Introduction: You are not alone
Have you ever been startled by seeing red blood every time you use the toilet? "Could it be colon cancer?" "I'm embarrassed to go to the hospital." "It will probably heal eventually." Many people think this way and keep postponing treatment.
In Japan, about one in three adults is said to experience hemorrhoids. It is not a rare condition. And in most cases, early-stage hemorrhoids can be effectively treated with over-the-counter medicines. This article first honestly explains "what hemorrhoids are," then introduces in detail the latest product from Boraginol, Japan's proud hemorrhoid specialist brand with over 100 years of history: the Boraginol Premium Series.
What exactly are hemorrhoids? Learn the three types correctly
Hemorrhoids are broadly divided into three types. Since their causes and symptoms differ, understanding which type you have is the first step toward proper treatment.
① Hemorrhoids (piles) — The most common type of hemorrhoids
Hemorrhoids are swollen, wart-like lumps that form inside or outside the anus. They occur when blood flow around the anus is stagnant due to constipation or prolonged sitting, causing blood vessels to become congested and swollen like lumps. Those inside the anus are called "internal hemorrhoids," and those outside are called "external hemorrhoids."
The biggest feature of internal hemorrhoids is "bleeding without pain." Bright blood on toilet paper or blood dripping into the toilet are typical signs of internal hemorrhoids. Since there are almost no pain nerves inside the anus, many cases do not feel pain until the condition is quite advanced. If you have "only bleeding without pain," internal hemorrhoids should be suspected first. External hemorrhoids, on the other hand, form outside and often cause swelling and severe pain.
② Anal fissure — Severe pain and bleeding
This is a condition where the skin around the anus tears when hard stool passes through. The main symptoms are sharp pain and bleeding during bowel movements, and if pain continues for a while after defecation, anal fissure is suspected. It is common in people who tend to have hard stools due to constipation or those with ongoing diarrhea. Repeated occurrences can cause chronic wounds and ulcers.
③ Anal fistula (tunnel hemorrhoid) — Cannot be treated with over-the-counter medicines
This is a condition where bacteria inside the anus cause infection, pus accumulates, and a "tunnel-like hole" forms around the anus. It tends to occur in people with frequent diarrhea or weakened immune systems. This usually requires surgery and is not treatable with over-the-counter medicines. If you have pus discharge or a hole-like area around the anus, please see an anorectal specialist or surgeon promptly.
What you should calmly know when "there is bleeding"
The characteristic of bleeding from hemorrhoids is "bright red blood." Bleeding from colon or rectal cancer is often dark and usually mixed with stool. Of course, self-diagnosis is not recommended, but if you notice "bright blood dripping into the toilet" or "red blood on toilet paper," it is highly likely to be hemorrhoids (internal hemorrhoids).
Over-the-counter medicines are effective for bleeding hemorrhoids because they suppress inflammation and improve blood congestion in blood vessels, stopping bleeding and reducing swelling. There is no need to assume "surgery is the only option because there is bleeding." If you choose the right medicine and use it correctly, symptoms can definitely improve.
Boraginol: A synonym for hemorrhoid treatment born from 200 years of history
Now, let me tell you about the company that has continued making this medicine.
In 1813 (the 10th year of the Bunka era), a general store called "Tenshinya Tosuke" was established in Kyoto. Listening to the voices of worshippers, the store gradually began handling medicines that contributed to health—this is the origin of Tendo Pharmaceutical. About 100 years later, in 1921 (the 10th year of the Taisho era), the eighth-generation owner, Kinzo Otsuki, faced the urgent request of a doctor at Kyoto Imperial University Medical School Hospital's compounding room and completed Japan's first new domestic medicine for hemorrhoids, which became the prototype of Boraginol.
On October 11 of the same year, Boraginol suppositories and ointments were first shipped to Takeda Chobei Shoten's new drug department in Osaka (now Takeda Pharmaceutical Company). This day is still commemorated as Tendo Pharmaceutical's founding anniversary.
In 1933, amid a shortage of raw materials, the company shifted its approach and developed a cream-like liquid medicine. This became the prototype of the current "suppository ointment." In 1955, in collaboration with the current Kao Corporation, they developed a suppository base that melts at body temperature, establishing the easy-to-use modern suppository form. Then, in 1992, they carefully reselected ingredients and created the formulation that became the foundation of the current Boraginol A Series.
In 2021, celebrating its 100th anniversary, Tendo Pharmaceutical became part of the Rohto Pharmaceutical Group, continuing to evolve hemorrhoid treatments under a stronger research and manufacturing system. Then, in November 2025, the **Boraginol Premium Series**, containing the largest amount of active ingredients in the brand's history, was finally born. This is the first major new product in about 30 years.
What is the Boraginol Premium Series?
