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Hemorrhoids also known as piles refer to the swelling of the blood vessels in the lower region of the rectum or anus. Mild cases of hemorrhoids tend to heal easily with home remedies and certain over-the-counter (OTC) medications. Long-standing conditions, however, require medical attention or surgical treatment. Pregnant women must always consult the doctor before taking any medications.1,2

OTC Medications

The common OTC medications for hemorrhoids can be grouped as follows:2–6

  • Vasoconstrictors.
  • Astringents.
  • Protectants.
  • Local anesthetics.
  • Keratolytics.

Most of the OTC medications are a combination of these groups of medications.


These medications result in constriction of the blood vessels thus reducing their swelling. It also helps in relieving the itching and discomfort associated with hemorrhoids. Some of the vasoconstrictors included in hemorrhoid medications are:

  • Ephedrine sulphate
  • Phenylephrine hydrochloride


  • Elevation of blood pressure.
  • Cardiac arrhythmias.
  • Nervousness.
  • Loss of sleep.
  • Aggravation of symptoms of hyperthyroidism.


Vasoconstrictors are contraindicated in individuals who are suffering from the following:

  • Diabetes.
  • Hyperthyroidism.
  • Hypertension.

It is also contraindicated in individuals who are taking medications such as monoamine oxidase inhibitors or tricyclic antidepressants.


These agents result in coagulation of the proteins in the skin cells thereby decreasing the size of the swelling. They also reduce the inflammation, irritation and burning sensation in the affected area to a certain extent. Some of the commonly available astringents include:

  • Calamine (concentrations of 5–25%).
  • Zinc oxide (concentrations of 5–25%).

These can be applied to the affected region up to six times a day for relief of the symptoms.

No specific side-effects or contraindications have been mentioned for the use of astringents.


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These agents form a protective barrier over the skin surface to reduce the inflammation in the affected regions. Some of the protectants that are commonly included in the OTC medications are:

  • Aluminium hydroxide gel.
  • Cocoa butter.
  • Glycerine.
  • Kaolin.
  • Mineral oil.
  • White petrolatum.
  • Topical starch.


Mild cases of hypersensitivity.


Known allergy to the drugs.

Local Anesthetics

The local anesthetics cause numbness in the affected region and hence relieve the associated symptoms such as pain, itching, burning sensation and discomfort. Some of the local anesthetics included in OTC medications are:

  • Benzocaine.
  • Benzyl alcohol.
  • Lidocaine.


Can cause allergic reaction in certain individuals.


Known allergy to the drugs.


The keratolytic agents cause sloughing of the skin cells, which aid in increasing the effectiveness of other medications being administered. These agents are also known to reduce itching and discomfort to a certain extent. Some of the common keratolytic agents are:

  • Aluminium chlorhydroxy allantoinate
  • Resorcinol


Can cause allergic reaction in certain individuals.


  • Known allergy to the drugs
  • Resorcinol should not be used on open wounds

When to Seek Medical Help for Hemorrhoids

Prompt medical care should be sought in the following instances:

  • If the symptoms do not relieve with home treatment.
  • If bleeding is noticed from the anus or rectum.


  1. American Gastroenterological Association medical position statement: Diagnosis and treatment of hemorrhoids. Gastroenterology. 2004; 126(5): 1461–1462.
  2. Hodes B. Hemorrhoidal Products. In: Handbook of Nonprescription Drugs, 11th edn. Washington, DC: American Pharmaceutical Association, 1996, pp. 261–271.
  3. Wuest JR, Gossel TA. Continuing Education. Advising consumers on OTC hemorrhoidal remedies: An update. Mass State Pharmaceut Assoc Newsletter. 1992; 9(2): 25–29.
  4. Sause RB. Self-treatment of hemorrhoids. US Pharm. 1995; 20(6): 32–40.
  5. Meade V. Dealing with hemorrhoids. Am Pharm. 1992; NS32(3): 64–65.
  6. Gossel TA. Self-treatment of hemorrhoids. US Pharm. 1993; 18(7): 16–24.

Written by: healthplus24.com team
Date last updated: May 10, 2015