** Thanks for contacting HCM with your health concern 1. Hemorrhoids are usually caused by straining during bowel movements and are inflamed veins which can form internally or externally in and around the anus and silvadene cream is an antimicrobial agent containing silver sulfadiazine which is bactericidal for gram positive and gram negative bacteria but since it acts only on the cell membrane and cell wall and does not penetrate [unlike silver nitrate] thus explain the relief initially and not after continue application. 2. As coconut oil has both anti inflammatory and anti bacterial properties thus is a perfect topical application for soothing pain and reduce the swelling. 3. Apart from the medicine one should include a fibre rich diet and drink plenty of water [to avoid constipation], which is the main cause of hemorrhoids.