The concept of the Premium Series is clear: to "include the maximum amount of active ingredients in Boraginol history" and to achieve "pinpoint formulations tailored to internal and external hemorrhoids." While the conventional A Series contained 4 ingredients, the Premium Series contains 6 ingredients in the suppository ointment and ointment, and 5 ingredients in the suppository. The main roles of the included ingredients are as follows.
- Prednisolone acetate (steroid): A core ingredient that powerfully suppresses inflammation and calms bleeding, swelling, and itching
- Lidocaine: A local anesthetic ingredient that quickly relieves pain and itching
- Allantoin: An ingredient that helps wounds heal and repairs tissue
- Vitamin E acetate: Improves peripheral blood circulation and relieves congestion
- Glycyrrhetinic acid: Supports inflammation relief (included in Suppository and Suppository ointment)
- Isopropyl methylphenol: Disinfects the affected area and prevents bacterial growth (included in Suppository ointment and Ointment)
By working simultaneously, these products can address all painful symptoms—bleeding, pain, swelling, and itching—at a level beyond previous Boraginol products.
Complete guide to using the three products appropriately
The Premium Series has three formulations, each optimized for different locations and symptoms.
🔴Boraginol Premium Suppository ointment — Versatile type for both inside and outside use
This ointment comes in individually packaged tubes and can be used both by inserting the nozzle into the anus for injection and by applying directly to the outside. It works for both internal hemorrhoids and external hemorrhoids, making it a safe choice for those unsure which side their hemorrhoids are on. It contains the maximum amount of six active ingredients and is especially recommended for hemorrhoids with bleeding and anal fissures. For injection, use 1 to 2 times a day (after bowel movements and before bedtime); for application, 1 to 3 times a day is recommended. Note that tubes used for application should not be used for injection for hygiene reasons.
🟡 Boraginol Premium Ointment — Focused approach to external hemorrhoids
This ointment is applied directly to the outside of the anus. It delivers medicine directly to external hemorrhoids, anal fissures, and inflammation, itching, and pain of the skin around the anus. In addition to six active ingredients, it contains isopropyl methylphenol for disinfecting, helping keep the affected area clean and supporting recovery. Apply 1 to 3 times a day, ideally after morning bowel movements, at noon, and before bedtime. It can be applied with fingers or gauze, making it gentle on sensitive areas.
🟢 Boraginol Premium Suppository — The shortest route to deliver directly to internal hemorrhoids
This is a Suppository type inserted into the anus. A special base (hard fat) that melts at body temperature slowly dissolves inside the anus, delivering medicine directly to the internal hemorrhoids. It is the most direct formulation for bleeding, swelling, and itching caused by internal hemorrhoids and is especially suitable for those concerned about bleeding or with internal hemorrhoids. Since no external ointment is needed and it is simple to use, it is an easy choice for first-time hemorrhoid medicine users. Use 1 to 2 times a day after bowel movements and before bedtime.
Which one should you choose? Simple chart
Here is a guideline to help you select the product that suits your symptoms.
- "Bleeding present + unsure which side" → Suppository ointment
- "Strong swelling, pain, and itching outside" → Ointment
- "Main symptoms are bleeding and swelling inside" → Suppository
- "Both inside and outside are painful" → Suppository ointment (both insertion and application)
To those who are bleeding: please don’t give up.
Bleeding can indeed be frightening. But on the flip side, it is a sign that "your body is currently crying out for help." It means you noticed early and can respond quickly.
The steroid ingredient (prednisolone acetate) in the Boraginol Premium Series works by reducing inflammation, shrinking congested blood vessels, and stopping bleeding. Vitamin E improves blood flow, and allantoin helps repair damaged tissue. If the medicine reaches the affected area correctly, you should notice changes in bleeding within a few days in many cases.
However, if there is no improvement in symptoms after 5 to 6 days of use, or if there is heavy bleeding, dark-colored blood, or blood mixed in the stool, we strongly recommend promptly consulting a proctologist, surgeon, or gastroenterologist. Over-the-counter medicines are options only for early or mild stages and do not replace professional medical diagnosis.
Summary
Boraginol, created in 1921 by Tendo Pharmaceutical with a history of 200 years, has evolved its technology and commitment, culminating in the launch of the "Boraginol Premium Series" in 2025. This series offers three formulations—Suppository ointment, Ointment, and Suppository—that deliver the largest amount of active ingredients in the brand's history, precisely targeting the affected areas.
Hemorrhoids are not an embarrassing condition. They are a very common issue experienced by one in three Japanese people. With the right knowledge and the right medicine, you can surely feel better than now. Take the first step.
⚠️ Caution: This article is intended to provide information about pharmaceuticals. If your symptoms are severe or persist, please be sure to consult a doctor or pharmacist.