###Human: How can external pile be treated? ###Assistant: Hi. If you are using Sheriproct (Prednisolone), there should be at least some improvement because it contains a steroid and it helps clear up the piles within seven days. I hope you are using it correctly. I hate to tell you this but if there is no improvement with topical treatment, you may need to go to the doctor for sclerotherapy. They will use a sclerosing agent as an injection which can effectively cause shrinkage of the hemorrhoids. My advice would be to not delay in seeking proper treatment, which in your case would be sclerotherapy. If the topical is not working at all, delaying it further might make it worse and then you might require surgery. I do not mean to scare you, I hope you understand. If there has been at least slight improvement with Sheriproct, then continue it for three more days and see what happens. If no significant improvement, go for sclerotherapy. Eat plenty of fiber rich food like fruits and green leafy vegetables, drink plenty of water, avoid carbonated drinks, avoid constipation and straining.