Does witch hazel work for hemorrhoids?

Witch hazel is a plant extract in pads and liquids that people use for itching and burning from hemorrhoids. It is reasonable to try on the outside skin for a short time. The AGA clinical practice update on hemorrhoids says astringents such as witch hazel can be considered, and that there is little data to show they work ¹.

An astringent is a liquid that makes skin feel tighter and drier. The studies behind witch hazel looked at sunburn-type redness, eczema, minor skin injuries in children, and diaper rash. None was a randomized trial in adults with hemorrhoids. This page covers what the plant is, what those studies measured, how to use a pad for about a week, and who should skip it.

For the rest of home care, start with hemorrhoid home remedies and which ones have evidence. Witch hazel is compared head to head with aloe in witch hazel vs aloe vera for hemorrhoids, and with 19 other options in natural remedies for hemorrhoids, graded by evidence. Popular online remedies such as vinegar and tea tree oil are checked in apple cider vinegar for hemorrhoids.

What witch hazel is

Witch hazel is the shrub Hamamelis virginiana. The bark has been used in traditional medicine for hemorrhoid symptoms, irritated skin, and minor wounds. Writers on the plant credit the tannins, a group of plant compounds that give it the dry, tightening feel ². A 2025 review of the skin research describes antimicrobial, anti-inflammatory, and wound-healing effects in lab and animal work, plus a small number of clinical trials, mostly on skin rather than on hemorrhoids ³.

Lab work on bark extract found that the extract and one of its tannins, hamamelitannin, calmed inflammatory signals in human cells and helped skin cells move across a scratch in a dish. The same paper found that skin bacteria can change the extract. One breakdown product, ellagic acid, raised inflammatory signals from connective-tissue cells in that lab model ². A pad on your skin is not the same thing as a fresh extract in a test tube.

That history explains the hemorrhoid aisle. A pad has not been shown to shrink a hemorrhoid or stop bleeding.

What studies show about witch hazel

The strongest human experiments used hamamelis distillate, a refined liquid from the plant, on the skin of the back or on eczema. They did not put it on hemorrhoids.

In 1993, researchers tested the distillate on 24 healthy adults. They caused redness with ultraviolet light and by lifting off the outer skin with tape. A low-dose witch hazel cream reduced the ultraviolet redness at 24 hours. Hydrocortisone 1% cream looked stronger. A fourfold higher witch hazel dose did not work better ⁴.

In 1998, 30 healthy volunteers got a controlled sunburn-type redness, then an occlusive patch for 48 hours. A lotion with 10% hamamelis distillate cut redness by about 20% at 7 hours and about 27% at 48 hours. The comparison lotions, without that distillate, cut redness by about 11 to 15%. The difference was statistically significant ⁵. This is the ultraviolet-redness test of a 10% hamamelis lotion. It shows a mild anti-inflammatory effect on irritated skin. It does not show what happens to a bleeding internal hemorrhoid.

The eczema trial is the one that should temper the drugstore claims. In 1995, 72 people with moderately severe atopic eczema used creams for 14 days in a double-blind test, meaning neither they nor the raters knew which cream was which. Each person was part of a comparison of witch hazel distillate cream, the same cream without the distillate, and 0.5% hydrocortisone. All three reduced itch, redness, and scaling after one week. Hydrocortisone reduced the main symptom score by 2.7 points. Witch hazel reduced it by 1.6. Witch hazel did not beat the plain base cream (score drops of 1.8 and 2.0). The creams were well tolerated ⁶. That eczema trial of witch hazel versus hydrocortisone is the clearest head-to-head we have, and the steroid won. Witch hazel tied the moisturizer base.

Two studies in children are about other rashes, not piles. An observational study followed 309 children from 27 days old to 11 years with minor skin injuries, diaper rash, or a small area of inflamed skin. They received either hamamelis ointment (231 children) or dexpanthenol ointment (78 children). Both groups improved on symptom scores. Doctors rated witch hazel tolerability as excellent or good in 99.1% of cases, and parents did so in 98.2% ⁷. The groups were not a randomized hemorrhoid trial.

A 2026 randomized trial in 60 infants with diaper rash compared breast milk with a cream that contained Hamamelis virginiana at 12 mg per 100 g. Scores fell in both groups. The breast-milk group started much worse (mean score 5.17 versus 2.83), so the trial cannot tell us which treatment worked better ⁸. Do not treat that paper as instructions for a baby with rectal bleeding.

If the itch is bad enough that you want something stronger than a pad, read anti-itch cream versus numbing cream. Hydrocortisone beat witch hazel in the eczema trial ⁶. The AGA says topical steroids should not be used for more than 2 weeks at a time ¹.

How to use witch hazel for hemorrhoids

Use witch hazel on the outside skin during a flare. Pair it with softer stools. The pad is for comfort. The fiber is the part with trial evidence for bleeding.

The NIDDK page on hemorrhoid treatment says most people can start at home with fiber, fluids, less straining, shorter toilet sits, and a warm sitz bath. It says doctors most often recommend over-the-counter creams, ointments, or suppositories for 1 week. Follow up if symptoms are still there after that week, or if you get dry skin around the anus or a rash ⁹.

