Haemorrhoid treatment: creams and remedies that work
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
Sitz baths
Warm water — not hot — for 10–15 minutes, 2–3 times a day. You can keep it simple with plain warm water; there is no need to add anything unless a healthcare professional has advised it. A sitz bath can help reduce discomfort, relax the area and ease itching quickly. It costs nothing and it works.
Do not hold it in, do not strain, do not sit there forever
Three golden rules for going to the toilet:
- Go when you need to go, do not put it off.
- Do not strain: if nothing happens, get up and try again later.
- Do not spend more than 5 minutes sitting on the toilet. No phone in the bathroom.
Move more
A sedentary routine can slow bowel transit and increase pressure around the rectal veins. Walking for 30 minutes a day can already make a difference. Avoid sitting for more than 2 hours without getting up and moving around.
Avoid certain foods and drinks during a flare-up
Spicy food, alcohol, too much coffee and heavily processed meals can worsen symptoms during an active piles flare-up. You do not need to remove them forever, but it makes sense to reduce them while you are uncomfortable.
Pharmacy recommendations for treating piles and haemorrhoids
After years on the other side of the pharmacy counter, there is one thing I am clear about: piles are not something to be embarrassed about. They are a health issue. And the sooner you deal with them properly, the sooner they stop taking over your day.
My advice is simple: start with fibre and water, keep the area clean with suitable wipes or damp toilet paper, and use an appropriate cream or ointment during the flare-up. If symptoms do not improve within a week, or if you have bleeding, severe pain, a lump that does not go away or symptoms that keep coming back, speak to your GP or pharmacist.
And if you are unsure which product is right for you, write to us or call us. That is what we are here for.
Piles: the essentials at a glance
| Grade | Description | Usual treatment |
|---|---|---|
| I | Internal haemorrhoids that do not prolapse. They may bleed slightly. | Diet rich in fibre, hydration, topical creams, sitz baths. |
| II | Prolapse when opening the bowels but go back in on their own. | Same as grade I + anti-haemorrhoid creams. Consider oral pharmacological treatment (phlebotonics). |
| III | Prolapse and have to be reduced manually. | Medical treatment. Possible rubber band ligation or other outpatient procedures. |
| IV | Permanently prolapsed, cannot be reduced. | Surgery (haemorrhoidectomy or minimally invasive techniques). |
Frequently asked questions
Scientific references
