Prescription vs Over-the-Counter Hemorrhoid Cream Options
When a hemorrhoid flares, the itching and soreness can make it hard to sit, work or sleep, so most people reach for a hemorrhoid cream. Some creams are sold over the counter, and others need a prescription. They can look alike on the shelf, but they differ in what they contain, how they are chosen and who checks your symptoms first.
Over-the-counter creams can ease mild pain, swelling and itching,[1] and so can a prescription cream.[2] The main differences with a prescription cream are that it pairs a numbing medicine with a steroid in one tube, and a licensed clinician reviews your symptoms before you use it.[2] Through Starfish.com, you can request our prescription hemorrhoid cream online, and if it is right for you, the prescription reaches your pharmacy, usually within 1 to 2 hours.
Hemorrhoid Cream Compared
| Over-the-counter creams | Our prescription cream | |
|---|---|---|
| What is in it | Depends on the product. Common ingredients include hydrocortisone, a numbing medicine called pramoxine, or phenylephrine[3] | Lidocaine, a numbing medicine, and hydrocortisone, a steroid that calms inflammation, in one cream[2] |
| What it is for | Relief of mild pain, swelling and itching from external hemorrhoids[1] | Relief of itching, pain, soreness and discomfort from hemorrhoids[2] |
| Who checks your symptoms | You choose the product yourself | A licensed clinician reviews your questionnaire first |
| For symptoms inside the rectum | Some products come as suppositories[1] | A hydrocortisone suppository can be added, which needs a prescription[6] |
| How long to use it | Usually 1 week, then follow up with a doctor if it has not helped[1] | For the time your prescription states. The label advises against long use inside the anal canal[2] |
Why People Choose a Prescription Hemorrhoid Cream
A prescription cream is not simply a stronger version of a store cream. Its value is in the combination and in the review that comes with it.
Two jobs in one cream. Lidocaine numbs the area to ease pain and itching. Hydrocortisone works on the inflammation behind the swelling.[2] Store products vary in which of these ingredients they contain, so it is worth reading the label.
A clinician looks at your symptoms. With a store cream, you decide on your own whether your symptoms sound like hemorrhoids. With ours, a licensed clinician reads your answers first, including details such as bleeding or severe pain that point toward an in-person visit instead.
An option for symptoms inside. If some of your symptoms are inside the rectum, you can request a hydrocortisone suppository alongside the cream.
When a store cream has not been enough. If an over-the-counter product has not helped after a week, the NIDDK advises following up with a doctor.[1] Mention in your questionnaire what you have already tried and for how long.
Request Prescription Hemorrhoid Cream
Tell us about your symptoms and what you have tried. A licensed clinician reviews your answers and decides whether the cream is right for you.
What Lidocaine Hydrocortisone Cream Does
Lidocaine hydrocortisone cream is a prescription cream that combines a numbing medicine with a steroid. Its label lists it for the anti-inflammatory and numbing relief of itching, pain, soreness and discomfort from hemorrhoids.[2]
The label also gives a few cautions worth knowing. Brief stinging or burning can happen where the skin is broken. If the area becomes irritated or sensitive, or signs of infection appear, stop using it. And because it contains a steroid, it is not meant for long-term use.[2] Long-term use of creams that contain numbing medicines or steroids can also cause allergic reactions.[3]
How Getting the Prescription Works
You answer a short questionnaire about your symptoms, your health and any medicines you take. A licensed clinician reviews it and decides whether the cream, the suppository or both are right for you. If so, the prescription goes to the pharmacy you picked, and you can collect it there. You pay for the medication at the pharmacy, the same way you would with a prescription from your own doctor. To learn more about timing, see how fast you can get a prescription online.
When to Skip the Cream and Be Seen in Person
Whichever cream you use, some signs need an exam rather than a treatment.
Bleeding from the rectum. It is a common hemorrhoid symptom, but it can also be a sign of other bowel conditions, including colorectal cancer, so the NIDDK advises having it checked by a doctor.[4]
Heavy bleeding, or bleeding with dizziness or faintness. Get medical help right away.[5]
Severe pain with rectal bleeding. The NIDDK advises seeking care right away.[1]
You are pregnant. If you are pregnant, contact your obstetrician instead, because we do not treat anyone who is pregnant.
FAQ
Is prescription hemorrhoid cream stronger than over-the-counter cream?
Not necessarily, ingredient by ingredient. Store creams can also contain a numbing medicine, such as pramoxine, or hydrocortisone.[3] What sets ours apart is the rest of the treatment. It pairs lidocaine and hydrocortisone in one cream,[2] you can add a hydrocortisone suppository for symptoms inside, which needs a prescription,[6] and a licensed clinician reviews your symptoms before you start.
What is the best hemorrhoid cream?
There is no single best cream for everyone. Over-the-counter products with hydrocortisone, pramoxine or phenylephrine can be considered for mild symptoms.[3] If you want a cream that numbs and calms inflammation together, with a clinician’s review, request our prescription cream.
Can I use hemorrhoid cream inside the rectum?
Follow the directions on your prescription or product. For symptoms inside the rectum, a suppository is often easier, and you can request a hydrocortisone suppository with the cream.
Can I get a prescription hemorrhoid cream online through Starfish.com?
Yes. Answer a short questionnaire, and if a licensed clinician approves it, we send the prescription to your pharmacy, usually within 1 to 2 hours. You can also pay with an FSA or HSA account.
Get Prescription Hemorrhoid Relief
A licensed clinician reviews your answers and, if treatment is right for you, sends the prescription to your pharmacy, usually within 1 to 2 hours.
References
- National Institute of Diabetes and Digestive and Kidney Diseases. “Treatment of Hemorrhoids.” https://www.niddk.nih.gov/health-information/digestive-diseases/hemorrhoids/treatment
- U.S. National Library of Medicine, DailyMed. “Lidocaine hydrochloride and hydrocortisone acetate cream.” Human prescription drug label. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=0cd1394d-e7b2-4e60-87ac-e12a0bda9d67
- Arnold MJ, Smith D. “Management of Hemorrhoids: Guidelines From the ASCRS.” American Family Physician, 2025. https://www.aafp.org/pubs/afp/issues/2025/1200/practice-guidelines-hemorrhoids.html
- National Institute of Diabetes and Digestive and Kidney Diseases. “Symptoms & Causes of Hemorrhoids.” https://www.niddk.nih.gov/health-information/digestive-diseases/hemorrhoids/symptoms-causes
- U.S. National Library of Medicine, MedlinePlus. “Hemorrhoids.” Medical Encyclopedia. https://medlineplus.gov/ency/article/000292.htm
- Apnar Pharma. “Hydrocortisone Acetate Suppositories 25 mg.” Prescribing information, via DrugCentral. https://drugcentral.org/label/cb60f2a6-8bab-c0f9-e053-2a95a90a422a/view
