Thrombosed external hemorrhoids usually do not require anti-inflammatory medication, if it is not very serious you can take hemorrhoid decongestants or apply hemorrhoid cream topically for treatment. If it is more serious, it can be removed surgically, or you can take a sitz bath with warm salt water, both of which can have a good effect and can reduce a lot of pain. For thrombosed external hemorrhoids if they are in an acute flare-up, they can be treated conservatively with hot water sitz baths or by applying hemorrhoid cream, or with hot compresses. It can also be treated by taking Diyu Sophora Pills orally. This non-surgical treatment, however, may not be particularly effective for severe thrombosed external hemorrhoids. So if the more severe pain symptoms are more pronounced, you should still go to the hospital for surgery to strip the thrombus.