The invention herein describes an improved approach to managing hemorrhoids by combining current approaches of topical anesthetics, vasoconstrictors, ant-inflammatories, protectants, anti-pruretics, astringents, keratolytics, anticholinergics, cicatrizants, and antimicrobials with Croton species material. The botanical extracts are concentrated biologically active materials and thus provide enhanced therapeutic benefit. The Croton species components add a breadth and immediacy to the termination of neurogenic responses that mediate, sustain, and prolong the symptoms and underlying pathology.