What Is RectiCare And How Does It Treat Hemorrhoids?

Anyone standing in the hemorrhoid aisle comparing options eventually runs into RectiCare, usually after a friend, a pharmacist, or a search for the strongest hemorrhoid cream pointed them toward it. It stands out from a shelf full of witch hazel wipes and mild soothing creams because of what is actually in it, a numbing medication rather than just a comfort ingredient. Understanding exactly what that means, and what it does not mean, makes it easier to decide if it is the right product for a specific flare.

What Is RectiCare

RectiCare is an over-the-counter anorectal cream made by Ferndale Healthcare, sold specifically for the pain, itching, and burning associated with hemorrhoids and other anorectal irritation. It comes in two versions worth telling apart before buying. Plain RectiCare Anorectal Cream contains a single active ingredient, 5% lidocaine, and is marketed, by the manufacturer’s own claim, as having the highest percentage of lidocaine available without a prescription. RectiCare Advanced Hemorrhoidal Cream keeps that same 5% lidocaine but adds phenylephrine HCl, a vasoconstrictor, along with mineral oil and white petrolatum as protectants, aimed at swelling as well as pain.

Where it fits among hemorrhoid products is fairly straightforward. It is a numbing cream, and in the Advanced formula a mildly decongesting one too, not a healing treatment and not a substitute for a suppository aimed at internal tissue. People typically reach for it when pain or burning is the main complaint rather than mild itching alone, which a gentler witch hazel-based product can usually handle without a stronger active ingredient involved.

Lidocaine is not the only numbing ingredient used in OTC anorectal products, and it is worth knowing the realistic alternatives on the same shelf. Benzocaine, found in some competing hemorrhoidal creams, works through a similar nerve-blocking mechanism but has a somewhat higher rate of reported skin sensitization in some people. Pramoxine, another common anorectal anesthetic, is generally considered gentler on sensitive or broken skin but tends to produce a milder numbing effect than lidocaine at the concentrations typically used. RectiCare’s 5% lidocaine sits at what the manufacturer describes as the top end of what is available without a prescription, which is a reasonable claim for the ingredient’s concentration specifically, not a claim that it outperforms every other anesthetic ingredient for every person.

How RectiCare Works

Lidocaine works by temporarily blocking pain signals in the nerve endings of the skin it touches, the same basic mechanism used in numbing gels for minor cuts or dental procedures, just formulated and labeled specifically for anorectal use here. At 5%, it is a meaningful concentration, enough to produce a genuine numbing effect within a few minutes for most people, which is the main reason it feels different from a plain moisturizing or witch hazel product. In RectiCare Advanced, phenylephrine adds a vasoconstrictor effect, meaning it temporarily narrows blood vessels in the area, which is the ingredient responsible for that version’s swelling-relief claim.

What it does not do is treat the hemorrhoid itself. Numbing the area and temporarily reducing swelling make the experience more tolerable, they do not shrink the underlying swollen tissue, resolve straining-related causes, or speed up healing beyond what the body does on its own. Many people find real relief from burning and itching within minutes of application, but that relief is symptomatic and temporary, wearing off as the medication clears, which is exactly what the label promises and no more.

There is also a meaningful difference between how RectiCare works and how a hydrocortisone-based hemorrhoid cream works, even though both end up on the same store shelf. A steroid like hydrocortisone reduces inflammation gradually over repeated applications, which can shrink some of the swelling contributing to discomfort over several days. Lidocaine does not touch inflammation at all, it simply interrupts the pain signal on contact, which is why the two ingredients are often described as complementary rather than competing approaches, one calming the tissue over time, the other making the moment-to-moment discomfort more bearable while that happens.

How To Use RectiCare

Directions differ slightly between the two versions because of what is in them. Plain RectiCare, with lidocaine as its only active ingredient, is labeled for adults and children 12 and older to apply externally up to 6 times a day. RectiCare Advanced, with the added vasoconstrictor and protectants, is labeled for up to 4 times daily instead, a distinction worth checking on the box rather than assuming both products share the same frequency limit.

Both versions are for external use only. The label is explicit that the cream should not be inserted into the rectum with a finger or any applicator, a detail that surprises some people who assume any hemorrhoid product doubles as an internal treatment the way a suppository does. For hygienic application, both include a finger cot, a small disposable sleeve that rolls over a finger before the cream is squeezed onto it and smoothed over the affected area, keeping the applying finger, not just the tube opening, clean between uses. When practical, the label recommends gently cleaning the area with mild soap and water and patting it dry before applying.

RectiCare typically comes in a small travel-friendly tube, usually well under two ounces, which is convenient for keeping in a bathroom cabinet or a bag for work or travel days. It should be stored at normal room temperature and kept away from direct heat, and like most topical medications it is worth checking the expiration date printed on the tube if it has been sitting unused for a while, since lidocaine potency can decline over time. Anyone applying it without a finger cot, in a pinch, should wash hands thoroughly afterward, since numbing the fingertips accidentally can lead to an unpleasant, temporary loss of sensation wherever they touch next.

Can You Use RectiCare With A Hydrocortisone Cream?

This is a common question that is surprisingly hard to find a straight answer to, including on the manufacturer’s own site. Lidocaine and hydrocortisone work through different mechanisms, lidocaine numbs nerve signals almost immediately, while hydrocortisone is a low-dose steroid that reduces inflammation gradually with repeated use, so there is no direct chemical conflict between the two ingredients. In South Fork Pharmacy’s experience, many people use a hydrocortisone product and a lidocaine product like RectiCare at different times of day, for example a steroid cream in the morning and evening and RectiCare as needed for breakthrough pain.