1. After a bowel movement, pat the outside dry. If a wipe stings, stop using that wipe.
2. Apply the witch hazel pad to the outside skin. Do not push a dry pad inside. Internal tissue that has slipped out can be gently eased back only if you already know that is safe for you. Our guide to external hemorrhoids explains why the outside ones are the ones that itch and hurt.
3. The cooling-pad listing says you can fold a pad and leave it as a compress for up to 15 minutes. Buyers often do 10 to 15 minutes. That timing is a product direction and a user habit, not a dose from a hemorrhoid trial.
4. Use it for about a week, alongside the stool plan below. If you are no better, or the skin dries or a rash appears, stop and contact a doctor ⁹.
5. Keep going with fiber after the pad goes back in the cabinet. A flare that returns every time you strain will not stay quiet on witch hazel alone.

On our best hemorrhoid wipes and cooling pads page, the medicated cooling pads are the pick for itching, burning, and soreness after birth. Buyers often describe a quick cooling feeling, including in the weeks after childbirth. A common gripe is that the pads stick together and take a moment to separate.

TUCKS (Pads)

TUCKS Medicated Cooling Pads, 100 count

Best for: Itching, burning and postpartum soreness

Cooling100 padsDye-free

The best-rated hemorrhoid product we found in any category. The pads are soft, cooling and gentle enough for everyday use.

What recent buyers say

Tens of thousands of reviews, and the theme never changes: soothing, quick relief, and near-universal praise from people recovering after childbirth. Many fold a pad and leave it in place as a compress for 10 to 15 minutes. The one common gripe is that the pads stick together and can be fiddly to separate.

What buyers like

• Instant cooling relief
• Gentle on sensitive skin
• 100-count tub is good value

Common complaints

• Pads stick together
• Can be messy to handle

Price $$$budgetAmazon reviews checked September 2026

Check price on Amazon

A cream does a different job from a pad. The pad cools and wipes. A cream stays on the skin. The tradeoffs are in Preparation H versus Tucks. Store products as a group are covered in over-the-counter hemorrhoid treatment.

Fiber, which has the better evidence

A meta-analysis of seven fiber trials in 378 people with symptomatic hemorrhoids found that fiber lowered the risk of symptoms failing to improve (relative risk 0.53) and lowered the risk of bleeding by about half (relative risk 0.50). Pain, itching, and prolapse might also improve, but the confidence intervals were wide and still compatible with no effect ¹⁰. Relative risk 0.50 means the fiber groups had about half the bleeding risk of the comparison groups. That is stronger evidence than anything we have for witch hazel.

The NIDDK page on diet and hemorrhoids cites the Dietary Guidelines figure of 14 grams of fiber per 1,000 calories. On a 2,000 calorie day, that is 28 grams ¹¹. Food first, then a supplement if you are short. Our best fiber supplements page compares powders and capsules. A full plan for the next two days is in how to ease a flare fast.

Who should skip witch hazel

Skip it, or stop it, in these situations.

If your skin reacts

Dryness and rash are the side effects NIDDK names for over-the-counter hemorrhoid products ⁹. Stinging is a reason to wash it off and not reapply. The eczema trial reported good tolerability, and the unwanted skin reactions were mostly on the plain base ⁶. Good tolerability in that trial does not mean every person will be fine.

Pregnancy and breastfeeding

A review of hemorrhoids in pregnancy says treatment is mostly fiber, stool softeners, fluids, and toilet habits. It also says common topical hemorrhoid products have not been assessed for safety in pregnancy, though the authors thought the usual anesthetic, steroid, and anti-inflammatory pieces were unlikely to harm a third-trimester baby ¹². Witch hazel itself was not tested in that paper. The AGA says hemorrhoids occur in up to two-thirds of women during pregnancy and that care should stay conservative: fiber, constipation treatment, and topical ointments ¹. Ask the obstetric provider before you use a pad through pregnancy. The pregnancy guide is hemorrhoids during pregnancy.

Infants

The diaper-rash trial is not a hemorrhoid study, and the two groups did not start at the same severity ⁸. The childhood ointment study was about minor skin injuries and diaper rash, with a doctor involved ⁷. Do not put an adult hemorrhoid pad on a baby unless a clinician tells you to.

When bleeding or prolapse is the problem

A pad will not replace fiber, and it will not replace an office procedure if tissue keeps coming out or bleeding. The full range is in hemorrhoid treatment, from home care to procedures.

If a steroid is already in the product

The AGA limit for topical steroids is 2 weeks unless a doctor says otherwise ¹. Follow the label on the box you actually bought. If you have already used a steroid cream for two weeks, stop and ask a doctor before you continue.

What to do if witch hazel does not help

Give the combination one week: pad on the outside, softer stools, less time straining on the toilet, and a warm soak if that eases the spasm. The NIDDK follow-up point is one week ⁹. If itch is the main problem and a steroid cream is appropriate for you, the eczema data say hydrocortisone outperforms witch hazel, with the two-week cap ^1,6.

Bleeding needs a look even when hemorrhoids are the likely cause. MedlinePlus says to see a clinician if symptoms last more than a week of home care, or if you have rectal bleeding, because inflammatory bowel disease and colorectal cancer can bleed too ¹³. The U.S. Preventive Services Task Force recommends colon cancer screening starting at age 45 for adults at average risk ¹⁴.

If the week of pads and fiber has not settled the flare, book the visit rather than adding a second untested home remedy. What happens at that visit is covered in when to see a doctor for hemorrhoids.