Natural remedies for hemorrhoids, graded by the evidence

Natural remedies for hemorrhoids range from things with solid trials behind them to things that can burn your skin. Fiber, a plant food, has the best evidence of any hemorrhoid treatment you can buy without a prescription. Flavonoid pills made from citrus have dozens of trials. Most of the creams, oils and herbs people try have one small study or none.

This guide grades 21 natural remedies against the published research, in plain language, with a link to every study so you can check our reading. Start with the explorer below if you are looking up one remedy. Read on for how they fit together into a plan for a flare. If you want the kitchen and bathroom version only, see hemorrhoid home remedies that work.

How we grade natural remedies

Each remedy gets one of five grades, based on studies in people with hemorrhoids, not on how often a remedy shows up online.

A randomized trial assigns people to a remedy or a comparison by chance, which is the fairest test. A review pools several trials. Where a remedy has only been tested after surgery, or only on dry skin or leg veins, we say so, because those results may not carry over to an ordinary flare.

The natural remedies with the best evidence

Fiber

Fiber is the natural remedy with the most proof. A meta-analysis of seven fiber trials with 378 people found that fiber lowered the chance of symptoms persisting by 47 percent and the chance of bleeding by 50 percent ¹. NIDDK’s target is 14 grams of fiber per 1,000 calories, which is 28 grams on a 2,000-calorie day ². Psyllium husk, oats, beans, pears and berries are easy ways to get there.

Water helps the fiber work. In 117 adults with constipation who were already eating about 25 grams of fiber, those who drank about 2 liters of fluid a day had more frequent stools and used fewer laxatives than those who drank about 1 liter ³. Foods, portions and a no-bloat plan are in the hemorrhoid diet, and supplements are compared on the best fiber supplements for hemorrhoids.

Flavonoids (diosmin and hesperidin)

Flavonoids are plant compounds, and the purified mix of diosmin and hesperidin from citrus is the most tested natural pill for hemorrhoids. The Cochrane review of phlebotonics pooled 20 trials with 2,344 people and found less bleeding, itching and leakage, and more overall improvement, with methodological limits in the trials ⁴. A stricter 2018 review of 10 trials found that only the bleeding benefit held up, at low quality ⁵. After surgery, a 2024 review of 10 trials found less pain and bleeding with flavonoids ⁶. The full breakdown is in diosmin for hemorrhoids.

Natural comfort remedies: soaks and cold

Warm sitz baths

A sitz bath is a soak of the bottom in a few inches of warm water. In a lab study, resting anal pressure dropped after immersion in 40°C water and stayed the same in cold or room-temperature water, with the effect lasting 15 to 30 minutes ⁷. That eases the spasm behind throbbing pain. A review of sitz bath research found little trial evidence that soaks treat hemorrhoids, and noted that patients prefer warm water ⁸. Timing and temperature are in how to take a sitz bath.

Epsom salt is a popular add-in. No study has compared it with plain water, and a review found the idea that skin absorbs useful magnesium from baths scientifically unsupported ²². More detail is in Epsom salt for hemorrhoids.

Cold packs

A wrapped ice pack is the cheapest swelling remedy. The clearest trial was after surgery: in 166 people, ice packing gave lower pain scores in the first 16 hours and less swelling at 24 hours than warm sitz baths ⁹. For an ordinary flare, use cold for swelling and warm water for spasm. Ice or heat for hemorrhoids explains which to reach for.

Plant creams, gels and oils

The American Gastroenterological Association’s expert review of hemorrhoid treatment says there is little data that topical hemorrhoid products work ¹². That applies to natural ones too. These are the ones with any study.

Aloe vera

In a placebo-controlled trial of 49 people after hemorrhoid surgery, aloe cream reduced pain, pain with bowel movements and healing time ¹⁰. A network analysis of 26 surgery trials ranked aloe first for pain at 24 hours, and called the overall results inconclusive ¹¹. No one has tested aloe on a flare at home. See aloe vera for hemorrhoids for how to use the gel, and why not to drink aloe.

Witch hazel

Witch hazel is an astringent plant liquid sold in pads. The AGA review lists it among topical options that can be considered and says such products have little supporting data ¹². It is fine for a cool, soothing wipe. More is in does witch hazel work for hemorrhoids?, and the side-by-side with aloe is in witch hazel vs aloe vera for hemorrhoids.

