QUESTION: Can I use an over the counter hemorrhoids cream or solution on my internal or prolapsed hemorrhoid?
ANSWER: Nope, sorry, over the counter creams are meant to be applied to external hemorrhoids, not internal hemorrhoids. Even a prolapsed hemorrhoid still counts as an internal hemorrhoid for this purpose.
If you want to see the difference between external and prolapsed hemorrhoids, check out the photos and pictures of hemorrhoids.
To clarify the answer, you can't use an external hemorrhoids cream on an internal hemorrhoid because there is a huge difference in how much medication each will absorb. Skin absorbs a tiny fraction of medication compared to internal mucus membrane.
When a cream is formulated for external hemorrhoids, as all of the over the counter creams are, the cream may carry 500 mg of medication in any dose. However, because skin absorbs so little, only 5 mg will make it to the bloodstream. The company that made the cream created the formula with this in mind.
However, if that cream is applied to mucus membrane, which is what internal and prolapsed hemorrhoids are covered by, instead of getting only 5 mg dumped into the bloodstream, 450 mg is absorbed instead. This would constitute a huge overdose, as 5 mg was the intended dose.
The field that deals with how medications are delivered to and move within the bloodstream is called pharmacokinetics, and it's quite complicated to say the least.
Since a prolapsed hemorrhoid is just an internal hemorrhoid that protrudes outside the body, it's still covered by mucus membrane. Therefore, if you use an over-the-counter hemorrhoids cream on it, you're still getting a massive overdose.
After significant time spent in research, I could not find a single hemorrhoids cream offered without a prescription that is suitable for internal use.
Internal hemorrhoids creams are only available by prescription, and frequently have to be hand-mixed by a licensed pharmacist.
On the rare occasions when an external cream is prescribed for an internal hemorrhoid, the medication dosage must be recalculated to account for the higher rate of absorption. Calculating that new dosage takes an education including both calculus and pharmacokinetics.
Does this make a bit more sense now?
Never apply an external hemorrhoids cream to an internal hemorrhoid, even if it's prolapsed, as no over the counter hemorrhoids cream is approved for internal usage by the medication oversight committees in either the United States or Australia. The same probably holds true in other developed countries.
Research and main write by Loni L. Ice, editing and quality control by D. S. Urquhart.
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All the best to you in your search for hemorrhoid relief and prevention
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