As someone who has experienced several excrutiating thrombosed events, excision and removal is the best/only option. Don't mess with the rubber bands and don't bother with the creams, as they won't do anything. Just get to a colo-rectal doctor ASAP for the in-office procedure, as these things can go nuclear in well under 24 hours, at which point you'll be in the ER with what feels like a white-hot jagged piece of shrapnel trying to tear through your rectum (I've been there).
If this isn't your only one, for the love of God, get a bidet, as you do NOT want to wipe in order to clean your ass when these horrors appear.