External hemorrhoids are enlarged veins located under the skin around the anus. They differ from internal hemorrhoids in their location and symptoms. External hemorrhoids develop on the outside of the anal canal and can be easily seen and felt. They are usually soft to the touch, but in cases of thrombosis, when a blood clot forms in the vein, they can become hard and very painful.

In this article, we will look at methods of treatment for external hemorrhoids - home remedies, medications and medical procedures, as well as preventive measures that can help relieve symptoms and prevent their recurrence.


1. Treatment of external hemorrhoids with home remedies


Home remedies for external hemorrhoids are often used as the first line of therapy because of their availability and low cost. They can significantly relieve symptoms and help manage discomfort.


1. Warm sitz baths

Warm sitz baths are an effective method to relieve pain and reduce inflammation. They help increase blood circulation in the anal area, which helps reduce swelling. It is important that the water is warm, not hot, to avoid further skin irritation. Take warm sitz baths 2-3 times a day for 15-20 minutes.


2. Application of cold compresses

Applying a cold compress for 10-15 minutes can reduce the inflammation and itching sensation. It is recommended to use a clean cloth or special ice packs to avoid direct contact of the ice with the skin, which can cause a burn.


3. Using wet towels instead of toilet paper

Using wet wipes instead of toilet paper is helpful as they are gentler on the skin and prevent further irritation. Wet wipes should be fragrance-free and alcohol-free to avoid irritating the sensitive skin around the anus. They can be used after every bowel movement.


4. Maintaining good hygiene

Maintaining good hygiene is essential to prevent infections and further complications. The anal area should be washed carefully with warm water after each bowel movement. Avoid using soaps and products with fragrances that can cause irritation. Drying should be done carefully, with light patting, not rubbing.


5. Changes in diet

Including more fiber in the diet can help soften the stool and make it easier to pass, thus reducing the stress on the hemorrhoids. Eat more fruits, vegetables, whole grains, and other sources of fiber. Drinking enough water is also important to stay hydrated and prevent constipation.


6. Exercises and physical activity

Regular physical activity helps improve blood circulation and reduce the risk of constipation. Light exercise, such as walking, swimming, and stretching, can be especially helpful.


2. Treatment of external hemorrhoids with medication


Medical treatment of external hemorrhoids is often the next step if home remedies do not provide enough relief. There are different types of medications that can be used to relieve symptoms and treat external hemorrhoids.


Topical creams and ointments


Topical creams and ointments are widely used to relieve the pain, itching, and inflammation associated with external hemorrhoids. They may contain different active ingredients:

  • Hydrocortisone: A corticosteroid that reduces inflammation and relieves itching;
  • Lidocaine: A local anesthetic that relieves pain and discomfort;
  • Witch Hazel: A natural anti-inflammatory that helps reduce swelling and itching.


These products are applied directly to the affected area several times a day, depending on the doctor's instructions or the instructions on the package.


Topical creams and ointments


Pain relievers


Pain relievers such as acetaminophen (Tylenol) and ibuprofen (Advil) can be used to relieve pain and reduce inflammation. These medications are especially helpful in thrombosed hemorrhoids, where the pain can be intense. They should be taken according to the dosages recommended on the package or prescribed by a doctor.




Venotonics are a class of medications that improve vein tone and elasticity while reducing venous congestion. They can be used to treat hemorrhoids and other venous diseases. One of the commonly used venotonics is diosmin.




Laxatives can be helpful for people who suffer from constipation. They help to soften stools and facilitate their passage. There are different types of laxatives, including:

  • Osmotic laxatives: Draw water into the intestines, which softens the stool and stimulates defecation;
  • Stimulants: Stimulate muscle contractions in the intestines, which helps move stools.


3. Treatment of external hemorrhoids with medical procedures


If conservative methods and medical treatment do not give the desired effect, various medical procedures can be considered for the treatment of external hemorrhoids. These procedures are usually performed by specialists and may provide longer-term relief of symptoms.


