If you're dealing with hemorrhoids, you know how uncomfortable they can be. Burning, itching, swelling - it’s not just annoying, it can make sitting, walking, or even going to the bathroom a chore. Pilex is one of the most talked-about herbal treatments for this issue, especially in the UK and parts of Asia. But is it the best option? And what else is out there that actually works?
Pilex is a herbal formulation made by Himalaya Wellness, originally developed in India. It comes in two forms: tablets and topical cream. The tablets contain ingredients like Pilex, Neem, and Triphala, which are believed to reduce inflammation and strengthen blood vessels. The cream includes ingredients like Witch Hazel, Myrrh, and Hemlock, meant to soothe external hemorrhoids directly.
Many users report relief from itching and swelling within a few days. But here’s the catch: there’s no large-scale clinical trial proving Pilex works better than a placebo. Most of the evidence comes from small studies funded by the manufacturer or anecdotal reports. That doesn’t mean it doesn’t help - it just means you can’t be sure it’s the herbs doing all the work.
You don’t have to stick with Pilex if it’s not working. Several other options exist, each with different strengths. Here are the most commonly used alternatives:
Speed matters when you’re in pain. Preparation H delivers relief in under an hour for many users because of its vasoconstrictor (phenylephrine) and local anesthetic (lidocaine). Pilex cream takes longer - usually 2-3 days - because it relies on herbal anti-inflammatories that build up slowly.
But here’s what most people don’t tell you: Preparation H can cause rebound swelling if used for more than a week. Pilex doesn’t have that risk. So if your symptoms are mild to moderate and you’re looking for something you can use daily, Pilex might be the safer long-term pick.
If you want proof, Daflon wins. A 2019 meta-analysis in the European Journal of Gastroenterology reviewed 12 randomized trials and found Daflon reduced bleeding, pain, and prolapse by over 60% compared to placebo. Pilex had no comparable studies.
Daflon is a prescription drug in the UK, so you’ll need to see your GP. But it’s covered by the NHS if you have recurring hemorrhoids. Pilex? You can buy it over the counter - no prescription, no questions asked. So if you’re okay with less evidence but more convenience, Pilex still has its place.
Pilex isn’t for everyone. Avoid it if:
Same goes for most herbal remedies. They’re not risk-free just because they’re “natural.” Always check with your pharmacist if you’re on other meds.
Here’s the truth: no cream, tablet, or oil cures hemorrhoids. They manage symptoms. The real fix? Lifestyle changes.
Studies from the NHS and the American College of Gastroenterology agree: 80% of hemorrhoid cases improve with:
These habits reduce pressure on the veins in your rectum. That’s where hemorrhoids come from - not bad herbs or weak creams.
I talked to three people in Birmingham who’ve tried multiple treatments:
The pattern? People who combine treatment with lifestyle changes see the best results. Those who rely only on creams? Symptoms come back.
Yes - if you want a gentle, herbal option for mild symptoms and you’re okay with slower results. It’s safe for daily use, doesn’t cause rebound effects, and won’t interfere with most medications (unless you’re on blood thinners).
No - if you need fast relief, have severe symptoms, or want something backed by strong clinical data. In those cases, Preparation H for quick relief or Daflon for long-term control are better choices.
But here’s the real takeaway: none of these products fix the root cause. The only thing that does is changing how you eat, drink, and sit. No cream, no tablet, no miracle herb can replace that.
If you’re unsure where to start:
Hemorrhoids are common. They’re embarrassing, but they’re not dangerous. With the right mix of smart treatment and daily habits, you can get back to normal - without relying on a single product to fix everything.
Yes, Pilex is generally safe for daily use, especially the topical cream. Unlike steroid creams or vasoconstrictors (like in Preparation H), it doesn’t cause skin thinning or rebound swelling. But if you’re using the tablets long-term, check with your doctor - some herbal ingredients may affect liver enzymes or interact with blood thinners.
No. Pilex helps reduce symptoms like itching, swelling, and discomfort, but it doesn’t cure hemorrhoids. The only way to prevent them from coming back is through long-term lifestyle changes - eating more fiber, drinking enough water, avoiding straining, and staying active. Treatments like Pilex are symptom managers, not cures.
Witch hazel wipes are simpler and more targeted. They cool and soothe the area immediately after bowel movements. Pilex cream has more ingredients and may offer longer-lasting anti-inflammatory effects, but it’s thicker and takes longer to absorb. Many people use both: witch hazel for quick relief after going to the toilet, and Pilex cream for overnight healing.
