This extra strength formula is designed to treat chronic or acute hemorrhoid conditions. It activates the system to unravel twisted veins, shrink swollen blood vessels, and strengthen the circulatory tract. For additional pain relief, this treatment can also be used with Fissure Control. Horse chestnut and witch hazel medicinal plant extracts work fast to heal, shrink, and help prevent recurrence of hemorrhoids. Results are often experienced within days or less when applied 2-3 times per day.