There’s much more to getting hemorrhoids than sitting for too long. In fact, sitting is one of the least common ways to develop hemorrhoids, which are swollen and enlarged veins in the rectum and anus. They’re typically caused by more active activities than sitting. “Any increase in intra-abdominal pressure or pelvic pressure can exacerbate hemorrhoids,” says Dr. Judy Nee, a gastroenterologist at Beth Israel Deaconess Medical Center. And though that definition can technically include sitting, your bowel movements are much more likely to be the cause, especially if you have a condition like irritable bowel syndrome, rather than spending too much time at your desk. Other strenuous activities like childbirth or weight-lifting can also be the culprit.
So once your doctor diagnoses you with hemorrhoids, the first step for treatment is actually “getting down to the root of why they’ve happened,” says Dr. Felice Schnoll-Sussman, a gastroenterologist at Weill Cornell Medicine and NewYork-Presbyterian, because if you don’t solve the original issue you start on a “vicious cycle.” It’s only after you implement a solution to prevent hemorrhoids moving forward — like taking a laxative to thwart constipation and straining while going to the bathroom — that you can tackle them. There are different treatments for internal hemorrhoids, which stand up in the anus, and external ones, which drop down outside the anus, so below, we have recommendations for different over-the-counter creams, wipes, and bath-like products that will reduce any of the itching, swelling, burning, or discomfort that can come with both types.
Best topical treatments for hemorrhoids
This is probably the most well-known over-the-counter hemorrhoid treatment, and it came recommended to us by all six of the gastroenterologists interviewed. Schnoll-Sussman likes this treatment because it has “a combination of steroids and lidocaine,” which are sometimes necessary for treating hemorrhoids. The steroids “shrink the area down,” according to Schnoll-Sussman, while the lidocaine numbs it. Together, they treat itching, burning, and general discomfort. All you have to do is apply a layer to your external hemorrhoids with your finger for it to work.
But if you have internal hemorrhoids, you’ll need to purchase the treatment in suppository form, which will help you insert the ointment into your anus. Because it’s a hardened version of the hemorrhoidal cream and inserted with your finger, “it’ll soften and melt in your bottom,” says Schnoll-Sussman, so it directly reaches your internal hemorrhoids. And if the over-the-counter treatments don’t seem to help either internal or external hemorrhoids, talk to your doctor, who can prescribe a higher steroid percentage.
Schnoll-Sussman also tends to recommend Tucks, formerly known as Anusol, for patients with itchy or irritated hemorrhoids. And though Tucks doesn’t help shrink hemorrhoids like Preparation-H does, their multi-relief care kit can help with some of the most uncomfortable symptoms. As Nee explains, it contains a maximum strength lidocaine cream to treat pain and numb the area, and medicated witch hazel wipes to soothe any itchiness or burning that may occur. Combined, they can decrease swelling and pain.
Best butt-cleaning products
A big part of treating hemorrhoids isn’t a specific ointment or cream — it’s just proper anal care. A lot of patients with hemorrhoids have other conditions (like IBS) that make going to the bathroom difficult. So with that in mind, Schnoll-Sussman says, “Something that causes a lot of discomfort for people is when they do finally go to the bathroom, they have to use really abrasive toilet paper to wipe themselves, which not only hurts but also irritates hemorrhoids as well.” She recommends very gentle baby wipes instead of toilet paper. These Burt’s Bees baby wipes are chlorine-, fragrance-, and irritant-free, and they have a clothlike texture, so they’re extra gentle on sensitive areas.
Or, if you prefer to flush the wipes afterwards instead of throwing them away, the gentle version of Cottonelle’s sewer-safe, plumber-tested flushable wipes might be more up your alley. They’re lubricated, which Schnoll-Sussman tends to recommend, yet they’re infused with aloe and Vitamin E, ensuring they’ll be extra gentle on your bottom and might even soothe the area.
Best bottom soothers
“One of the best things to do for people that have active hemorrhoids is basically to sit in a bathtub,” says Schnoll-Sussman. She adds that you don’t “need to do anything special with it: just warm water and sit for 15 minutes.” This allows the anus to relax and soothes hemorrhoids while allowing them to regress, and it works for both internal and external hemorrhoids. But since most who live in apartments don’t have access to a bathtub, a sitz bath works as an alternative. You place the apparatus filled with warm water on your toilet seat and sit on it for 10 to 15 minutes. Nee recommends using a sitz bath “a few times a day” because that will be most effective to “decrease the pain and swelling” occurring with hemorrhoids. However, if you’re not able to do it so frequently, just morning and night will make a difference. You can also add epsom salts if you like, but “it’s not necessary,” says Schnoll-Sussman.
Each gastroenterologist notes that if you’re dealing with hemorrhoids, you should be sitting less overall to decrease irritation. But if you must sit (and it’s uncomfortable), a donut cushion might help you. “When you sit in it, your hemorrhoid will be in the donut, so there will be nothing push up against it, causing irritation,” says Dr. Lawrence Brandt, a gastroenterologist at the Montefiore Medical Center. This one from Amazon has a cover, so the donut shape is a bit more inconspicuous than most.