Most hemorrhoids do go away on their own, typically within a few weeks when you make basic changes to your diet and bathroom habits. The key factors are what type of hemorrhoid you have and how severe it is. Mild internal hemorrhoids almost always resolve with conservative care, while thrombosed external hemorrhoids can take significantly longer and may benefit from medical treatment.
How Long Hemorrhoids Take to Heal
The timeline depends heavily on the type you’re dealing with. Internal hemorrhoids, the kind that form inside the rectum, have a good prognosis overall. Most resolve with simple at-home measures within four to six weeks. These hemorrhoids are graded on a scale of one to four based on severity: grade I hemorrhoids bulge into the anal canal but don’t prolapse, grade II prolapse during a bowel movement but slide back on their own, grade III prolapse and need to be pushed back in manually, and grade IV prolapse permanently and can’t be pushed back.
Grades I and II are the most likely to resolve without any procedure. Grade III hemorrhoids sometimes respond to conservative treatment but often need intervention. Grade IV hemorrhoids rarely resolve on their own.
External hemorrhoids that aren’t thrombosed (meaning no blood clot has formed) generally improve within a few days to a couple of weeks with proper care. The more painful scenario is a thrombosed external hemorrhoid, where a blood clot forms under the skin near the anus. These cause intense pain for the first few days, then gradually improve over several weeks. In one study of 231 patients with thrombosed external hemorrhoids, those managed without surgery took an average of 24 days to resolve, compared to about 4 days for those who had the clot surgically removed.
What Helps Hemorrhoids Heal Faster
The single most effective thing you can do is soften your stool so you’re not straining. That means increasing fiber and water intake. The recommended fiber target is about 14 grams for every 1,000 calories you eat, which works out to roughly 28 grams per day on a standard 2,000-calorie diet. Good sources include beans, whole grains, fruits, and vegetables. Pair that fiber with plenty of water and other clear liquids throughout the day, since fiber without adequate fluid can actually make constipation worse.
Sitz baths help relieve discomfort and promote healing. Sit in a few inches of warm water for about 20 minutes after each bowel movement, plus two or three additional times per day. You can use a small basin that fits over your toilet seat or just use the bathtub. Beyond that, avoid sitting on the toilet longer than necessary. Scrolling your phone on the toilet creates prolonged pressure on the hemorrhoidal tissue and slows recovery.
Over-the-counter creams and suppositories containing hydrocortisone or witch hazel can ease itching and swelling in the short term. These are fine for temporary relief but aren’t solving the underlying problem. Regular exercise also helps by promoting healthy bowel function.
When a Thrombosed Hemorrhoid Needs Treatment
If you develop a hard, painful lump near your anus, that’s likely a thrombosed external hemorrhoid. The first 72 hours are the most painful. If you can get to a doctor within that window, surgical removal of the clot provides the fastest relief and also cuts the chance of recurrence. One study found recurrence rates of about 6% after surgical excision versus 25% with conservative management alone.
After the 72-hour mark, the worst pain is usually starting to subside on its own. At that point, doctors typically recommend riding it out with sitz baths, pain relievers, and stool softeners rather than operating, since you’ve already passed the peak. The lump may take a few weeks to fully shrink, and you might notice a small skin tag left behind once it heals.
Signs Your Hemorrhoids Won’t Resolve Alone
Not every hemorrhoid will cooperate with home treatment. Pay attention to these signals that it’s time to get professional help:
- Symptoms lasting more than a week without improvement, especially persistent pain, itching, or discomfort
- Bleeding during bowel movements that doesn’t stop or keeps recurring
- A prolapsed hemorrhoid that you can’t push back in or that causes pain and bleeding
- Worsening symptoms despite consistent home care
- Uncertainty about the cause, particularly if you’ve never had hemorrhoids before, since rectal bleeding can have other causes that need to be ruled out
For hemorrhoids that don’t respond to conservative measures, doctors have several office-based options. Rubber band ligation, where a small band is placed around the base of an internal hemorrhoid to cut off its blood supply, works well for grades I through III. It’s done in a regular office visit and doesn’t require anesthesia. More advanced cases may need surgical hemorrhoidectomy, but the vast majority of people never reach that point.
Why Hemorrhoids Come Back
Even after successful treatment, hemorrhoids have a notable tendency to recur. Most studies report recurrence rates of 20% or less after surgical procedures, but there’s very little data on recurrence after home treatment alone. The reality is that hemorrhoids are normal anatomical structures. Everyone has hemorrhoidal tissue, which consists of cushions of blood vessels that help with bowel control. Problems develop when those cushions become swollen and inflamed, usually from chronic straining, low fiber intake, prolonged sitting, or pregnancy.
If you go back to the habits that caused the problem, the hemorrhoids will likely return. The fiber and water changes that help hemorrhoids heal in the short term are the same changes that prevent them from coming back. Think of them as permanent adjustments rather than temporary fixes. Maintaining regular bowel habits, staying physically active, and avoiding long stretches on the toilet are the most practical ways to keep hemorrhoids from becoming a recurring issue.