Best over-the-counter options for hemorrhoids (piles)
Over-the-counter only — nothing here needs a prescription. Want the prescription options too? Every hemorrhoids (piles) option we rate, prescription included →
Most hemorrhoids improve on their own with simple measures, and the foundation is preventing straining, not a cream. MedlinePlus and NIDDK put the same basics first: eat more fiber, drink enough fluids, use a stool softener, and avoid straining or sitting long on the toilet, so stool passes without pressure on the veins. OTC creams and pads can calm itch, swelling, and pain for a few days, but they relieve symptoms rather than fix the cause. One rule overrides everything else: any rectal bleeding needs a clinician to find the cause. MedlinePlus is explicit that although hemorrhoids are a common cause of bleeding, so are Crohn's disease, ulcerative colitis, colorectal cancer, and anal cancer, 'so it's important to see your provider to find the cause of the bleeding.' Do not assume blood is 'just hemorrhoids.'
Your OTC options, honestly rated
Dietary fiber, fluids, and not straining (plus sitz baths)
Effective first-line OTCMore fiber and water soften and bulk the stool so it passes without straining, which is the pressure that causes and worsens hemorrhoids; warm sitz baths (sitting in a tub of warm water several times a day) relax the area and ease pain.
MedlinePlus and NIDDK list this first: eat high-fiber foods, take a fiber supplement such as psyllium (Metamucil) or methylcellulose, drink enough fluids, avoid straining and long toilet sits, and take warm/sitz baths 'several times a day to help relieve pain.' NHS: 'drink lots of fluid and eat plenty of fibre to keep your poo soft' and 'do not push too hard when pooing.'
Caution: Increase fiber gradually and with water to avoid gas and cramping. This is the measure that actually reduces recurrence; creams do not.
Check price on Amazon ↗OTC hydrocortisone cream or wipes (short-term)
Relieves symptomsA mild topical steroid that reduces inflammation, itching, and swelling around the anus for a few days.
NIDDK and MedlinePlus say OTC hemorrhoid creams, ointments, or suppositories 'may relieve mild pain, swelling, and itching' of external hemorrhoids. NHS medicines guidance sets a hard limit: 'Do not use hydrocortisone treatments for more than 7 days' without seeing a doctor.
Caution: Do not use for more than about 1 week without a doctor. Prolonged steroid use on the anal skin can thin and damage it. If symptoms persist past a week, see a clinician rather than continuing.
Phenylephrine / witch-hazel pads and ointments (Preparation H, Tucks)
Relieves symptomsSoothing and astringent products; witch hazel calms irritation and phenylephrine is a vasoconstrictor marketed to reduce swelling. They provide symptom relief only.
MedlinePlus and NIDDK group OTC hemorrhoid creams, ointments, wipes, and suppositories together as relieving 'mild pain, swelling, and itching.' NHS notes a pharmacist can suggest 'creams to ease the pain, itching and swelling.' No authoritative source claims these shrink or cure hemorrhoids.
Caution: Comfort measures, not a fix. If a product does not help within about a week, or symptoms return quickly, see a clinician instead of buying stronger versions.
OTC pain relief (acetaminophen; caution with NSAIDs)
Relieves symptomsOral analgesics for the ache of a painful hemorrhoid.
NHS advice for piles: 'take paracetamol if piles hurt' but 'do not take ibuprofen if your piles are bleeding.' (Paracetamol is the UK name for acetaminophen.)
Caution: Prefer acetaminophen (paracetamol) when there is bleeding. NSAIDs such as ibuprofen and aspirin can worsen bleeding, so avoid them if you are bleeding. Follow label dosing.
Stool softeners (docusate) and fiber supplements
Effective first-line OTCA stool softener (docusate) or bulking fiber supplement keeps stool soft so bowel movements do not require straining, protecting the swollen veins while they heal.
NIDDK and MedlinePlus recommend 'taking a stool softener or a fiber supplement such as psyllium (Metamucil) or methylcellulose' as part of first-line home care, alongside fluids and avoiding straining.
Caution: Softeners help you stop straining now; the long-term fix is dietary fiber and fluids. If you need a softener for more than about a week, or constipation persists, talk to a clinician.
Check price on Amazon ↗Advertising disclosure: Some links are affiliate links. We may earn a commission at no extra cost to you. This never affects our independent ratings.
See a clinician if…
- Rectal bleeding of any kind. Do not assume it is hemorrhoids. MedlinePlus lists Crohn's disease, ulcerative colitis, colorectal cancer, and anal cancer as other causes and says to see your provider to find the cause of the bleeding.
- Black, tarry, or maroon stools, which can signal bleeding higher in the digestive tract and need prompt evaluation.
- Severe anal pain with rectal bleeding, especially with abdominal pain, diarrhea, or fever. NIDDK says to seek medical care right away.
- A sudden hard, tender lump at the anus, which may be a thrombosed (clotted) hemorrhoid and is often treated best within the first few days.
