Chinese Herbal Hemorrhoid Creams: Ingredients, Evidence, Safe Use and Home Care
Anal and perianal skin care
Chinese herbal hemorrhoid creams use cooling and Heat-clearing herbs to soothe the itching, burning and discomfort of external hemorrhoids and irritated perianal skin. They work best alongside the basics that ease hemorrhoids themselves: softer stools, less straining and warm sitz baths. Among natural options, plant flavonoids taken by mouth have the strongest clinical evidence.
- Fibre, fluids, less straining and sitz baths are the first-line home treatment for hemorrhoids.
- A meta-analysis of 14 trials found plant flavonoids reduced persistent hemorrhoid symptoms by 58%, with less bleeding, pain and itching.
- Menthol, a cooling ingredient in many herbal creams, is listed in the US FDA's rules for external anorectal products at 0.1% to 1%.
- Creams for the skin are for external use only. Rectal bleeding should always be checked by a doctor.
What are hemorrhoids?
Hemorrhoids are swollen veins in the anus and lower rectum. External hemorrhoids form under the skin around the anus and can itch, ache or form a tender lump. Internal hemorrhoids form inside the lower rectum and usually cause painless, bright red bleeding or bulge out (prolapse) during bowel movements (NIDDK). Straining, constipation, long periods on the toilet and pregnancy are common triggers.
How do you treat hemorrhoids at home?
Most hemorrhoid symptoms improve with simple changes that reduce pressure during bowel movements (NIDDK):
| Step | Why it helps | Tip |
|---|---|---|
| More fibre | Softer stools need less straining | Increase gradually with fruit, vegetables, whole grains or a fibre supplement |
| Enough fluids | Helps fibre work | Drink regularly through the day |
| Less time on the toilet | Reduces pressure on the veins | Avoid scrolling your phone on the toilet |
| Warm sitz baths | Eases pain and itching | 10 to 15 minutes in warm water, then pat dry |
| A soothing external cream | Relieves itch, burning and discomfort | Apply to clean, dry skin around the anus |
What do hemorrhoid creams contain?
Over-the-counter hemorrhoid products combine one or more types of ingredient:
- Protectants such as petrolatum, which shield irritated skin.
- Counterirritants such as menthol, which give a cooling sensation that distracts from itch and discomfort. The US FDA lists menthol at 0.1% to 1% for external anorectal use (21 CFR 346.16).
- Local anaesthetics such as lidocaine for short-term pain.
- Astringents such as witch hazel.
- Corticosteroids such as hydrocortisone, intended for short courses only.
- Herbal ingredients in Chinese creams, chosen to clear Heat, reduce swelling and stop itching.
How does Traditional Chinese Medicine treat hemorrhoids?
TCM often describes hemorrhoids as Damp-Heat and Blood Heat collecting in the lower body, with bleeding, swelling and itch. Treatment aims to clear Heat, resolve Dampness and cool the Blood. Classic herbs include Huai Hua (Sophora japonica flower), traditionally used for bleeding hemorrhoids, and external Heat-clearing, itch-relieving herbs such as Ku Shen, She Chuang Zi and cooling Bing Pian (borneol).
A traditional Chinese ointment, Sanhuang ointment, reduced inflammation and swelling in a laboratory hemorrhoid model, with effects comparable to the widely used Mayinglong musk hemorrhoid ointment used as a reference (Yu et al., 2024).
What does the evidence show for natural hemorrhoid treatments?
Plant flavonoids. A meta-analysis of 14 randomised trials (1,514 patients) found flavonoids reduced the risk of persistent symptoms by 58%, with less bleeding, pain, itching and recurrence, although trial quality varied (Alonso-Coello et al., 2006). Sophora japonica flower is a traditional source of these flavonoids.
Sophora flower formula. In a randomised, double-blind trial alongside fibre advice and sitz baths, 78.2% of people taking an oral Sophora flower formula were symptom-free at 14 days. The placebo group also improved strongly with good bowel habits, so the difference was not statistically significant, highlighting how important home care is (Man et al., 2013).
Herbal ingredients for itch. Osthole from She Chuang Zi reduced scratching by blocking the TRPV3 itch channel in mice (Sun et al., 2018), and borneol relieved itch through cold-sensing nerve channels (Tian et al., 2023).
Is it hemorrhoids or perianal itch?
