Vasoconstrictors

Temporarily reduces the swelling associated with irritated hemorrhoidal tissues and other anorectal disorders.

Temporarily shrinks hemorrhoidal tissue.

Be Careful

Hemorrhoidal medications should be used after a bowel movement, not before, for maximum results. This allows the medication to have a longer contact time.
Wash and dry the anorectal area before applying any medications.
Remember, the only ingredients that can be used inside the rectum are vasoconstrictors, protectants, and astringents. All other medications must be applied on the outside.
Anorectal products can be used four to six times per day, depending on the ingredients. Refer to the package.
If symptoms do not improve, or worsen after seven days, consult a physician.

Warnings

Antiseptic

Consult a physician before using or do not use if you have:

Allergy to topical antiseptics (such as benzalkonium chloride, boric acid, resorcinol, or salicylates)
Bleeding hemorrhoids
Skin conditions such as eczema or psoriasis

Astringent

Consult a physician before using or do not use if you have:

Allergy to astringent

Counterirritants

Consult a physician before using or do not use if you have:

Allergy to any counterirritants
Open sores or wounds

Or if you:

Plan to apply to wounds, lesions, broken, or damaged skin.
Plan to use inside the rectum

Hydrocortisone

Consult a physician before using or do not use if you have:

Allergy to hydrocortisone products
Open wounds or sores
Skin infection

Or if you:

Develop rash or other skin irritation after use
Plan to use inside the rectum
Plan to apply to wounds, lesions, or broken, damaged, or sensitive skin
Plan to use for more than three days

Keratolytic agents

Consult a physician before using or do not use if you have:

Allergies to resorcinol of aluminum chlorhydroxy allantoinate (alcloxa)
Open sores or wounds

Or if you:

Develop further redness, swelling, itching, or irritation
Plan to apply to wounds, lesions, or broken, damaged, or sensitive skin
Plan to use at higher than recommended doses
Plan to use inside the rectum

Topical anesthetics

Consult a physician before using or do not use if you have:

Allergy to any topical anesthetics or any component in burn and sunburn products
Open wounds or sores
A pre-existing skin infection

Or if you:

Have symptoms that do not improve within seven days or worsen; consult a physician
Plan to use more than three or four times daily
Plan to use inside the rectum

Vasoconstrictor

Consult a physician before using or do not use if you have: