The best hemorrhoid ointments for sore, irritated skin

An ointment is the better hemorrhoid product when the skin is raw, when a cream rubs off on underwear, or when you need one tube labeled for inside and outside. Our usual first pick is Preparation H Ointment. Calmoseptine is for sore, itchy skin from wiping or loose stools. Americaine is for severe pain on the outside after milder creams have fallen short. Motherlove is a non-medicated balm for pregnancy and the weeks after birth.

Ointments ease symptoms. They are a weak choice for bleeding on their own, because fiber still has the trial evidence for that. This page explains how these four differ from creams, what ointment studies have actually measured, and how long it is reasonable to use one. If the problem is itching and burning on intact skin, start with the best hemorrhoid creams. Every product type is listed on the best hemorrhoid products.

Our picks compared

All four are ointments. Two are medicated and aimed at pain or swelling, one is a barrier for raw skin, and one is a plain balm.

Reviews of our picks

The notes under each award come from recent buyer comments: what people said the ointment did, and the complaints that showed up more than once.

How we chose these hemorrhoid ointments

We looked for ointments with strong overall ratings from a large number of buyers, then read recent reviews for the same praises and the same complaints. Preparation H Ointment has a long record. Buyers talk about a smooth layer that stays put, a larger tube, and mixed results for itch. A few tubes have arrived close to the expiry date, so checking the box is part of the advice.

Calmoseptine’s reviews were not summarized by the retailer in a neat block, so we read them. People use it for anal itching, a sore bottom after diarrhea, and raw skin a caregiver is trying to protect. The warm tingle at the start is the complaint that repeats, along with the fact that it does not numb sharp pain. Americaine’s reviews are short: it numbs when milder products did not. Greasy texture is the tradeoff. It has fewer reviews than Preparation H, and enough of them agree that it earned the severe-pain slot.

Motherlove, sold for years and still discussed under its older name by some buyers, has a smaller medical job. Recent reviews from new parents call it gentle. Grease, stains, and a small jar are the downsides. We included it because pregnancy and postpartum shoppers ask for a non-medicated option, not because a trial tested this jar. No brand pays for a place on the list. The editorial policy explains how we update a page.

What the research says

The NIDDK treatment page groups creams, ointments, and suppositories together: they may ease mild pain, swelling, and itching of external hemorrhoids, usually for about a week ¹. The NHS instructions for hydrocortisone for piles are more specific about form. Creams, ointments, and sprays go on the outside skin. Suppositories are for internal piles. Hydrocortisone treatments stop at 7 days unless a doctor says otherwise ².

A 2019 review says medical therapies for hemorrhoids have not been formally studied except for fiber ¹¹. The ointment trials that do exist are mostly about numbing after a procedure, a clotted external hemorrhoid, or the weeks after surgery. None of them compared the four ointments on this page.

For a thrombosed external hemorrhoid, a 2001 trial compared 1.5 percent lidocaine ointment alone with the same ointment plus 0.3 percent nifedipine, used every 12 hours. At 7 days, pain was completely relieved in 24 of 48 people on lidocaine alone (50 percent) and in 43 of 50 on the combination (86 percent). At 14 days the lump had resolved in 45.8 percent with lidocaine alone and in 92 percent with the combination. No systemic side effects were seen in the nifedipine group ⁴. A 2025 review of that same pairing concluded it should be considered for thrombosed hemorrhoids, chronic anal fissure, and pain after hemorrhoidectomy, and that the literature is still limited ⁷. Nifedipine is a prescription drug. Americaine is a different product: the over-the-counter numbing ointment buyers use when milder creams have not been enough.

After rubber band ligation, 2 percent lidocaine ointment three times a day for five days lowered pain at one hour versus placebo in a 99-person trial. The authors said the pain relief looked short term ⁵. A safety study of a 5 percent lidocaine ointment in 24 people with anorectal pain found blood levels stayed below the thresholds the authors called therapeutic and toxic ⁶. A review of pain care after hemorrhoid surgery lists topical lidocaine among the options supported by trials, alongside laxatives and other medicines ²¹.

Barrier ointments show up in itch care, not in hemorrhoid shrinkage trials. A review of pruritus ani suggests washing, then a barrier such as zinc oxide or a plain petroleum ointment, and a short course of 1 percent hydrocortisone morning and night for mild itch. Once the skin settles, the steroid comes off and the barrier stays. The same review says topical anesthetics relieve itch for only a few hours and can sensitize skin, and that potent steroid creams can thin skin, cause dermatitis, and trigger more itch when you stop them. Those steroid problems are much less common with 1 percent hydrocortisone, and a safe maximum duration for the weak steroid has not been defined ³. That is why we do not suggest weeks of a steroid ointment for ordinary hemorrhoid itch. How anti-itch and numbing creams differ goes further on that choice.

