Anal skin tags are common, benign growths of excess skin tissue located around the anus. They represent a residual effect of previous trauma or inflammation in the area. This article explores how these growths form and the options available for management.
What Anal Skin Tags Are
Anal skin tags are small, soft, flesh-colored flaps of skin that protrude from the perianal area. They are composed of fibrous connective tissue and vary in size from a few millimeters up to a centimeter or more.
They are typically asymptomatic, meaning they do not cause pain or bleeding. Larger tags can sometimes interfere with hygiene, potentially leading to irritation, itching, or discomfort from trapped moisture and fecal matter. Doctors may refer to them as perianal skin tags or fibroepithelial polyps.
Primary Causes of Their Development
The formation of an anal skin tag is primarily a result of the body’s healing process following swelling or trauma to the anal tissues. The skin around the anus is naturally loose to allow for expansion during bowel movements. When the underlying tissue swells, this loose skin stretches significantly.
The most frequent cause is the resolution of a thrombosed external hemorrhoid. When the swelling recedes, the overlying stretched skin often fails to fully retract. This residual, deflated flap of skin remains as the skin tag.
Chronic anal fissures, which are small tears in the anal lining, are another common mechanism. When a fissure becomes chronic, the repeated inflammation and healing process can lead to the formation of a firm, distinct skin tag at the outer edge of the tear, sometimes called a “sentinel pile.” Conditions that cause chronic irritation, such as persistent diarrhea, constipation, or aggressive wiping, also contribute to their development. These factors cause repeated pressure and friction, leading to tissue damage and scarring that the body attempts to repair by forming excess skin.
Systemic inflammatory conditions, like Crohn’s disease, can also be associated with the development of anal skin tags. The chronic inflammation present in the digestive tract can encourage excess skin growth and impair normal tissue healing in the perianal region. This can result in the formation of multiple or larger skin tags.
Differentiating Them from Other Conditions
Anal skin tags must be distinguished from other growths that may appear in the same area. Anal skin tags are generally soft, the same color as the surrounding skin, and lack pain. They typically do not bleed unless they are severely irritated or torn.
Active external hemorrhoids, in contrast, are usually comprised of swollen blood vessels, giving them a red or purple color. Hemorrhoids often cause pain and can bleed easily. Unlike some hemorrhoids, anal skin tags do not move back inside the anal canal.
Anal warts, caused by the Human Papillomavirus (HPV), are another distinct condition. Warts often have a rough, cauliflower-like texture and may appear in clusters. They can cause a burning itch and may spread across the perianal and genital regions. A medical professional is necessary to definitively diagnose any unusual anal growth.
Options for Removal and Care
Anal skin tags are harmless and do not require removal for medical reasons. Management is typically pursued when tags cause persistent hygiene issues, chronic irritation, or cosmetic concerns. If removal is considered, it should only be performed by a qualified healthcare provider, such as a colorectal surgeon or proctologist.
Professional removal methods are simple and often performed in an office setting under local anesthesia. The most common techniques include surgical excision, where the tag is cut away, and electrocautery, which uses electrical current to burn off the tissue. Cryotherapy, which involves freezing the tag with liquid nitrogen, is another option that causes the tissue to shrivel and fall off.
It is unsafe to attempt at-home removal methods, such as cutting or tying off the tags, due to the high risk of severe pain, infection, and bleeding. To prevent irritation of existing tags, maintaining good hygiene is recommended, including gentle cleaning with mild soap and warm water. Dietary changes that promote softer stools, such as increasing fiber intake, can help reduce the strain and irritation that might lead to future tags.