Anusol and Preparation H are two of the most popular over-the-counter hemorrhoid treatments, but they're not the same product. Each uses different active ingredients and targets different symptoms. This guide compares them head-to-head so you can choose the right one — or learn why neither alone may be enough.
Medically reviewed by the HemRid Medical Team | Last updated: April 2026
Anusol vs Preparation H: Side-by-Side Comparison
| Feature | Anusol | Preparation H |
|---|---|---|
| Manufacturer | Church & Dwight | Pfizer (formerly Wyeth) |
| Key active (cream/ointment) | Zinc oxide + Pramoxine HCl | Phenylephrine HCl + Petrolatum |
| Primary action | Skin protection + pain relief | Shrinks swollen tissue |
| Reduces swelling | Mild (zinc oxide astringent) | Yes (phenylephrine vasoconstrictor) |
| Pain relief | Yes (pramoxine anesthetic) | Yes (pramoxine in Rapid Relief) |
| Itch relief | Yes (Anusol HC with hydrocortisone) | Yes (Anti-Itch with hydrocortisone) |
| Forms | Cream, ointment, suppositories | Cream, ointment, suppositories, wipes, gel |
| Hydrocortisone option | Anusol HC (1%) | Prep H Anti-Itch (1%) |
| Price range | $7-14 | $8-15 |
| Availability (US) | Most pharmacies | All pharmacies, grocery stores |
What Is Anusol?
Anusol is a hemorrhoid treatment brand that uses zinc oxide as its primary skin protectant and pramoxine HCl as a topical anesthetic for pain relief. The combination protects irritated skin while numbing the area to reduce discomfort.
Anusol product lineup (US):
- Anusol Ointment — Zinc oxide (25%) + pramoxine HCl (1%) + mineral oil
- Anusol Suppositories — Topical starch for internal soothing
- Anusol HC — Hydrocortisone acetate (1%) for inflammation and itch (some formulations require prescription)
Key strengths: Anusol's zinc oxide provides one of the strongest physical skin barriers of any hemorrhoid product. The pramoxine provides genuine numbing for pain relief, which many users find more noticeable than Preparation H's standard ointment.
What Is Preparation H?
Preparation H is the most widely recognized hemorrhoid brand in America. Its flagship product uses phenylephrine HCl, a vasoconstrictor that narrows blood vessels to reduce swelling[1].
Preparation H product lineup:
- Prep H Ointment — Phenylephrine HCl (0.25%) + petrolatum + mineral oil + shark liver oil
- Prep H Rapid Relief — Phenylephrine + pramoxine HCl (1%) for pain
- Prep H Anti-Itch Cream — Hydrocortisone (1%)
- Prep H Suppositories — Cocoa butter + phenylephrine for internal relief
- Prep H Totables Wipes — Witch hazel (50%) for gentle cleansing
- Prep H Soothing Relief Cooling Spray — Witch hazel + aloe
Key strengths: Preparation H's phenylephrine actively shrinks swollen hemorrhoid tissue — something Anusol's standard formula doesn't do. The wider product range also gives users more options. Learn more in our Preparation H deep-dive.
Which Should You Choose?
Choose Anusol if:
- Your primary symptom is pain (pramoxine provides strong numbing)
- You have raw, irritated skin around hemorrhoids (zinc oxide provides excellent barrier)
- You want a slightly cheaper option
- You need skin protection throughout the day
Choose Preparation H if:
- Your primary symptom is swelling (phenylephrine shrinks tissue)
- You want more product options (wipes, sprays, multiple cream types)
- You need internal treatment (suppositories with active ingredients)
- You prefer widely available products (found everywhere)
The Limitation Both Products Share
Neither Anusol nor Preparation H addresses the root cause of hemorrhoids. Both are symptom-management products. Hemorrhoids form because of weakened vein walls, poor venous circulation, and increased pressure on rectal blood vessels[2].
For lasting relief, you need to address the underlying vascular issue — not just the surface symptoms.
Go beyond symptom relief. HemRid Max works from the inside out with diosmin and horse chestnut — clinically-tested ingredients that strengthen vein walls and improve venous tone. Pair it with your preferred topical treatment for the most comprehensive approach. Try HemRid Max →
The Best Approach: Combine Treatments
- Topical relief: Use Anusol or Preparation H (or alternate between them) for immediate symptom management
- Root cause: Take HemRid Max daily to support vein health from the inside
- Lifestyle: Increase fiber and water intake, take regular sitz baths, avoid straining and prolonged sitting
This three-pronged approach addresses immediate symptoms and the underlying cause — the only way to achieve lasting relief. See our complete evidence-based treatment guide for more.
When to See a Doctor
If OTC treatments don't provide relief within 1-2 weeks, consult a healthcare provider. Also see a doctor if you experience heavy bleeding, severe pain, or suspected thrombosed hemorrhoids.
Frequently Asked Questions
Is Anusol or Preparation H better for hemorrhoids?
It depends on your primary symptom. Preparation H is better for swelling (contains phenylephrine). Anusol is better for pain and skin protection (contains pramoxine and zinc oxide). Both have hydrocortisone options for itching.
Can you use Anusol and Preparation H together?
You can alternate between them, but layering both simultaneously isn't recommended. Use one at a time and switch if needed.
What are the active ingredients in Anusol?
Anusol Ointment (US): zinc oxide (25%) and pramoxine HCl (1%). Anusol HC adds hydrocortisone (1%). UK formulations differ — containing bismuth and balsam peru.
Which is cheaper, Anusol or Preparation H?
Anusol tends to be slightly cheaper ($7-14 vs $8-15), but prices vary by retailer and formulation.
Do Anusol or Preparation H cure hemorrhoids?
Neither cures hemorrhoids. Both provide temporary symptom relief. For root-cause treatment, consider oral supplements with diosmin (like HemRid Max) combined with lifestyle changes.