Rubber band ligation

Rubber band ligation is a minimally invasive procedure in which a small rubber band is placed around the base of the hemorrhoid. This cuts off its blood supply, causing the hemorrhoid to shrink and fall off after a few days. The procedure is relatively painless and has a high success rate.



Sclerotherapy is a procedure in which a chemical solution is injected into the hemorrhoid. This solution causes the hemorrhoid to shrink and dry up. Sclerotherapy is effective for treating small to medium-sized hemorrhoids and can be performed on an outpatient basis. The risk of complications is low, but re-treatment may be necessary.


Laser therapy

Laser therapy uses a laser beam to coagulate the blood vessels in the hemorrhoid. This procedure causes the hemorrhoid to shrink and disappear. Laser therapy is minimally invasive and has a short recovery period. It is suitable for patients looking for quick relief with minimal discomfort.


Infrared coagulation

Infrared coagulation is a method that uses infrared light to coagulate the blood vessels in the hemorrhoid. The procedure is quick and effective for treating small to medium sized hemorrhoids. It can be performed in an outpatient setting and has minimal side effects.


Surgical removal

In severe cases, when other methods are not effective, surgical removal of hemorrhoids may be necessary. Hemorrhoidectomy is a surgical procedure in which the hemorrhoids are completely removed. This procedure is performed under general or local anesthesia. Although it is the most invasive option, it offers the longest lasting results and is suitable for severe cases.


4. Prevention


Prevention of external hemorrhoids is essential to prevent the development and recurrence of symptoms.

Following a few simple steps can significantly reduce your risk and help maintain a healthy lifestyle:

  • Maintaining a healthy diet: Including fiber-rich foods such as fruits, vegetables, whole grains, and legumes;
  • Drinking enough water: Try to drink about 2 liters of water a day;
  • Regular physical activity with light exercises such as swimming and walking;
  • Avoiding prolonged sitting;
  • Avoiding straining during bowel movements;
  • Proper hygiene: Use moist towels without fragrances and alcohol or washing with warm water after defecation;
  • Avoid lifting heavy objects and strength training.




5. When to consult a doctor?


Although many cases of external hemorrhoids can be treated successfully with home remedies and over-the-counter medications, there are situations in which it is necessary to consult a doctor. Timely medical help can prevent complications and provide more effective treatment.


Severe pain and discomfort

If you are experiencing severe pain and discomfort that is not relieved by home remedies or over-the-counter pain relievers, it is important to consult a doctor. Severe pain may be a sign of a thrombosed hemorrhoid or another serious medical situation that requires immediate attention.


Heavy bleeding

Heavy bleeding from the anus or in the stool is a serious symptom that requires medical evaluation. Bleeding can be a sign of severe inflammation, infection, or other health problems that require diagnosis and treatment by a specialist.


Lack of improvement in symptoms

If the symptoms of hemorrhoids do not improve after two weeks of home treatment, you should consult a doctor. Lack of improvement may indicate that the condition is more serious and requires more specialized treatment.


Severe swelling and inflammation

Inflammation may be a sign of infection or other complication that should be evaluated and treated by a specialist.


Changes in the frequency of bowel movements and stools

Changes in stool frequency, shape, or consistency that last more than a few days also require a doctor's consultation. These changes can be symptoms of more serious conditions, including colorectal cancer or other bowel diseases.


Accompanying symptoms

If you experience additional symptoms such as fever, weakness, unexplained weight loss or anemia, you should consult a doctor immediately. These symptoms may be related to more serious health conditions and require immediate medical evaluation.




Treatment of external hemorrhoids can include a variety of methods, from home remedies and medications to specialized medical procedures. In more serious cases or if symptoms do not improve, timely consultation with a doctor is essential for correct diagnosis and effective treatment.



1. WebMD: Hemorrhoids: Symptoms, Causes, and Treatment (25.05.2024)
2. Healthline: Causes of Hemorrhoids and Tips for Prevention (25.05.2024)
3. Mayo Clinic: Hemorrhoids: Symptoms (25.05.2024)