Almorranas: tratamiento, cremas y remedios que funcionan

Haemorrhoid treatment: creams and remedies that work

Let’s talk about piles. Yes, that thing almost everyone has had at some point but nobody mentions over lunch. I’ve spent years in the pharmacy and I can assure you of one thing: you’re not the first, and you won’t be the last, to lower your voice when asking me for help. So let’s take the drama out of it, explain it properly and, above all, see what you can do to stop suffering.

DATO CLÍNICO

It is estimated that 50% of the adult population have experienced symptoms of haemorrhoids at least once before the age of 50. It is one of the most frequent conditions seen in primary care consultations.

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What are piles and why do they happen

Piles (the clinical term is haemorrhoids) are swollen veins in the anal canal. Think of them as varicose veins, but in a much more awkward place. There are two main types:

Internal haemorrhoids

These form inside the rectum. They don’t usually hurt (that area has fewer pain receptors), but they can bleed when you go to the toilet. Sometimes they prolapse, meaning they bulge outwards.

External haemorrhoids

These appear under the skin around the anus. They can be painful, itchy and inflamed, and sometimes a clot forms (a thrombosed haemorrhoid), making them hard and particularly uncomfortable.

Why do they happen? There isn’t one single cause. It’s usually a combination of factors:

  • Chronic constipation and straining — the number one cause.
  • Pregnancy and childbirth — pressure from the uterus on pelvic veins.
  • Sitting for long periods — at work, in the car, on the sofa.
  • A low-fibre diet and not drinking enough fluids.
  • Regular heavy lifting (gym or physical work).
  • Genetics — family predisposition does play a part.

Piles symptoms: when to see a doctor

Symptoms depend on the type and severity, but the most common are:

  • Bright red bleeding when you wipe or on toilet paper.
  • Itching or stinging around the anus.
  • A lump sensation, especially after opening your bowels.
  • Pain when sitting down or going to the toilet.
  • Staining on underwear due to mucus discharge.

Red flags: see a doctor if...

  • The bleeding is heavy or doesn’t settle after several days.
  • The blood is dark or mixed in with the stool.
  • You have fever alongside severe anal pain.
  • You notice a very hard, painful lump that won’t go back in (possible thrombosed haemorrhoid).
  • You’ve lost weight without trying or your bowel habit has changed suddenly.

I’ll stress this: rectal bleeding should always be medically assessed the first time it happens, to rule out other causes. Don’t self-diagnose.

Haemorrhoid grades and treatment by severity

Clinicians classify internal haemorrhoids into four grades. Each grade needs a different approach:

Grades I and II can often be managed well with suitable pharmacy treatments plus a few habit changes. Grades III and IV need medical assessment, without exception.

Haemorrhoid creams, ointments and wipes recommended by a pharmacist

This is what I get asked about most at the counter. I’ll be direct: not all haemorrhoid creams are the same. It depends whether you need itch relief, reduced inflammation, skin protection, or simply gentler hygiene. Here’s what I use and why. If you’re comparing options for the best mosquito repellent UK, it’s similar logic: match the product to the problem you’re trying to solve rather than buying on name alone.

Ointments with anti-inflammatory and protective action

The Aboca NeoFitoroid BioOintment 40 ml is my first recommendation. It’s 100% plant-based, with Hamamelis virginiana, Aesculus hippocastanum (horse chestnut) and biotechnological hyaluronic acid. It helps protect the mucosa, reduce inflammation and form a barrier that supports regeneration. It’s what I most often suggest for external haemorrhoids and mild grade I–II cases that protrude slightly.

An interesting alternative is Derbos Linfabir Hem Ointment 30 ml, formulated with extracts that support local venous circulation. It can work particularly well when the area feels congested and heavy. The tube is smaller but concentrated.

Cleansing wipes for anal hygiene with haemorrhoids

Hygiene is half of treatment, and I don’t repeat this enough. Dry toilet paper can irritate inflamed skin. The Ansollitas Anal Hygiene Wipes (50 wipes) are designed specifically for anal cleansing: they soothe itching, clean without rubbing, and include calming ingredients. They’re an ideal add-on to any ointment.

If you want a larger pack size, the Hemofarm Plus Wipes (60 units) help keep the area clean and fresh throughout the day. They’re handy for work or travel.

I’m also asked a lot about the Cumlaude Lab Rectal Lipogel 30 ml, an emollient lipogel that can be useful for internal haemorrhoids with discomfort. We don’t currently have it in stock; if you’re interested, leave your email address and we’ll let you know as soon as it’s available again. And if you’re weighing up options like Mosquito repellent for kids, it’s worth applying the same caution here too: always check suitability for age group, pregnancy/breastfeeding status, and any relevant medical conditions before using any product.

Home remedies and habits to ease piles

Creams help, but without changing certain habits, haemorrhoids tend to come back. Here’s what genuinely works, based on evidence:

Fibre and water: the foundation

If your stools are hard, you’ll strain. If you strain, you worsen haemorrhoids. It really is that simple. Aim for 25–30 g of fibre per day (vegetables, pulses, fruit with skin on where appropriate, wholegrains) plus at least 1.5–2 litres of water. If you struggle to reach that intake, a supplement of Psyllium husk/Psyllium seed/Ispaghula husk, taken with plenty of water, can help significantly.

If you’re trying to decide between approaches in other areas—like reading about , where “natural” isn’t automatically safer or more effective—the same principle applies here: focus on what reliably reduces straining (fibre + fluids) rather than what sounds appealing.

Sitz baths

Lukewarm water (not hot), for 10–15 minutes, 2–3 times daily. You can add coarse salt or a few drops of chamomile infusion. It reduces swelling, relaxes muscles and gives quick itch relief. It’s simple and it works.

pThree golden rules for bowel movements:

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  • , don’t put it off.
  • : if nothing happens, stand up and try again later.
  • pA sedentary lifestyle slows gut transit time and increases pelvic venous pressure. A 30-minute walk each day makes a real difference. Avoid sitting for more than two hours without getting up.

    pSpicy foods, alcohol, too much coffee and highly processed meals can worsen symptoms during an active flare-up. You don’t need to cut them out forever—just reduce them while you’re symptomatic.

    My pharmacist advice for treating piles

    , registered pharmacist (Spain) and nutritionist (registration number 1383). Last updated: May 2026.

    Piles: the essentials at a glance

    GradeDescriptionUsual treatment
    IInternal haemorrhoids that do not prolapse. They may bleed slightly.Diet rich in fibre, hydration, topical creams, sitz baths.
    IIProlapse when opening the bowels but go back in on their own.Same as grade I + anti-haemorrhoid creams. Consider oral pharmacological treatment (phlebotonics).
    IIIProlapse and have to be reduced manually.Medical treatment. Possible rubber band ligation or other outpatient procedures.
    IVPermanently prolapsed, cannot be reduced.Surgery (haemorrhoidectomy or minimally invasive techniques).

    If you are unsure what to choose, this chart sets out the objective criteria you need to bear in mind.

    Preguntas frecuentes

    Do piles go away on their own?

    Grade I and II haemorrhoids can resolve with dietary changes, adequate hydration and topical creams. However, grade III and IV haemorrhoids usually need medical intervention. If you have had symptoms for more than a week with no improvement, speak to your doctor.

    What is the best cream for piles?

    There is no single universal cream. For external haemorrhoids with inflammation, ointments with plant extracts such as Aboca BioPomada work well because of their soothing action. For haemorrhoids with intense itching, wipes containing witch hazel provide immediate relief. Ideally, a pharmacist should assess your specific case.

    Do sitz baths help with haemorrhoids?

    Yes. Sitz baths with lukewarm (not hot) water for 10–15 minutes, 2–3 times a day, reduce inflammation and relieve itching. You can add coarse salt or chamomile infusion. It is one of the most effective remedies and one of those with the strongest evidence base.

    Can piles bleed a lot?

    Internal haemorrhoids can cause bright red bleeding when you open your bowels. If the bleeding is heavy, persistent or the colour is dark, see a doctor immediately to rule out other conditions. Mild, occasional bleeding is common and is not usually serious.

    Does pregnancy cause piles?

    Yes, it is very common. Increased abdominal pressure, hormonal changes and constipation associated with pregnancy all promote the appearance of haemorrhoids. They usually improve after childbirth, but it is advisable to treat them with safe products during pregnancy under pharmaceutical or medical supervision.

    Referencias científicas

    • Lohsiriwat V. Hemorrhoids: from basic pathophysiology to clinical management. World Journal of Gastroenterology. 2012;18(17):2009-2017. — DOI: 10.3748/wjg.v18.i17.2009
    • Perera N, Liolitsa D, Iype S, et al. Phlebotonics for haemorrhoids. Cochrane Database of Systematic Reviews. 2012;(8):CD004322. — DOI: 10.1002/14651858.CD004322.pub3
    • Alonso-Coello P, Zhou Q, Martinez-Zapata MJ, et al. Meta-analysis of flavonoids for the treatment of haemorrhoids. British Journal of Surgery. 2006;93(8):909-920. — DOI: 10.1002/bjs.5378
    • Mounsey AL, Halladay J, Sadiq TS. Hemorrhoids. American Family Physician. 2011;84(2):204-210. — PMID: 21766771
    • AEMPS — CIMA: Fichas técnicas de preparados tópicos rectales. — https://cima.aemps.es/cima/publico/lista.html
    • Higuero T, Abramowitz L, Castinel A, et al. Guidelines for the treatment of hemorrhoids (short version). Journal of Visceral Surgery. 2016;153(3):213-218. — DOI: 10.1016/j.jviscsurg.2016.03.004
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