Hemorrhoid Cream Gets a Beauty-Industry Makeover — With Real Prescriptions

Up to 86 percent of women develop hemorrhoids during pregnancy, yet the hemorrhoid aisle stayed a wall of identical yellow boxes for decades. New brands — Norms, Megababe and Bummed — are now rebuilding the category with clear packaging, prescription-strength formulas and beauty-industry marketing.

"For decades, the hemorrhoid aisle was a wall of identical yellow boxes, so patients grabbed whatever was on the bottom shelf, used it awkwardly, and never asked questions," Dr. Wendi LeBrett, a double board-certified gastroenterologist, founding partner and medical advisor for Norms, told ELLE.

How common are symptomatic hemorrhoids?

The incidence of symptomatic hemorrhoids ranges from 5 to 50 percent, a gap driven by under-reporting of a traditionally taboo condition, according to Dr. Carmen Fong, MD, FACS, FASCRS, chief medical officer for Bummed and a double-board-certified colorectal surgeon. "I like to quote 50% by the age of 50, but most of the people I see in my office are under 50," Fong said. "I'd estimate 25 percent by the age of 25, and 35 percent by the age of 35, because of our lifestyles, especially after COVID."

LeBrett puts the global figure at roughly 1 in 4 adults.

What actually causes flare-ups?

Fong lists prolonged toilet sitting — often tied to constipation or diarrhea — long hours seated at a desk, extended standing (as with waiters), straining, long bicycle rides, and long plane or car trips. LeBrett adds that anything raising pressure in the pelvic region reduces vascular flow and dilates blood vessels. Age weakens the connective tissue anchoring hemorrhoids, and cirrhosis can impair blood return from the anorectal region. In pregnancy, the growing uterus plus hormone-driven constipation — estimated at around 40 percent of pregnant women — compounds the risk.

What has changed in treatment?

The core pharmacology has not. "The ingredients that work, like protectants, lidocaine for pain and itch, phenylephrine to temporarily shrink swelling, and witch hazel, have decades of safety data behind them and are regulated by the FDA. Fiber, water, and better bathroom habits are still the foundation," LeBrett said.

What changed is delivery and education. Prevention remains first-line: guidelines recommend 25–30 g of fiber daily, adequate hydration, psyllium supplements, and tools like the Squatty Potty stool that straightens the rectum anatomically. For persistent symptoms, Fong said surgeons have "about eight different ways to treat hemorrhoids, ranging from less invasive banding (ligation), injection, or infrared coagulation (IRC), to more invasive options like laser, transanal hemorrhoidal dearterialization (THD), and finally, excision. Most people do not need excision." The surgical gold standard — complete excision of all three hemorrhoidal columns — is painful and causes significant scarring, which is why care has shifted toward less invasive procedures and topical compounds that "treat the root of the problem, rather than just putting a band-aid on it," Fong said.

LeBrett flags one limit: rectal bleeding or pain that doesn't improve should always be medically evaluated, not self-treated indefinitely.

How are newer brands different?

Bummed, co-founded by CEO Jennifer Dwork, moves beyond OTC symptom relief with compounded prescription creams previously available only through gastroenterologists or colorectal surgeons. "We've made them accessible to everyone across the U.S., as long as a medical provider on our site deems them appropriate," Dwork said. The formulas include diltiazem — clinically proven to heal up to 91 percent of fissures — plus lidocaine and bupivacaine for pain, hydrocortisone for swelling, and metronidazole for infection, with nitroglycerin and nifedipine options depending on symptoms and history.

Norms stays with FDA-regulated, maximum-strength versions of proven ingredients, adds wipes, sprays and travel formats, and samples products in doctors' offices so embarrassed patients can leave with relief in hand. It recently launched Squeezies, single-use sachets. "A product you're happy to carry is a product you'll actually use when you need it," LeBrett said.

She also notes the category was "built by men, for men," even though pregnant and postpartum women need it most. Consumers now research these ingredients the way they quiz a dermatologist, and perianal skin is as thin and sensitive as the under-eye area. As Fong put it: "If your butt hurts, you are completely miserable, so I am so excited that self-care is finally extending to butt care."