Over-the-counter, or OTC, medications such as topical analgesics and corticosteroid creams can relieve hemorrhoid symptoms. However, these OTC medications offer only temporary relief of symptoms and don't stop hemorrhoids from returning. Studies published in Alternative Medicine Review and Surgeon suggest that OTC supplements such as bioflavonoids (diosmin and hesperidin) may treat and prevent hemorrhoids.
OTC Topical Analgesics
Topical analgesics such as local anesthetics, phenylephrine and witch hazel are used for the temporary relief of hemorrhoidal pain, itching and burning. Local anesthetic products include pramoxine hydrochloride (Tronolane Cream), dibucaine (Nupercainal) and benzocaine (Americaine, Lanacane). They numb the nerve endings so that pain is no longer felt, although this is a temporary effect. Be aware that local anesthetics may cause allergic reactions that increase burning and itching. Phenylephrine (Preparation H) is a vasoconstrictor drug that reduces the swelling of blood vessels. It temporarily decreases the swelling, size and pain of hemorrhoids. Witch hazel (Fleet Medicated, Tucks) is a natural astringent that contains tannins and volatile oils that relieve pain, burning and itching.
OTC Skin Protectants and Corticosteroid Creams
Skin protectants such as zinc oxide, petroleum jelly, mineral oil, lanolin, glycerin and cocoa butter provide a physical barrier over hemorrhoids to protect the skin while healing. This reduces irritated skin, itching and pain. Skin protectants are often included in hemorrhoid products. Topical corticosteroids can relieve skin inflammation and itching. Low strength preparations (0.5 or 1 percent) of hydrocortisone ointment or cream (Preparation H with hydrocortisone) are OTC steroid medications, or corticosteroids. Be aware that topical corticosteroids should not be used for more than two weeks because they can cause skin damage, such as thinning of the skin.
OTC Bioflavonoids
Bioflavonoids such as diosmin and hesperidin may promote venous strength and function and treat hemorrhoid symptoms. Daflon (MPFF), containing a flavonoid mixture of 90 percent diosmin and 10 percent hesperidin, has been used in several hemorrhoid studies. A 2004 study published in Surgeon examined the effectiveness of Daflon on hemorrhoid treatment. Researchers administered four Daflon tablets a day in two doses to 268 patients with hemorrhoid symptoms, for four weeks. They found a significant improvement in all hemorrhoidal symptoms, including pain, heaviness, bleeding, pruritus and anal discharge. "Daflon has been shown to be effective in alleviating (variable degree) hemorrhoidal symptoms and improving the proctoscopic appearance of hemorrhoids," the study author writes. "Therefore, it should be considered initially for patients presenting with hemorrhoidal symptoms."
References
- Madoff RD and Flexhman JW. American Gastroenterological Association technical review on the diagnosis and treatment of hemorrhoids. Gastroenterology Apr 2004 126(5): 1463--1473.
- MacKay D. Hemorrhoids and varicose veins: a review of treatment options. Altern Med Rev. Apr2001;6(2):126-40.
- Meshikhes AW. Daflon for haemorrhoids: a prospective, multi-centre observational study. Surgeon. 2004 Dec;2(6):335-8, 361.