After surgery, the ointment evidence is real and messy. A network meta-analysis of 26 randomized trials and 2,132 people compared locally applied products after excisional hemorrhoid surgery. A numbing cream ranked high for pain at 12 hours, an aloe cream at 24 hours, and metronidazole ointment at 7 and 14 days. The authors called the results inconclusive and asked for better trials ⁸. One of those trials, in 49 people, found an aloe cream applied three times a day reduced pain at 12, 24, and 48 hours and at two weeks versus placebo cream, with better wound scores at two weeks ⁹. That is postoperative care, not a drugstore plan for a weekend flare. MedlinePlus still lists hydrocortisone and lidocaine creams, witch hazel, and 10 to 15 minute warm soaks for home symptoms ¹⁴.

Fiber remains the treatment with a pooled estimate for bleeding. Seven trials, 378 people, about a 50 percent lower risk of bleeding and a 47 percent lower risk that symptoms would not improve ¹⁷. An ointment can protect skin while you do that. It does not stand in for it. The fiber supplement guide is the pairing we would actually buy with an ointment.

A painful lump has its own clock. In a chart review, conservative care took an average of 24 days for symptoms to settle, versus 3.9 days after the clot was removed ¹⁸. Most people treated without surgery did improve ¹⁸. Excision in the first two or three days can greatly reduce pain when a clinician offers it ¹⁰. If that is your situation, read thrombosed hemorrhoid before you rely on a barrier ointment alone.

Pregnancy and breastfeeding need a separate sentence from the buyer reviews. The NHS page on hydrocortisone in pregnancy says hydrocortisone ointments for piles can be used in pregnancy, and for a short time while breastfeeding. Wash your hands before you pick up the baby ¹³. A study of 204 women who used a hydrocortisone-and-numbing foam in the third trimester found no increase in prematurity or birth complications ²⁰. A 2008 review noted that everyday topical products had not each been tested in pregnancy, and that symptoms often ease after delivery ¹². Motherlove is not that foam, and we do not have a trial of the balm. Use it as a comfort product, and ask your obstetric provider before any medicated ointment. Postpartum hemorrhoids and the postpartum product guide cover the rest of that week.

How to choose

Skip Americaine if numbing creams have stung or rashes you before. Skip Calmoseptine if you need the pain to go quiet in the next hour. Skip Motherlove if you need numbing. Skip all four as your only treatment if the main symptom is bleeding: add fiber, and read external hemorrhoids so you know whether the lump is on the outside at all.

If wiping is what keeps the skin raw, the ointment has less chance to help until you rinse. Hemorrhoid sprays and rinse bottles and wipes are the cleaning side of that problem. The NHS piles page says to pat the skin dry ¹⁹.

How to use them safely

1. Clean gently. The NHS method for an external hydrocortisone ointment is to wash your hands, apply a small amount around the outside of the anus, and wash your hands again ². Use that pattern unless your leaflet says something different.
2. Preparation H Ointment is labeled for internal use as well. If you use the applicator, follow the drawing in that box. Do not put Calmoseptine, Americaine, or Motherlove inside.
3. For hydrocortisone ointments, the usual times are morning, night, and after a bowel movement, and not longer than 7 days ². NIDDK’s window for over-the-counter products in general is about a week. Stop if you get a rash or the skin dries out ¹.
4. Expect Calmoseptine to feel briefly warm. If the feeling becomes burning that builds, wash it off.
5. Americaine is greasy. Use a thin layer and give it a minute before you dress. If you have reacted to numbing medicine before, do not start with this one.
6. Motherlove can mark fabric. A small amount goes far, according to buyers. It is a comfort balm, so pair it with fiber and a rinse if stools are hard.
7. While breastfeeding, keep hydrocortisone ointments short, and wash your hands before you hold the baby ¹³. If your baby’s feeding changes, call your clinician.
8. If nothing has changed after a week, stop layering ointments and get examined ^1,2. A clot that is still severely painful in the first two or three days is a same-week doctor question, not a day-14 ointment question ¹⁰.

When to see a doctor instead

Ointment on the wrong problem delays the visit that would sort it out. The American Cancer Society’s symptom list for colorectal cancer includes stool that looks dark brown or black from blood, a change in bowel habits lasting more than a few days, belly pain, weakness, and unintended weight loss ¹⁶. Screening for adults at average risk starts at 45 ¹⁵.

NIDDK says to seek care right away for severe anal pain and rectal bleeding, especially with belly discomfort, diarrhea, or fever ¹. When to see a doctor for hemorrhoids explains the exam. If an ointment and fiber have already had a fair trial, the treatment overview covers office procedures such as banding.

GuideExternal hemorrhoids: symptoms and relief

Why external hemorrhoids hurt, itch, and swell, how long a flare usually lasts, and what helps with soreness and cleaning at home.