Haemorrhoid Creams Compared
Which preparation for which problem, why steroid-containing products are short-course only, and the measures that do more than the tube does.
Part of the Complete Haemorrhoids Guide.
Key fact: No cream shrinks a haemorrhoid permanently — they ease itching, soreness and swelling while it settles. The split that matters is steroid versus non-steroid: soothing preparations can be used for longer, while steroid-containing products are short-course only because prolonged use thins the skin.
What the creams actually do
No topical treatment shrinks a haemorrhoid permanently. What they do is reduce the symptoms — itching, soreness, swelling and discomfort — while the underlying problem settles, which it usually does if the bowel habit that caused it is also addressed. That framing matters, because it explains why a cream alone often disappoints and why the boring measures in our prevention guide do more of the work than the tube does.
The products fall into two groups: soothing preparations without a steroid, and preparations containing a steroid, usually with a local anaesthetic.
The four compared
| Product | Contains | Best for | Duration |
|---|---|---|---|
| Anusol | Soothing and astringent ingredients; no steroid | Mild itching and soreness; suitable for longer use than steroid products | Can be used for longer courses — follow the pack |
| Anusol Plus HC | The above plus hydrocortisone | Inflammation and itching that soothing preparations have not settled | Short courses only |
| Uniroid HC | Hydrocortisone with a local anaesthetic (cinchocaine) | Inflamed, painful haemorrhoids where pain is prominent | Short courses only |
| Scheriproct | A stronger steroid (prednisolone) with a local anaesthetic | More marked inflammation and pain | Short courses only |
Steroid-containing preparations are for short courses. Prolonged use on the delicate skin around the anus can thin it and make matters worse, so these are typically used for about a week rather than continuously, with the product information and your pharmacist or prescriber setting the exact limit. If symptoms are not settling within that time, the answer is assessment rather than a repeat tube.
Cream, ointment or suppository?
The same medicine often comes in more than one form, and the form should match where the problem is.
- Cream or ointment with an applicator — for internal haemorrhoids, applied using the nozzle provided
- Cream or ointment applied externally — for external haemorrhoids, skin irritation and itching around the anus
- Suppositories — sit inside and suit internal haemorrhoids, particularly where bleeding and discomfort come from higher up
Practical points that make a real difference: apply after a bowel movement and at bedtime rather than randomly, wash and dry the area first, use the applicator gently, and wash your hands afterwards. Suppositories are easier to insert if you lie on your side with knees drawn up.
What to do alongside the cream
The cream treats the symptom. These treat the cause, and without them the haemorrhoid tends to return:
- Soften the stool — more fluid, more soluble fibre, and a bulk-forming or osmotic laxative if needed
- Stop straining, and do not sit on the toilet for long periods
- Warm baths or sitting in shallow warm water several times a day, particularly after a bowel movement
- Ice packs wrapped in a cloth for swelling and discomfort
- Simple painkillers — paracetamol is preferred; codeine causes constipation and makes things worse
- Keep the area clean and dry, patting rather than rubbing
Avoid fragranced or alcohol-based wipes and antiseptics, which irritate already inflamed skin. Plain water and a soft towel, or unfragranced wipes used gently, are better tolerated.
If the cream is not working
Reconsider the diagnosis first. Sharp pain on passing stool with bright red blood is more likely to be an anal fissure, which needs a different approach. A sudden, exquisitely painful lump is likely to be a thrombosed external haemorrhoid. Persistent itching without bleeding can be a skin condition rather than a haemorrhoid at all.
If it is haemorrhoids and topical treatment plus bowel measures have not settled them, the next steps are procedural rather than pharmaceutical — rubber band ligation, sclerotherapy or surgery depending on grade, all covered on the main haemorrhoids page.
See a clinician rather than continuing to self-treat if bleeding persists or recurs, if bleeding is painless and you are over 40, if you have a change in bowel habit, weight loss or tiredness, or if pain is severe. Bleeding should never be assumed to be haemorrhoids without assessment — see rectal bleeding compared.
Frequently Asked Questions
What is the difference between Anusol and Anusol Plus HC?
Anusol contains soothing and astringent ingredients with no steroid, so it suits mild itching and soreness and can be used for longer. Anusol Plus HC adds hydrocortisone, a steroid, which tackles inflammation more effectively but is intended for short courses only because prolonged steroid use thins the delicate skin around the anus.
How long can I use a steroid haemorrhoid cream?
Short courses only, typically around a week, with the product information and your pharmacist or prescriber setting the exact limit. Continuing beyond that risks thinning the skin and making symptoms worse. If things have not settled in that time, the answer is assessment rather than another tube.
Should I use a cream, an ointment or a suppository?
Match the form to the site. Cream or ointment applied externally suits external haemorrhoids and skin irritation; the same product used with the applicator nozzle reaches internal haemorrhoids; suppositories sit inside and suit internal haemorrhoids, particularly with bleeding or discomfort higher up.
Do haemorrhoid creams shrink piles?
Not permanently. They reduce itching, soreness and swelling while the haemorrhoid settles, which it usually does if the bowel habit behind it is also addressed. That is why softening the stool, avoiding straining and not sitting on the toilet for long periods matter more than which tube you choose.
What painkillers can I take?
Paracetamol is the usual choice. Avoid codeine and codeine-containing painkillers, because they cause constipation and constipation is what aggravates haemorrhoids in the first place. Ibuprofen can help with inflammation if it suits you otherwise.
Why is the cream not helping?
Often because the diagnosis is different. Sharp pain on passing stool with bright red blood suggests an anal fissure; a sudden exquisitely painful lump suggests a thrombosed external haemorrhoid; persistent itching with no bleeding may be a skin condition. If it is haemorrhoids and creams plus bowel measures have failed, the next steps are procedures rather than more cream.
References
- NHS. Piles (haemorrhoids). nhs.uk
- NHS. Anal fissure. nhs.uk
- National Institute for Health and Care Excellence. Clinical Knowledge Summary: Haemorrhoids. cks.nice.org.uk
- National Institute for Health and Care Excellence. Suspected cancer: recognition and referral (NG12). nice.org.uk
- National Institute for Health and Care Excellence. Quantitative faecal immunochemical testing to guide referral for colorectal cancer in primary care (DG56). nice.org.uk
Medical disclaimer: This article is for informational purposes only and does not constitute medical advice. Rectal bleeding should never be assumed to be haemorrhoids without assessment. Always consult a qualified healthcare professional for diagnosis and treatment. In a medical emergency, call 999.