Hemorrhoid treatment can often be done with simple at-home measures, such as taking warm sitz baths and increasing your intake of fiber and water to help reduce discomfort and inflammation.

Anti-inflammatory or pain-relieving ointments may be recommended by a primary care provider or a colorectal surgeon (also known as a proctologist) and can help treat hemorrhoids by reducing pain and swelling and promoting healing in the affected area.

When hemorrhoids are very large or happen often, a colorectal surgeon may recommend surgery. However, in most cases, hemorrhoid treatment with medications and home care is enough to improve symptoms.

person holding a roll of toilet paper down by their side

Treatment options

The main options for external hemorrhoid treatment include:

1. Taking sitz baths

Taking sitz baths with warm water can help relieve swelling and pain. Each bath should last about 15 to 20 minutes, and you can do them several times a day.

Some medicinal plants that can be added to the basin of warm water include chamomile, lavender, arnica, and witch hazel, which can help soothe the area and ease discomfort within a few minutes.

To help prevent infection, use a clean stainless-steel basin that has been properly cleaned and disinfected with 70% isopropyl alcohol, and change the water each time you do a sitz bath.

2. Eating high-fiber foods

Eating high-fiber foods at every meal helps soften stool, which reduces discomfort during bowel movements. Examples of high-fiber foods include figs, papaya, and oatmeal.

You can also add an over-the-counter powder you mix with liquids, such as Metamucil (psyllium). Mix 2 tsp or 1 packet of the powder into a glass of water, soup, or juice and take it with meals, following label directions or your clinician’s guidance.

3. Drinking more water

Drinking more water is an important part of hemorrhoid treatment because it helps keep stools softer, especially when you increase your fiber intake.

If you do not drink enough fluids, fiber can have the opposite effect, making stools harder and more difficult to pass, which can worsen hemorrhoids.

4. Taking a laxative

Another option for treating external hemorrhoids, and for preventing symptoms from worsening or becoming more painful during bowel movements, is using a laxative, but only if a healthcare provider recommends it.

Softer stools reduce straining and excess pressure during bowel movements, allowing external hemorrhoids to shrink and return to their usual state.

5. Applying cold and warm compresses

Applying cold compresses for 10 minutes and then warm compresses for 15 minutes, 3 times a day, may help reduce inflammation and relieve hemorrhoid discomfort.

Cold helps by narrowing blood vessels, and warmth helps improve local circulation, which can reduce pain and support external hemorrhoid treatment.

Apply compresses with a clean cloth or gauze to the area, and discard them after each use.

6. Using hemorrhoid ointment

Hemorrhoid ointments may be recommended by a primary care provider or colorectal surgeon because they can help reduce the size of an external hemorrhoid and relieve pain within a few minutes.

Commonly used options include hemorrhoid creams or ointments containing hydrocortisone 1% and/or a topical anesthetic such as pramoxine or lidocaine, depending on symptoms.

These products should only be used when recommended by a healthcare provider based on your symptoms, and applied to the external hemorrhoid area while pain and discomfort are present.

7. Trying home remedies

One option for treating external hemorrhoids is using homemade ointments, such as witch hazel ointment, chamomile compresses, and aloe vera gel, for example. Check out more home remedies for hemorrhoids.

Chamomile can cause allergy or irritation in some people, especially in those with allergies to plants like ragweed, daisies, or chrysanthemums. If irritation develops, stop using it.

8. Taking oral medication

Medications in pill form, such as acetaminophen and ibuprofen, may be used for external hemorrhoid treatment under medical guidance to help relieve pain.

In addition, a primary care provider or colorectal surgeon may recommend an oral stool softener, such as docusate sodium, to make bowel movements easier and reduce straining, which can worsen hemorrhoid-related swelling, pain, and bleeding.

External hemorrhoids often improve quickly with these treatments and may go away in 2 to 3 days. However, in more severe cases where there are no signs of improvement, surgery may be needed.

9. Having surgery

Surgery for external hemorrhoids is recommended only in more severe cases, such as when the hemorrhoid becomes thrombosed or ruptures.

After surgery, it is important to continue a high-fiber diet and avoid straining during bowel movements to help prevent new hemorrhoids.

Other treatment options include minimally invasive procedures, such as rubber band ligation or Doppler-guided procedures, which may be recommended for recurring cases or when standard treatments are not effective. These techniques are often done in an office setting and tend to allow for faster recovery.

Care measures

During treatment, some helpful care measures include:

Avoid using toilet paper; wash the anal area with soap and water after bowel movements;
Avoid lifting heavy weights;
Avoid very spicy or heavily seasoned foods;
Do light or moderate physical activity, such as walking and stretching;
Use a donut-shaped cushion (with an opening in the center) for sitting, if needed.

Another important tip is to avoid straining during bowel movements, since this increases the risk of developing more hemorrhoids.

Signs of improvement

Signs that external hemorrhoids are getting better include less pain (especially when sitting or during bowel movements), reduced swelling of the hemorrhoid, and little to no bleeding during bowel movements.

If you can no longer feel the external hemorrhoid when touching the area, it may mean it has gone away.

Signs of worsening

Signs of worsening external hemorrhoids include greater pain (especially when sitting or during bowel movements), larger swelling of the hemorrhoid, and more bleeding during bowel movements. See blood in stool.

Hemorrhoid Treatment: Home Remedies, Medication & Surgery