Most hemorrhoids are not permanent. The majority of cases resolve on their own or with simple at-home care within about a week, and even more severe hemorrhoids can be treated effectively with medical procedures. That said, hemorrhoids have a strong tendency to come back, especially if the underlying causes aren’t addressed. So while any single episode is usually temporary, the pattern of getting hemorrhoids can feel like a lifelong problem.
How Long a Typical Episode Lasts
Mild to moderate hemorrhoids, the kind that cause itching, minor bleeding, or discomfort during bowel movements, generally clear up within a week using basic treatments like warm baths, over-the-counter creams, and stool softeners. These are the most common type, and they don’t require any medical intervention.
Thrombosed external hemorrhoids, where a blood clot forms inside a swollen vein near the anus, are more painful but still temporary. If left alone, the body reabsorbs the clot and the swelling goes down over 7 to 10 days. The pain typically peaks in the first 48 to 72 hours and gradually improves from there. If the pain is severe, a doctor can remove the clot in a quick office procedure, which provides faster relief.
Pregnancy-related hemorrhoids, which are extremely common due to increased pressure on pelvic blood vessels, typically improve within a few days to weeks after delivery.
Why Some Hemorrhoids Don’t Go Away
Hemorrhoids are graded on a four-point scale based on how much tissue protrudes from the anal canal. Grade I hemorrhoids don’t prolapse at all. Grade II prolapse during a bowel movement but slide back in on their own. Grade III prolapse and need to be manually pushed back in. Grade IV are permanently prolapsed and can’t be reduced.
Grades I and II almost always respond to conservative treatment. Grade III and IV hemorrhoids are the ones most likely to become a persistent problem. At grade IV, the tissue stays outside the body continuously, causing ongoing discomfort, mucus discharge, and difficulty with hygiene. These won’t resolve without a procedure.
Even at lower grades, hemorrhoids involve stretched and weakened blood vessel walls. Once that tissue has been repeatedly inflamed, it becomes more vulnerable to swelling again. This is why people who’ve had hemorrhoids once are significantly more likely to have them again.
How Often Hemorrhoids Come Back
Recurrence is one of the most frustrating aspects of hemorrhoids. Roughly one in four adults has symptomatic hemorrhoids at any given time, based on a large meta-analysis that found a pooled prevalence of about 31% for symptomatic cases. Many of those people are dealing with repeat episodes rather than a first occurrence.
The factors that drive recurrence are largely lifestyle-related: chronic constipation, low fiber intake, prolonged sitting, excess body weight, and straining during bowel movements. Pregnancy is another major trigger. If these root causes stay in place, hemorrhoids will keep returning regardless of how well each individual episode is treated.
What Procedures Can Do
For hemorrhoids that keep coming back or won’t respond to home care, several procedures can provide longer-lasting results.
Rubber band ligation is the most common office-based treatment for internal hemorrhoids. A small band is placed at the base of the hemorrhoid, cutting off its blood supply so the tissue shrinks and falls off. Long-term studies show a cumulative success rate of about 80%. However, nearly 30% of patients need retreatment after the first round, and recurrence tends to happen faster with each subsequent treatment course. It’s effective, but not a guaranteed permanent fix.
Surgical removal (hemorrhoidectomy) is the most definitive option and is typically reserved for grade III or IV hemorrhoids or cases that haven’t responded to less invasive treatments. Recurrence rates after surgery are notably lower, around 5% in long-term follow-up studies. Patient satisfaction tends to be high, with most rating their outcome 8 out of 10 or better. Recovery takes longer than office procedures, usually two to four weeks, and the first week can be quite painful. But for people with severe or chronic hemorrhoids, it comes closest to a permanent solution.
Skin Tags After Healing
One thing that can be permanent, or at least very persistent, is the skin tags hemorrhoids sometimes leave behind. When a hemorrhoid swells and then shrinks, the stretched skin doesn’t always go back to normal. These small flaps of excess tissue around the anus are harmless but can be annoying, sometimes making it harder to stay clean after a bowel movement or causing mild irritation.
Skin tags won’t go away on their own. If they bother you, removal is a quick in-office procedure done under local anesthesia. A doctor can cut them away with scissors, freeze them off with liquid nitrogen, or remove them with a laser. The procedure itself is fast, though the area can be tender for several days afterward.
Preventing Recurrence Long-Term
The single most effective way to keep hemorrhoids from coming back is increasing your fiber intake. The NIDDK recommends 14 grams of fiber per 1,000 calories you eat, which works out to about 28 grams per day on a standard 2,000-calorie diet. Most people fall well short of this. Adding fiber gradually through whole grains, fruits, vegetables, and legumes (or a supplement if needed) softens stool and reduces straining, which is the primary mechanical cause of hemorrhoid flare-ups.
Staying hydrated matters too, since fiber works by absorbing water. Without enough fluid, increasing fiber can actually make constipation worse. Beyond diet, avoiding long periods of sitting on the toilet, not straining or forcing bowel movements, and staying physically active all reduce pressure on the veins in and around the rectum. For people who are overweight, even modest weight loss can lower the pressure that contributes to hemorrhoid formation.
These changes won’t guarantee you never have another episode, but they significantly reduce the frequency and severity. Many people who commit to a high-fiber diet and better bathroom habits find that what used to be a recurring problem becomes a rare one.