Myrtle, propolis and honey

In a triple-blind trial of 134 women with grade 1 or 2 hemorrhoids after childbirth, a myrtle ointment worked about as well as a standard hemorrhoid ointment, with less itching at 4 and 8 weeks ¹⁸. In 86 people with grade 2 or higher hemorrhoids, a lotion of propolis (a resin bees make) and olive oil improved symptoms more than a hydrocortisone and lidocaine ointment over a month ¹⁹. A mixture of honey, olive oil and beeswax reduced bleeding and itching in a pilot study of 15 people with no comparison group ²⁰. All three were prepared for the studies, and none has been repeated.

Coconut oil

No hemorrhoid trial has tested coconut oil. In a dry-skin trial, virgin coconut oil moisturized as well as mineral oil, with no skin reactions ²¹. That makes it a reasonable plain moisturizer for chafed outside skin and nothing more. Details are in coconut oil for hemorrhoids.

Herbal pills and supplements

Adding horse chestnut extract (aescin) to a flavonoid pill stopped bleeding in 2 days instead of 4 in a 2024 trial ¹³. Only standardized seed extracts are considered safe, because raw seeds, bark, flowers and leaves are toxic to swallow ³¹. The trial and the safety warnings are in horse chestnut for hemorrhoids. Pine bark extract beat placebo in a randomized trial of 84 people with an acute flare, in research from a single group ¹⁴. Gotu kola (Centella asiatica) and flavonoids both stopped bleeding a week sooner than routine care in another trial ¹⁵.

A Cochrane review of Chinese herbs for bleeding hemorrhoids found 9 low-quality trials and no strong evidence ¹⁶. A JAMA study found lead, mercury or arsenic in 20.7 percent of Ayurvedic medicines bought online ¹⁷. Probiotics have no hemorrhoid trial; across 30 constipation trials they raised stool frequency modestly, and results varied by strain ²³. How they compare with fiber is in probiotics for hemorrhoids. Each herb, with its safety notes, is in herbal supplements for hemorrhoids.

Natural remedies to avoid

Some of the most shared natural remedies are the ones most likely to hurt.

• Pure tea tree oil. The only hemorrhoid trial tested a gel that mixed tea tree oil with two other ingredients ²⁴. Tea tree oil has been linked to more published allergic reactions than other essential oils, mostly from the undiluted oil ²⁵. It should never be swallowed ³². See tea tree oil for hemorrhoids.
• Apple cider vinegar. There is no hemorrhoid trial, and vinegar put on skin has caused chemical burns in published cases ²⁶.
• Raw garlic. A review of published cases found that garlic left on skin usually caused a second-degree burn ²⁷.

The vinegar and garlic evidence is in apple cider vinegar and other viral hemorrhoid remedies.

A natural plan for a hemorrhoid flare

This plan uses the remedies with the most support, in the order they matter.

1. Today: start fiber. A psyllium supplement with a full glass of water is the simplest start. Build up over a week to avoid gas ^1,2.
2. Today: soak in warm water for 10 to 15 minutes, two or three times a day and after bowel movements ⁷.
3. When it throbs or swells: hold a cold pack wrapped in a thin towel against the area for up to 10 minutes ⁹.
4. On the toilet: go when you feel the urge, do not strain, and get up within a few minutes. Habits that help are in toilet habits for hemorrhoids.
5. If bleeding is the main problem: a short course of a flavonoid pill is a reasonable add-on to fiber ^4,5.
6. For sore outside skin: a thin layer of plain aloe gel, a witch hazel pad, or a barrier ointment.
7. After a week: if you are no better, see a clinician ²⁸.

Keeping flares from coming back is mostly the same list, done every day. How to prevent hemorrhoids covers fiber, fluids, movement and toilet time, and exercise with hemorrhoids covers safe workouts.

Natural remedies during pregnancy

Hemorrhoids are common late in pregnancy and after birth. A review for family doctors recommends fiber, stool softeners, more fluids and good toilet habits, and notes that most symptoms ease after delivery ³⁰. It also says common topical products have not been formally tested in pregnancy ³⁰. That includes natural creams and herbal pills. Ask your obstetric provider before using any of them, and see hemorrhoids during pregnancy and postpartum hemorrhoids.

When natural remedies are not enough

Natural care works for most small flares. It is the wrong tool for a hemorrhoid that keeps prolapsing, bleeding that keeps returning, or a sudden clot. Those are covered in hemorrhoid treatment, thrombosed hemorrhoid and bleeding hemorrhoids.

MedlinePlus advises seeing a clinician if a week of home care has not helped, and getting rectal bleeding checked, because Crohn’s disease, ulcerative colitis and cancers can bleed too ²⁸. Colon cancer screening is recommended from age 45 for adults at average risk ²⁹. Every study cited on this site, natural and medical, is listed in our research library, and you can check your symptoms first with the hemorrhoid symptom checker.