Discovering a lump or bump around the anal area is understandably concerning, often leading people to search for answers about what remains after a hemorrhoid episode resolves. It is common for people who have experienced swelling in the anal region to notice a flap of skin that does not disappear entirely. This residual tissue is frequently not an ongoing hemorrhoid but rather an anal skin tag. This condition is distinct from the swollen veins that initially caused the discomfort.
What Exactly Are Anal Skin Tags?
Anal skin tags are small, benign growths composed of excess skin and connective tissue that form around the anus. These growths typically appear as soft, flesh-colored, or slightly darker flaps of skin, ranging in size from a few millimeters up to a centimeter. Unlike active hemorrhoids, skin tags do not contain swollen blood vessels and are not generally painful. Once formed, they are essentially permanent structures that maintain a consistent size and texture, feeling pliable and soft to the touch.
While they are non-cancerous and medically harmless, they can sometimes cause minor symptoms like itching or irritation. This occurs particularly if they interfere with routine hygiene, but they do not resolve on their own.
The Mechanism: How Hemorrhoids Lead to Skin Tags
The formation of an anal skin tag is a direct physical consequence of the skin stretching due to underlying swelling, most often from an external hemorrhoid. When these swollen vessels become engorged, the overlying skin is forced to stretch significantly to accommodate the increased volume. This stretching is especially pronounced with a thrombosed external hemorrhoid, where a blood clot forms within the swollen vein.
The thrombosis causes rapid and intense swelling, stretching the perianal skin to its limit. As the body reabsorbs the blood clot and the swelling subsides, the stretched skin often fails to retract fully back to its original size. The result is a permanent flap of redundant tissue—the anal skin tag—left behind following the acute inflammation.
Other conditions that cause chronic anal inflammation or trauma, such as anal fissures or persistent diarrhea, can also lead to the formation of these tags. They do this by repeatedly irritating and stretching the tissue.
Distinguishing Skin Tags from Active or Severe Conditions
Differentiating an anal skin tag from an active hemorrhoid or a more serious anal condition is important for determining the correct course of action. The most telling difference lies in the presence of symptoms, particularly pain and bleeding. Anal skin tags are generally painless and do not bleed unless they are accidentally torn or excessively irritated. Their size is constant once fully formed, feeling soft and pliable to the touch.
In contrast, an active external hemorrhoid, especially a thrombosed one, is typically firm, tense, and causes significant, acute pain from the trapped blood clot. Active hemorrhoids often fluctuate in size, may appear purple or blue, and commonly cause bright red bleeding during or after a bowel movement. Unlike a skin tag, an active hemorrhoid may shrink with treatment or time.
“Red flag” symptoms suggest an issue beyond a simple skin tag and require prompt medical consultation. These symptoms could indicate other conditions like an anal fissure, an abscess, or other serious pathology that requires accurate diagnosis.
Symptoms Requiring Medical Evaluation
If you experience any of the following, seek professional evaluation:
- Severe, persistent pain
- Significant or continuous rectal bleeding
- Fever
- Drainage of pus
- An associated change in bowel habits
Treatment and Removal Options for Anal Skin Tags
Since anal skin tags are benign and typically asymptomatic, treatment is often unnecessary. Management usually involves focusing on good anal hygiene and preventing irritation. Maintaining cleanliness can be challenging due to the extra folds of skin, so using gentle cleaning methods and ensuring the area is kept dry helps prevent secondary irritation and itching.
If the skin tags interfere with hygiene, cause persistent irritation, or lead to cosmetic distress, professional removal is an option. Removal is considered an elective procedure performed by specialists like proctologists or dermatologists. Techniques typically involve a minor office procedure using local anesthesia to numb the area.
Common removal methods include surgical excision, where the excess skin is cut away with a scalpel or scissors. Other techniques are electrocautery, which uses heat, or cryosurgery, which involves freezing the tissue. Treating any underlying conditions, such as chronic constipation or anal fissures, is often recommended alongside removal to prevent the recurrence of future tags.