Walking down the pharmacy aisle, you'll find numerous hemorrhoid creams, ointments, and suppositories, each claiming to provide relief. But what actually makes these products work? Understanding the active ingredients in hemorrhoid treatments helps you choose the right product for your specific symptoms and avoid ingredients that may not be suitable for you.

This comprehensive guide breaks down the most common ingredients found in hemorrhoid treatments, explaining how each one works and what symptoms it targets.

Pain Relief Ingredients

Pain and discomfort are among the most troublesome hemorrhoid symptoms. Several ingredients provide local pain relief:

Lidocaine

Lidocaine is a local anaesthetic that works by temporarily numbing the affected area. It blocks nerve signals from the application site, providing quick relief from pain and burning sensations.

  • How it works: Blocks sodium channels in nerve cells, preventing pain signals from reaching the brain
  • Onset: Works within minutes of application
  • Duration: Effects typically last 1-3 hours
  • Concentration: Usually found in 2-5% concentrations in OTC products

Best for: Sharp pain, burning sensations, and discomfort during bowel movements

Pramoxine

Pramoxine is another local anaesthetic with similar pain-relieving properties to lidocaine but with a different chemical structure.

  • How it works: Stabilises nerve cell membranes, reducing pain transmission
  • Benefit: May be suitable for those sensitive to lidocaine
  • Found in: Some Preparation H formulations

Benzocaine

Benzocaine is a topical anaesthetic that provides temporary numbing relief.

  • Action: Similar to lidocaine but may have shorter duration
  • Note: Some people are allergic to benzocaine; test on a small area first
Choosing Pain Relief

If pain is your primary symptom, look for products listing lidocaine, pramoxine, or benzocaine as active ingredients. These provide the fastest relief for acute discomfort.

Anti-Inflammatory Ingredients

Inflammation causes much of the swelling, redness, and discomfort associated with hemorrhoids. These ingredients help reduce inflammatory responses:

Hydrocortisone

Hydrocortisone is a mild corticosteroid that reduces inflammation, itching, and swelling. It's one of the most effective ingredients for hemorrhoid symptom relief.

  • How it works: Suppresses inflammatory chemicals in the body, reducing swelling and irritation
  • Concentration: OTC products typically contain 0.5-1% hydrocortisone
  • Usage limit: Should not be used for more than 7 consecutive days without medical advice
  • Caution: Prolonged use can thin the skin in the application area
Hydrocortisone Precautions

While effective, hydrocortisone should be used cautiously. Don't use for more than one week continuously, avoid during pregnancy unless advised by a doctor, and don't use if you have an infection in the area. Prescription-strength hydrocortisone is available for severe cases but requires medical supervision.

Witch Hazel (Hamamelis virginiana)

Witch hazel is a natural plant extract with anti-inflammatory and astringent properties. It's one of the most popular natural ingredients in hemorrhoid treatments.

  • How it works: Contains tannins that reduce inflammation and tighten tissue
  • Benefits: Reduces swelling, soothes irritation, helps stop minor bleeding
  • Advantage: Generally safe for longer-term use and during pregnancy

Vasoconstrictor Ingredients

Vasoconstrictors narrow blood vessels, which can reduce swelling and bleeding:

Phenylephrine

Phenylephrine is a vasoconstrictor found in many popular hemorrhoid products, including Preparation H.

  • How it works: Constricts blood vessels, reducing blood flow to the hemorrhoid tissue
  • Benefits: Temporarily shrinks hemorrhoids and reduces bleeding
  • Concentration: Typically 0.25% in OTC products

Best for: Reducing swelling and shrinking hemorrhoid tissue

Ephedrine Sulfate

Another vasoconstrictor found in some formulations, though less common than phenylephrine.

Key Active Ingredients by Symptom
  • Pain: Lidocaine, Pramoxine, Benzocaine
  • Inflammation/Swelling: Hydrocortisone, Witch Hazel
  • Itching: Hydrocortisone, Witch Hazel
  • Bleeding: Phenylephrine, Witch Hazel
  • Tissue protection: Zinc Oxide, Petrolatum

Protective and Soothing Ingredients

These ingredients form a barrier over hemorrhoid tissue and provide soothing relief:

Zinc Oxide

Zinc oxide is a mineral that provides a protective barrier over irritated skin.

  • How it works: Creates a physical barrier that protects tissue from moisture and irritation
  • Benefits: Promotes healing, reduces friction, has mild astringent properties
  • Found in: Many ointment formulations

Petrolatum (Petroleum Jelly)

Petrolatum is a thick, protective base found in many ointment formulations.

  • How it works: Forms an occlusive barrier that locks in moisture and protects tissue
  • Benefits: Prevents drying, reduces friction during bowel movements
  • Advantage: Non-irritating for most people

Mineral Oil

Mineral oil lubricates and protects hemorrhoid tissue.

  • Benefits: Softens skin, eases bowel movements, reduces friction
  • Often combined with: Other active ingredients in ointment bases

Aloe Vera

Aloe vera is a natural soothing agent with healing properties.

  • How it works: Contains polysaccharides that reduce inflammation and promote healing
  • Benefits: Moisturises, soothes, supports tissue repair
  • Best for: Those seeking natural ingredient options

Natural and Herbal Ingredients

Many people prefer products with natural ingredients. Here are common natural components:

Calendula

Calendula (pot marigold) has traditional uses for wound healing and skin irritation.

  • May reduce inflammation and promote healing
  • Generally well-tolerated with few side effects

Chamomile

Chamomile has anti-inflammatory and soothing properties.

  • Helps calm irritated tissue
  • Often combined with other natural ingredients

Tea Tree Oil

Tea tree oil has natural antiseptic and anti-inflammatory properties.

  • Must be properly diluted to prevent irritation
  • Not for use during pregnancy

Reading Product Labels

When selecting a hemorrhoid product, understanding the label helps you make an informed choice:

Active Ingredients

These are the ingredients that actually treat symptoms. They're listed at the top of the label with their concentrations and purposes.

Inactive Ingredients

These are the base materials that deliver the active ingredients. They may include preservatives, fragrances, or texture enhancers. If you have sensitive skin or allergies, review these carefully.

Drug Facts Panel

All OTC hemorrhoid products in Australia must include a drug facts panel listing:

  • Active ingredients and their purposes
  • Uses (what symptoms the product treats)
  • Warnings and precautions
  • Directions for use

Choosing the Right Product

Consider these factors when selecting a hemorrhoid treatment:

  1. Identify your primary symptoms: Match ingredients to what bothers you most
  2. Consider formulation type: Creams absorb faster; ointments provide longer protection
  3. Check for contraindications: Pregnancy, allergies, or existing conditions
  4. Note usage restrictions: Some ingredients shouldn't be used long-term

For personalised recommendations based on your symptoms, try our product finder quiz or explore our full product comparison.

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Emma Thompson

Product Research Lead

Emma analyses hemorrhoid treatment ingredients and formulations. She reviews clinical evidence and product information to help readers understand their treatment options.