Hemorrhoids are swollen veins located in the rectum and anus, similar to varicose veins found elsewhere in the body. They can be internal, forming inside the rectum, or external, developing under the skin around the anus. These irritated veins often cause symptoms like itching, pain, and swelling. For most people experiencing mild to moderate discomfort, over-the-counter topical treatments are the most common first-line solution for temporary relief. Choosing the right product depends on matching the formulation to the specific symptom, rather than which is universally better.
Defining Creams and Ointments
The difference between a hemorrhoid cream and an ointment lies in their base composition. Creams are formulated as emulsions, meaning they are primarily water mixed with a small amount of oil. This water-based structure makes creams lighter, non-greasy, and allows them to disappear quickly into the skin upon application.
Ointments, by contrast, are oil-based, typically containing petroleum jelly or mineral oil. This composition makes them significantly thicker and greasier than creams. The oily base is designed to repel water and remain on the skin’s surface for an extended period, which is key to their therapeutic function.
Absorption, Lubrication, and Barrier Function
The base of the formulation directly impacts how the treatment interacts with the affected tissue. Creams, with their high water content, are designed for rapid absorption into the skin. This is beneficial when the goal is to quickly deliver an active ingredient to address symptoms like burning or inflammation. However, creams offer less lasting protection since the ingredients are absorbed quickly.
Ointments are superior when a protective barrier is needed because their occlusive base creates a physical seal over the irritated tissue. This barrier is effective for managing external hemorrhoids, shielding the area from friction and moisture that can worsen irritation. The thick layer also provides lubrication, which can ease discomfort during bowel movements. Since ointments are absorbed slowly, they provide a sustained release of therapeutic compounds, making them effective for long-lasting relief, such as overnight use.
Comparing Active Ingredients for Symptom Relief
Both creams and ointments deliver therapeutic compounds, but the ingredient determines the type of relief. Primary ingredients include anti-inflammatories, such as hydrocortisone, which reduces swelling and itching. Local anesthetics, like lidocaine or pramoxine, provide immediate relief by temporarily blocking nerve signals that transmit pain.
A third category includes protectants like zinc oxide, petrolatum, or mineral oil, which are often the primary components of ointments. Protectants physically coat the area to prevent further irritation and moisture loss, promoting a healing environment. Some products also contain vasoconstrictors, such as phenylephrine, which act by temporarily constricting small blood vessels to reduce swelling. While a cream may deliver a fast-acting anesthetic more quickly, an ointment is more effective at keeping a protectant barrier in place for hours.
Usage Guidelines and When to Consult a Doctor
Topical hemorrhoid treatments are typically applied up to four times daily, often after a bowel movement and at bedtime. Gently cleanse the area before application to ensure maximum contact with the affected tissue. If using products with an applicator for internal use, follow the specific package directions to avoid injury or overuse.
Most over-the-counter creams and ointments, especially those containing a steroid like hydrocortisone, should not be used continuously for more than seven days. Prolonged use of steroid products can lead to side effects like skin thinning or local irritation. If symptoms fail to improve after one week of diligent at-home treatment, or if you experience severe pain, excessive or persistent rectal bleeding, or a hard, dark-colored lump, consult with a healthcare provider for a thorough examination.