Dr. Antonio Privitera

About Hemorrhoids Cream: Uses & Application

What is a hemorrhoids Cream?

A Hemorrhoids cream (piles cream) is an over-the-counter medication that is applied in the anal region to improve symptoms related to hemorrhoids (piles). These include: discomfort, bleeding, itching, mucous discharge and prolapse.
A hemorrhoids cream can be applied in the anal region several times in day. A note of caution should be mentioned about steroid-based creams that should be used only for a short period of time in view of their side effects. In fact, steroids may cause the skin to become sensitive, irritated and they may induce atrophy (thinning). Common brands of hemorrhoids cream are: Anodesyn, Doxiproct, Anusol, Preparation H, Proctosedyl, Proctofoam HC, etc.
Hemorrhoid Creams

When is a Hemorrhoids Cream Helpful?

A hemorrhoid cream is an adjunct to the conservative management of haemorrhoids together with a high fibre diet, use of laxatives when needed, increased water intake, avoidance of straining and hygienic recommendations.
 

The use of hemorrhoids cream has been shown not to modify the course of the disease, but may well reduce the symptoms related to swelling, bleeding, discomfort and itching.

What are The main Components of a hemorrhoids cream?

The main products used in a hemorrhoid cream are steroids, local anesthetics, fibrinolytic agents, vasoconstrictors, antiseptics and herbal medications.

A well studied combination is steroids (tribenoside) with a local anesthetic (lidocaine) that is delivered as cream or suppository. Tribenoside has been shown to improve the microcirculation, stimulate healing at the level of the basement membrane and increase vascular tone. All these effects improve symptoms of haemorrhoids. Lidocaine as a local anesthetic reduces anal pain and discomfort. Studies have shown that the combination of tribenoside and lidocaine is more effective that the single use of these agents. Relief of symptoms is long-lasting allowing for an administration every 12 hours in the acute phase. After 2 weeks, applications can be reduced to once a day.  Contrary to other steroids, tribenoside used for up to 20 days has demonstrated to be well tolerated and without adverse effects typical of other steroids, such as hydrocortisone.

The association of tribenoside+lidocaine can also be a good option for patients with certain types of infections that would not be suitable for treatment with other steroids. Another category of haemorrhoids cream is based on herbal or polyherbal medications. These seem to have different properties including anti-inflammatory, analgesic and laxative. Another product that has been studied is the fibrinolytic agent streptokinase that has been shown in randomised trials to have an excellent effect on haemorrhoids, in particular when complicated by thrombosis.

Vasoconstrictors, e.g. phenylephrine, have also been adopted in the management of haemorrhoids A randomised multicentric clinical trial comparing streptokinase to phenylephrine in acute hemorrhoidal disease showed superiority of streptokinase.
At 5 days the response rate was 75% for streptokinase and 32% for phenylephrine. The need for thrombectomy was higher in the phenylephrine group. Streptokinase may have the benefit of increasing vascular permeability and improve lymphatic flow with consequent reduction of edema, exudate and local inflammation.

herbal/plant-based hemorrhoid cream

Are Herbal Based Hemorrhoid Creams Effective?

There is no strong evidence of herbal/plant-based hemorrhoid cream being effective in hemorrhoids. However, plants and herbs were used routinely in ancient times for this purpose and the effects of some of them have shown some anti-inflammatory and analgesic properties.
Comfrey (Symphytum officinale L.) is generally used in the treatment of burns, eczema and insect bites. The use in hemorrhoids has not been well studied and the efficacy is dubious.
Allium ampeloprasum subsp iranicum (Leek) has been shown in a randomised controlled clinical study to reduce bleeding severity and discomfort during defecation compared to standard hemorrhoid cream.
Aloe Vera cream was shown in a randomised trial the ability to reduce bleeding and discomfort following haemorrhoids surgical excision.

How to Apply a Hemorrhoids Cream?

Only a small amount is needed and gently rubbed over the affected anal area. The common mistake is to apply large quantity of product. In case of internal haemorrhoids, a small applicator helps to insert the product into the anal canal. Wash your hands before and after use. Suppositories and foams can also be used for internal piles.

Hemorrhoids Cream

Free Consultation for Hemorrhoids Treatment

A proctology service in Dubai not only for Hemorrhoids Treatment, but also for many other diseases is currently operating in NMC Royal Hospital Dubai Investment Park- DIP. Currently, Dr. Antonio Privitera is offering a free consultation for hemorrhoids in the same hospital in Dubai.

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