That said, layering two topical products on already-irritated skin increases the total amount of ingredients the area is exposed to, and using more of either than the label allows to compensate for the other is not a safe workaround. Anyone considering combining the two, especially for more than a few days, should run it by a pharmacist first rather than guessing, since the right combination and timing depends on which product is treating which symptom and how irritated the skin already is.

The same general logic applies to combining RectiCare with an oral pain reliever like acetaminophen or ibuprofen, which many people also reach for during a bad flare. There is no known direct interaction between topical lidocaine and either oral medication at typical OTC doses, since one acts locally on the skin and the other works throughout the body, but anyone with kidney issues, stomach ulcers, or another reason to be careful with NSAIDs should already be following their doctor’s guidance on that separately from anything related to RectiCare.

Warnings And Who Should Be Cautious

RectiCare Advanced’s added phenylephrine is the reason its warning list is longer than plain RectiCare’s. Anyone with heart disease, high blood pressure, thyroid disease, or diabetes should check with a doctor before using the Advanced formula, since a vasoconstrictor absorbed even in small amounts can theoretically affect these conditions. The same caution applies to anyone with difficulty urinating due to an enlarged prostate, a specific warning listed on the label. Plain RectiCare, without the vasoconstrictor, does not carry these same specific warnings, though anyone pregnant or breastfeeding should ask a health professional before using either version.

Stop using either product and call a doctor if rectal bleeding occurs, if the condition does not improve within 7 days, if symptoms clear up and then return within a few days, or if signs of an allergic reaction like rash, swelling, or worsening irritation show up. These are the same stop-use signs the FDA requires on the label, not an extra layer of caution added here, and they are worth taking at face value rather than pushing through with more product.

A skin reaction to RectiCare itself, rather than to the hemorrhoid symptoms it is treating, is uncommon but not impossible. Signs to watch for include new or worsening redness, a rash that spreads beyond where the cream was applied, unusual swelling, or a burning sensation that is sharper or longer-lasting than the mild tingling some people notice right after application. Discontinuing use and switching to a plain, fragrance-free product while the skin settles is a reasonable first step, and persistent reactions are worth mentioning to a pharmacist so the ingredient causing it can be identified before trying something else.

When To See A Doctor Or Pharmacist

A hemorrhoid that responds to a week of consistent home care, cleaning gently, using a numbing or protectant cream as directed, and adjusting diet and bathroom habits, is the expected pattern for most mild to moderate flares. RectiCare fits into that routine as the pain-and-itch-management piece, not the whole plan.

See a doctor sooner rather than later for rectal bleeding that does not stop, pain that is severe or getting worse instead of better, a hard lump that appears suddenly, or any hemorrhoid symptom that has not improved after a full week of appropriate home treatment. These are the same red flags that apply to any OTC hemorrhoid product, not something specific to RectiCare, but they are worth repeating, since a numbing cream can make pain more tolerable without addressing whatever is actually causing it.

South Fork Pharmacy keeps both plain RectiCare and RectiCare Advanced on the shelf, along with the full range of other OTC hemorrhoid options, and the pharmacist on duty can help sort out which one, or which combination, actually matches your symptoms. Stop by 732 N Main St in Moorefield, or ask next time you are in for a Tuesday or Thursday delivery pickup.

Frequently Asked Questions

Is RectiCare the same as Preparation H?

No. Preparation H’s classic formulas generally rely on ingredients like phenylephrine or mineral oil and petrolatum rather than a numbing anesthetic, while RectiCare’s defining ingredient is 5% lidocaine. Both are OTC hemorrhoid products, but they relieve symptoms through different mechanisms, numbing versus protecting and mildly decongesting, so one is not simply a substitute for the other.

Can I put RectiCare inside my rectum for internal hemorrhoids?

No, the label is specific that RectiCare is for external use only and should not be inserted into the rectum with a finger or applicator. If internal hemorrhoid symptoms need direct treatment, that is a question for a doctor or pharmacist about whether a suppository or a different approach makes more sense.

How fast does RectiCare start working?

Many people notice numbing within a few minutes of applying it, since that is how topical lidocaine typically behaves on skin and mucous membranes. How long the relief lasts varies by person, and it is temporary rather than a lasting fix, wearing off as the medication clears the area.

Is RectiCare Advanced safe if I have high blood pressure?

The label specifically lists high blood pressure as a condition to check with a doctor about before using RectiCare Advanced, because of the added phenylephrine, a vasoconstrictor. Plain RectiCare, without that ingredient, does not carry the same specific warning, so ask a pharmacist at South Fork Pharmacy which version makes more sense if you have high blood pressure or another condition on that warning list.

Can I use RectiCare every day?

It is labeled for use up to 6 times a day for the plain formula or 4 times a day for Advanced, which allows for daily use during an active flare. If symptoms are persistent enough that near-daily use over more than a week feels necessary, that is the point to talk to a doctor rather than continuing to manage it with cream alone.

Why does RectiCare come with a little plastic sleeve for my finger?

That is the finger cot, included specifically so the cream can be applied hygienically without the applying finger touching the tube opening directly. It is a small detail, but it matters for keeping the rest of the tube clean between uses, especially since the area being treated is already irritated.