Itching around the anus is often caused by irritated skin rather than hemorrhoids alone: moisture, over-cleaning, wipes, soaps and allergies are common triggers, and German guidelines recommend identifying and removing these (Weyandt et al., 2020). Read more in our guide to pruritus ani (anal itching).
Where QICAOGANGMU fits
QICAOGANGMU is a steroid-free Chinese herbal cream for itchy, irritated skin. For the skin around the anus, it brings together cooling menthol 0.5% (within the FDA's range for external anorectal products) and Bing Pian (borneol) 2%, the classic Heat-clearing, itch-relieving pair She Chuang Zi 3% and Ku Shen 1.5%, and Bai Bu 0.5%, in a protective petrolatum and glycerin base. Finished batches are independently tested by TÜV SÜD PSB, with Not Detected results for eight corticosteroids.
Apply a thin layer to clean, dry skin around the anus only, never inside, and follow the packaging directions. Test a small area first, as cooling ingredients can sting on broken skin.
When should you see a doctor?
- Any rectal bleeding, especially if you are over 45 or it is new
- Symptoms that do not improve after about a week of home care
- Severe pain, a hard and very painful lump, or a hemorrhoid that will not go back in
- Bleeding with diarrhoea, abdominal pain, fever, weight loss or a change in bowel habits
- Dark or tarry stools
Doctors can treat persistent hemorrhoids with simple office procedures such as rubber band ligation.
Frequently asked questions
Do Chinese herbal hemorrhoid creams work?
Chinese herbal creams use cooling and Heat-clearing herbs to soothe the itch, burning and discomfort of external hemorrhoids. They work best alongside fibre, fluids, less straining and sitz baths, which ease the hemorrhoids themselves.
What is the best natural treatment for hemorrhoids?
Fibre, fluids and warm sitz baths are the foundation. Among natural remedies, plant flavonoids have the strongest evidence: a meta-analysis of 14 trials found they reduced persistent symptoms by 58%.
Can I put an herbal cream inside the anus?
Only if the product is specifically made for internal use. Skin creams should be applied to the skin around the anus only.
Why does menthol help hemorrhoid itching?
Menthol activates cold receptors in the skin, creating a cooling feeling that eases itch and discomfort. The US FDA lists menthol at 0.1% to 1% for external anorectal products.
When is rectal bleeding serious?
Always have rectal bleeding checked by a doctor, and seek prompt care if it comes with severe pain, fever, dark stools, weight loss or a change in bowel habits.
Related articles
References
- National Institute of Diabetes and Digestive and Kidney Diseases. Hemorrhoids: symptoms and causes and treatment.
- Alonso-Coello P, Zhou Q, Martinez-Zapata MJ, et al. Meta-analysis of flavonoids for the treatment of haemorrhoids. Br J Surg. 2006;93(8):909-920. PMID 16736537
- Man KM, Chen WC, Wang HM, et al. A randomized, double-blind, placebo-controlled trial of a Chinese herbal Sophora flower formula in patients with symptomatic haemorrhoids. Afr J Tradit Complement Altern Med. 2013;10(2):343-351. PMID 24146460
- Yu Q, Zhao Y, Zhang X, et al. The beneficial effect of Sanhuang ointment and its active constituents on experimental hemorrhoids in rats. J Ethnopharmacol. 2024;319(Pt 2):117173. PMID 37741471
- Weyandt G, Breitkopf C, et al. German S1 guidelines for the diagnosis and treatment of perianal dermatitis (anal eczema). J Dtsch Dermatol Ges. 2020. PMID 32469472
- Sun XY, Sun LL, Qi H, et al. Antipruritic effect of natural coumarin osthole through selective inhibition of thermosensitive TRPV3 channel in the skin. Mol Pharmacol. 2018;94(4):1164-1173. PMID 30108138
- Tian W, He D, Liu J, et al. Topical borneol relieves nonhistaminergic pruritus via targeting TRPA1 and TRPM8 channels in peripheral nerve terminals of mice. Eur J Pharmacol. 2023;953:175833. PMID 37290679
- US Code of Federal Regulations. 21 CFR 346.16: Analgesic, anesthetic, and antipruritic active ingredients (anorectal).
Educational information only. Rectal bleeding, severe pain and persistent anal symptoms should be assessed by a qualified healthcare professional.
