Preparation H vs Tucks: which should you buy?

Preparation H and Tucks sit next to each other in the hemorrhoid aisle, and they do different jobs. Preparation H is a line of creams, an ointment, a gel, and suppositories you apply for burning, itching, or swelling. Tucks cooling pads are pressed on the skin for a few minutes when the area feels hot, itchy, or sore, including in the weeks after birth.

Match the form to the feeling. Lingering burn on the outside skin is a cream problem. A hot itch right after you wipe is a pad problem. Plenty of people use one and then the other on the same day. This page sorts them by product type, what buyers run into, and what studies of fiber, creams, and astringents actually show. The wider set of store products is in our guide to over-the-counter hemorrhoid treatment.

Cream, ointment, suppository, or pad

External hemorrhoids sit under the skin at the anal opening, so they itch, burn, and swell where a finger or a pad can reach. Internal hemorrhoids are higher inside. They tend to bleed and to slip down, and an outside-only cream does not land on them. A suppository is the form made to go inside.

The NIDDK page on hemorrhoid treatment says creams, ointments, and suppositories may relieve mild pain, swelling, and itching of external hemorrhoids. Doctors most often recommend those products for 1 week. If symptoms are the same after that, or the skin gets dry or a rash appears, follow up with a doctor ¹.

The Preparation H forms split along those lines:

• Maximum strength cream is for burning, itching, and soreness on the outside. Buyers describe relief within minutes to hours, with swelling easing over a few days. Some people who write about results say it did little. The tube runs out quickly if you use it several times a day.
• The ointment is sold for inside and outside use. Buyers say it goes on smoothly and stays put. Itch relief is more mixed than relief of discomfort. Check the date when a tube arrives, because some sit close to expiry.
• Cooling gel is the light option for skin that feels hot. Some buyers feel soothed within minutes. Others barely notice the cool.
• Rapid relief cream is the one people pick when sharp pain makes sitting hard. A few find it irritating, or feel no numbing. The child-resistant cap is hard for some people to open.
• Suppositories are for swelling and discomfort inside, especially overnight. The foil can be awkward, and some arrive cracked.
• Tucks cooling pads are for itching, burning, and postpartum soreness. Buyers fold a pad and leave it in place for 10 to 15 minutes. The pads stick together, which is the complaint that keeps coming up.

Our roundups of hemorrhoid creams, hemorrhoid ointments, and hemorrhoid wipes and cooling pads cover the listings in each group.

The Tucks multi-care kit puts a small cream and a short stack of pads in one box. People pack it for a hospital bag or a first flare. The tube and the pads run out fast, so treat it as a starter.

What studies say about creams and pads

About 10 million people in the United States have hemorrhoidal disease, according to a 2025 review in JAMA. First-line care in that review is more fiber, more water, and less straining on the toilet. Phlebotonics, a group of vein-tone medicines such as flavonoids, can reduce bleeding, pain, and swelling, and symptoms come back in as many as 80% of people within 3 to 6 months after they stop ⁴. A cream is for the days when the skin hurts. It is not the treatment with the strongest trial record.

Fiber is. A 2006 meta-analysis of seven fiber trials randomized 378 people to fiber or a non-fiber comparison. Fiber cut the risk of bleeding by about half (relative risk 0.50) and lowered the risk of symptoms failing to improve by 47% (relative risk 0.53). Pain, itching, and prolapse may improve too, but those results were too uncertain to settle ³. Our hemorrhoid treatment guide puts the order the same way: softer stools and shorter toilet time first, products for the symptoms you feel today, and a procedure only if those fail.

The AGA expert review on hemorrhoids says topical anesthetics, astringents (witch hazel), corticosteroids, and vasoactive agents can be considered, and that there is little data to show they work. Topical steroids should not be used for more than 2 weeks at a time ². Witch hazel is the astringent that review names. We look at the plant evidence separately in does witch hazel work for hemorrhoids. Cooling pads are the drugstore version of a cool, drying wipe. The review does not show that a pad beats a cream, or the reverse.