Yes, if you’re looking for proven, long-term results. Daflon is backed by multiple clinical trials showing it improves vein tone and reduces bleeding and prolapse. Pilex has no such evidence. Daflon requires a prescription and costs more, but it’s covered by the NHS for chronic cases. Pilex is cheaper and easier to get, but it’s not a substitute for medical treatment if symptoms are severe.
There’s no safety data for Pilex during pregnancy or breastfeeding. While some herbal ingredients like witch hazel are considered low-risk, others like Neem and Triphala have unknown effects on fetal development. Most doctors recommend avoiding herbal treatments during pregnancy and sticking to witch hazel, sitz baths, and dietary changes instead.
Buy Pilex from UK-based pharmacies like Boots, Superdrug, or registered online pharmacies like Pharmacy2U or LloydsPharmacy. Avoid third-party sellers on Amazon or eBay - counterfeit versions with unknown ingredients are common. Look for the Himalaya logo, batch number, and expiry date on the packaging.
They work - but only for symptoms. Creams with lidocaine numb pain. Vasoconstrictors like phenylephrine shrink swollen tissue. Herbal creams like Pilex reduce inflammation over time. None of them fix the underlying cause - increased pressure in the rectal veins. That’s why lifestyle changes are the only real solution. Creams are like a bandage on a broken bone: they help you feel better while you heal.
If you’ve tried everything and your hemorrhoids still won’t go away, don’t wait. See your GP. There are simple procedures - like rubber band ligation - that can resolve chronic cases in minutes. You don’t have to live with discomfort.
Let’s cut through the noise here. Pilex is a placebo with herbs. Daflon is the only thing with real RCT data behind it. The NHS prescribes it for a reason. Witch hazel wipes? Great for symptomatic relief. But if you’ve got grade 3 or 4 hemorrhoids, you’re not curing anything with coconut oil. You need venotonic pharmacology. Stop romanticizing herbalism. Science isn’t optional.
I tried Pilex for two weeks after my second kid. It did nothing. Witch hazel wipes and a footstool changed everything. I don’t care how ‘natural’ it is - if it doesn’t shrink the lump, it’s just expensive bathwater. And no, I won’t take Daflon. I don’t trust prescriptions. I trust my bowels.
Of course Pilex doesn’t work. It’s Indian herbal nonsense. Preparation H has real pharmaceuticals. Daflon’s got clinical trials. But you people? You’d rather believe in witch hazel because it’s ‘natural.’ That’s why America’s healthcare is a mess. You’re all just one bad bowel movement away from a colonoscopy.
As someone who grew up in the Philippines where Pilex is everywhere - yes it works for mild cases. But you’re right. Lifestyle is everything. My mom had hemorrhoids for 20 years. She stopped eating white rice, started drinking coconut water, and used a squat toilet. No cream. No pills. Just discipline. You can’t out-herb bad habits.
OMG I used Pilex and it felt like a warm hug for my butt?? Like literally I cried?? I mean I still poop like a raccoon but now it doesn’t burn?? Also I started eating chia seeds and now I’m basically a human toilet?? Like I’m not joking I’ve never been this regular??
Of course Himalaya makes a product that ‘works.’ They’ve been selling ‘ancient wisdom’ to gullible Westerners since the 90s. Daflon? Prescription. Regulated. Tested. Pilex? A jar of crushed leaves and hope. But hey - if you want to pay $40 for a placebo wrapped in Sanskrit branding, be my guest.
My abuela in Mexico used aloe vera, cold compresses, and sitting in a tub of chamomile tea. No pills. No creams. Just patience and warmth. I tried Pilex. Felt like a greasy mess. Witch hazel wipes? Clean. Simple. Effective. Sometimes the oldest remedies are the ones we forget because they don’t come in fancy bottles with logos.
Let’s be honest - Pilex is for people who don’t read the label. The ‘Triphala’ in it? A laxative. The ‘Neem’? Hepatotoxic in high doses. And you’re slathering it on your hemorrhoids like it’s hand cream? The fact that this even exists as a mainstream product in the UK is a testament to how little regulatory oversight there is. You’re not healing. You’re just delaying the inevitable.
Daflon? That’s a French drug. Why are we letting Europeans dictate our hemorrhoid treatment? Preparation H is American-made. Pilex? Made in India. Who cares if it has ‘clinical trials’? The real cure is squatting like a caveman. No machines. No meds. Just gravity and discipline. America’s problem isn’t hemorrhoids - it’s weak knees and too much sitting.
Hey - if you’re reading this and you’re struggling, you’re not alone. I had this for 5 years. Tried everything. Then I started walking 20 minutes after dinner. Used a squatty potty. Ate 3 cups of beans a week. Within a month? No more burning. No more panic before pooping. You don’t need a miracle cream. You need consistency. Small changes. Every day. You got this.