- A change in bowel habits (new constipation or diarrhea, thinner stools, or a change in caliber) that lasts more than a few days.
- Symptoms that do not improve after about a week of home treatment, or piles that keep coming back. NHS says to see a GP if there is no improvement or they keep recurring.
- Signs of anemia from ongoing blood loss, such as unusual fatigue, weakness, shortness of breath, or pale skin.
- Non-stop bleeding, a lot of blood, large blood clots, or pus leaking from the area, which NHS flags as urgent (A&E / 999).
Bottom line
Fiber, fluids, not straining, and warm sitz baths are the foundation and the only measures that reduce recurrence; OTC creams, witch-hazel pads, and hydrocortisone give short-term symptom relief only (hydrocortisone for no more than about a week) and do not shrink the hemorrhoid. Prefer acetaminophen over ibuprofen if you are bleeding. Above all, any rectal bleeding must be evaluated by a clinician to rule out serious causes including colorectal cancer, IBD, and anal cancer.
Frequently asked
- What is the best over-the-counter medicine for hemorrhoids (piles)?
- Most hemorrhoids improve on their own with simple measures, and the foundation is preventing straining, not a cream. MedlinePlus and NIDDK put the same basics first: eat more fiber, drink enough fluids, use a stool softener, and avoid straining or sitting long on the toilet, so stool passes without pressure on the veins. OTC creams and pads can calm itch, swelling, and pain for a few days, but they relieve symptoms rather than fix the cause. One rule overrides everything else: any rectal bleeding needs a clinician to find the cause. MedlinePlus is explicit that although hemorrhoids are a common cause of bleeding, so are Crohn's disease, ulcerative colitis, colorectal cancer, and anal cancer, 'so it's important to see your provider to find the cause of the bleeding.' Do not assume blood is 'just hemorrhoids.'
- Does Dietary fiber, fluids, and not straining help with hemorrhoids (piles)?
- More fiber and water soften and bulk the stool so it passes without straining, which is the pressure that causes and worsens hemorrhoids; warm sitz baths (sitting in a tub of warm water several times a day) relax the area and ease pain. MedlinePlus and NIDDK list this first: eat high-fiber foods, take a fiber supplement such as psyllium (Metamucil) or methylcellulose, drink enough fluids, avoid straining and long toilet sits, and take warm/sitz baths 'several times a day to help relieve pain.' NHS: 'drink lots of fluid and eat plenty of fibre to keep your poo soft' and 'do not push too hard when pooing.'
- Does OTC hydrocortisone cream or wipes help with hemorrhoids (piles)?
- A mild topical steroid that reduces inflammation, itching, and swelling around the anus for a few days. NIDDK and MedlinePlus say OTC hemorrhoid creams, ointments, or suppositories 'may relieve mild pain, swelling, and itching' of external hemorrhoids. NHS medicines guidance sets a hard limit: 'Do not use hydrocortisone treatments for more than 7 days' without seeing a doctor.
- Does Phenylephrine / witch-hazel pads and ointments help with hemorrhoids (piles)?
- Soothing and astringent products; witch hazel calms irritation and phenylephrine is a vasoconstrictor marketed to reduce swelling. They provide symptom relief only. MedlinePlus and NIDDK group OTC hemorrhoid creams, ointments, wipes, and suppositories together as relieving 'mild pain, swelling, and itching.' NHS notes a pharmacist can suggest 'creams to ease the pain, itching and swelling.' No authoritative source claims these shrink or cure hemorrhoids.
- When should I see a doctor for hemorrhoids (piles)?
- See a clinician if: Rectal bleeding of any kind. Do not assume it is hemorrhoids. MedlinePlus lists Crohn's disease, ulcerative colitis, colorectal cancer, and anal cancer as other causes and says to see your provider to find the cause of the bleeding.; Black, tarry, or maroon stools, which can signal bleeding higher in the digestive tract and need prompt evaluation.; Severe anal pain with rectal bleeding, especially with abdominal pain, diarrhea, or fever. NIDDK says to seek medical care right away.; A sudden hard, tender lump at the anus, which may be a thrombosed (clotted) hemorrhoid and is often treated best within the first few days.; A change in bowel habits (new constipation or diarrhea, thinner stools, or a change in caliber) that lasts more than a few days.; Symptoms that do not improve after about a week of home treatment, or piles that keep coming back. NHS says to see a GP if there is no improvement or they keep recurring.; Signs of anemia from ongoing blood loss, such as unusual fatigue, weakness, shortness of breath, or pale skin.; Non-stop bleeding, a lot of blood, large blood clots, or pus leaking from the area, which NHS flags as urgent (A&E / 999)..
Need the prescription options too?
This page covers what you can buy over the counter. Our guide to every treatment for hemorrhoids adds the prescription options a clinician can offer, each with our FDA recall-safety rating.
OTC options for other conditions
Sources
General information, not medical advice, and not a substitute for your clinician or pharmacist. Follow the label on any OTC product, mind interactions with your other medicines, and seek care for any red-flag symptom.