Preparation H is applied to clean, dry skin around the affected area, up to four times per day. The exact steps depend on which form you’re using: ointment, cream, or suppository. Each works slightly differently, and choosing the right one matters for getting the most relief.
Choosing the Right Form
Preparation H comes in creams, ointments, and suppositories, and they’re not interchangeable. Creams and ointments work best for external hemorrhoids, the kind you can feel on the outside. They coat the irritated surface, reduce swelling, and numb pain on contact. Suppositories are designed for internal hemorrhoids, where a cream can’t reach. They dissolve slowly inside the rectum, releasing medication over a longer period than topical products. Suppositories can also help soothe external symptoms as a secondary benefit.
If you’re not sure whether your hemorrhoids are internal or external, the location of your discomfort is the simplest guide. Pain and itching you can feel on the outside call for a cream or ointment. Discomfort that seems deeper, or that flares mainly during bowel movements, often responds better to a suppository.
How to Apply Ointment or Cream
Start by cleaning the area. Pat or blot gently with a moist cleansing wipe rather than rubbing with dry toilet paper, which can irritate swollen tissue further. Then pat the area dry with a soft cloth or tissue. Applying product to wet skin dilutes it and reduces how well it sticks.
Squeeze a small amount of ointment or cream onto your fingertip and apply it directly to the external area. Use just enough to coat the irritated skin with a thin layer. There’s no benefit to applying a thick glob. Wash your hands thoroughly afterward.
You can apply up to four times daily. The most effective times are in the morning, at night before bed, and after each bowel movement, since that’s when irritation peaks. Reapply after cleaning the area if you’ve wiped the previous application away.
How to Insert a Suppository
Clean and dry the area the same way you would for an ointment. Then detach one suppository from the strip. Peel the foil wrapper apart slowly and evenly by pulling the tabs down both sides. Don’t tear the foil, as that can damage the suppository inside.
Hold the unwrapped suppository with the rounded, tapered end pointing up. Gently insert it into the rectum, rounded end first. You don’t need to push it far. Just past the opening is enough for it to stay in place and dissolve. Try to insert it after a bowel movement rather than before, so it has time to work without being pushed out. You can use suppositories up to four times daily.
If the suppository feels too soft to insert, run it under cold water for a moment while still in the wrapper, or refrigerate it briefly. This firms it up enough to handle easily.
What the Ingredients Actually Do
Preparation H isn’t a single medicine. It combines several active ingredients that each handle a different symptom. The Maximum Strength formula, for example, contains a blood vessel constrictor (phenylephrine) that temporarily shrinks swollen hemorrhoidal tissue. This is what reduces the bulging, puffy feeling. It also contains a local anesthetic (pramoxine) that numbs pain, soreness, and burning on contact.
The other two active ingredients are protectants: glycerin and white petrolatum. These create a physical coating over the irritated surface, shielding it from friction during bowel movements and making them less painful. Different Preparation H formulas swap some of these ingredients. The witch hazel version, for instance, focuses on soothing and cooling rather than numbing. Check the box to see which active ingredients your specific product contains.
How Long to Use It
Preparation H is a short-term product. Most hemorrhoid flare-ups improve within a week of consistent use. If your symptoms haven’t improved after seven days, that’s a signal to talk to a doctor rather than continuing to self-treat. Prolonged use of products containing a blood vessel constrictor can cause skin irritation, and the numbing agents can mask symptoms that need medical attention.
Stop using the product and seek medical advice if you notice rectal bleeding, increasing pain, or if the condition worsens during treatment. Bleeding in particular can have causes beyond hemorrhoids that need to be ruled out.
Safety Considerations
Phenylephrine, the ingredient that shrinks swollen tissue, can be absorbed through the skin into the bloodstream. For most people this is harmless at the low doses in a topical product. But if you have high blood pressure, heart disease, or a history of stroke or heart failure, it can cause a rise in blood pressure. If any of those apply to you, choose a Preparation H formula that doesn’t contain phenylephrine, such as the witch hazel wipes or the plain protectant ointment.
For breastfeeding, topical hemorrhoid treatments are generally compatible with nursing a full-term, healthy infant. The medication dose is small, the application area is limited, and absorption into the bloodstream is minimal. The main precaution is practical: wash your hands thoroughly after applying the product and before handling your baby. During pregnancy, the same low-absorption logic applies to most formulas, but it’s worth confirming with your provider since phenylephrine-containing products carry the same blood pressure considerations.
Getting Better Results
Preparation H manages symptoms but doesn’t fix the underlying cause. A few habits make a significant difference in how quickly a flare-up resolves and whether it comes back. Increasing fiber intake (aim for 25 to 30 grams daily from food or a supplement) softens stools and reduces straining, which is the most common trigger. Drinking enough water works alongside fiber to keep things moving.
Avoid sitting on the toilet longer than necessary. Scrolling your phone for ten minutes while bearing down puts sustained pressure on the veins around the rectum. Get in, go, and get out. A sitz bath (sitting in a few inches of warm water for 10 to 15 minutes) can complement Preparation H by increasing blood flow to the area and relaxing the surrounding muscles. You can do this two to three times a day, applying the product afterward once you’ve dried off.