The NHS piles page tells you to keep the area clean and dry, and to pat rather than rub ⁵. A pad can lift soil off without the scrape of dry paper. Cream goes on after the skin is dry. That page also lists a warm bath and an ice pack wrapped in a towel, which are separate tools from either product.

How to use a cream and a pad on the same day

1. After a bowel movement, clean with a cooling pad or with plain water. Pat dry. Do not scrub with dry paper while the skin is sore.
2. If the burn or itch is still there, put a pea-sized amount of cream or ointment on the outside skin. Use an ointment inside, or a suppository, only when the label says that form can go inside.
3. For a hot, itchy spell, fold a cooling pad and leave it against the skin for 10 to 15 minutes. Buyers of the Tucks pads describe that as their usual method. A few times a day during a flare is enough.
4. If you want both, pad first, dry the skin, then cream. Cream smeared over a dripping pad slides off and keeps the skin wet.
5. Keep the sit short. Straining and long sits keep the flare going. The toilet habits guide covers a footstool and a time limit.
6. If a week has passed and you are no better, stop shopping for a second brand and talk to a doctor ¹.

Pregnancy and the weeks after birth

Hemorrhoids are common late in pregnancy. A 2008 review for family doctors said most care is practical: more fiber, a stool softener, more fluid, and better toilet habits. Those authors wrote that common topical hemorrhoid products had not been formally tested in pregnancy, and that harm to a baby in the third trimester was unlikely ⁷. Ask your obstetric provider before you start a medicated cream.

A hospital study followed 495 pregnant women in Saudi Arabia on one of two plans. Both groups used a fiber supplement and a glycerin suppository before bowel movements. One group (284 women) also took a warm salty sitz bath three times a day. The other (211 women) used a topical ano-rectal cream twice a day. The authors recorded complete healing in all 284 women in the sitz group, and in 179 of 211 (84.8%) in the cream group ⁶. This was a comparison of two protocols, not a blinded trial, and the salt was part of that hospital’s bath recipe. It does not mean a cooling pad is useless in pregnancy. It does mean a warm soak can matter as much as a cream. The steps are in how to take a sitz bath.

After a vaginal birth, cooling pads are the product new parents describe for itch and perineal soreness. A cream still helps if the skin burns between pad changes. Care through those weeks is covered in postpartum hemorrhoids.

When a wipe makes the itch worse

Cooling pads are usually well tolerated. A different problem shows up with some wet wipes. In a 2014 report, six children had a rash around the anus and on the face that did not clear with antibiotics or steroid creams. Each child had been using wet wipes that contained the preservative methylisothiazolinone. The rash cleared after the wipes stopped ⁸. Adult skin can react to a wipe too. If a new wipe spreads redness or itch, stop it. The report in Pediatrics is a small case series, and it is specific to that preservative, not to every pad on the shelf.

If the tube you picked up is a hydrocortisone cream, the NHS page on hydrocortisone for piles says not to use it for more than 7 days, because longer use can thin the skin ¹⁰. How that steroid compares with a numbing cream is in anti-itch or numbing cream.

If a week goes by and you are no better

Keep the fiber going while you decide on the next step. A sudden hard lump that shows up over hours is a different problem: a blood clot in an external hemorrhoid, called a thrombosed hemorrhoid. The first few days are the painful ones.

GuideThrombosed hemorrhoid: what the sudden painful lump is

A thrombosed hemorrhoid is a clot under the skin. Why the first 72 hours matter, how pain eases over 1 to 3 weeks, and when to get care.

Office treatments such as banding, also called rubber band ligation, are for internal hemorrhoids that keep bleeding or prolapsing after home care. They are not a substitute for a week of softer stools.

The USPSTF recommendation on colorectal cancer screening starts screening at age 45 ⁹. Hemorrhoids are a common reason for bright red blood on the paper, and they are not the only reason. If the cream and the pads have not changed your symptoms after 7 days, book the visit and take the product names with you.