Hemorrhoids are a common condition involving swollen veins located in the rectum or anus. While often associated with discomfort, itching, or bleeding, their appearance can sometimes vary, leading to questions about changes in color, such as turning white. This article explores why a hemorrhoid might appear white.
Understanding Hemorrhoids and Their Appearance
Hemorrhoids are swollen veins in the lower rectum and anus, developing when pressure causes them to become inflamed. They are categorized into two main types: internal hemorrhoids, which form inside the rectum, and external hemorrhoids, which develop under the skin around the anus. Their typical appearance varies; internal hemorrhoids may not be visible unless prolapsed, while external hemorrhoids usually appear as reddish, purplish, or skin-colored lumps.
The color of a hemorrhoid is generally influenced by its blood content and the overlying skin. Blood-filled hemorrhoids often present with a darker, purplish hue, especially if clotted. Those closer to the surface may take on a more reddish or skin-like tone.
Common Reasons for a White Appearance
A hemorrhoid appearing white can indicate several different underlying processes, often related to healing or changes in the tissue. One common reason is the natural healing process after the initial inflammation subsides. As a hemorrhoid shrinks and blood flow diminishes, the engorged tissue can become paler due to reduced blood volume and the remodeling of the affected area.
Another frequent cause for a white appearance is the formation of a skin tag. After a hemorrhoid resolves, particularly an external one that has swollen significantly, the stretched skin may not fully retract, leaving behind a small flap of excess tissue. These skin tags are typically skin-colored or lighter than the surrounding area, and they are not actual hemorrhoids but remnants of a past one.
Fibrin deposits can also contribute to a white or yellowish-white appearance on the surface of an irritated or ulcerated hemorrhoid. Fibrin is a protein involved in blood clotting and wound healing, and its presence can indicate an inflammatory or reparative process occurring on the tissue surface. This coating indicates active healing.
In cases where a thrombosed external hemorrhoid (one with a blood clot inside) begins to resolve, the clot may gradually reabsorb. As the clot dissipates, the overlying skin and tissue can lose their dark, purplish color and become lighter, potentially leaving behind a pale area or a skin tag.
While less common, a fungal infection in the perianal region could manifest with white patches or a white coating that might be mistaken for a white hemorrhoid. Fungal infections, such as candidiasis, can cause skin discoloration and other symptoms like itching or irritation in the moist environment around the anus. Additionally, certain dermatological conditions affecting the perianal skin can lead to localized areas of hypopigmentation or white lesions, which could also be confused with a hemorrhoid itself.
Accompanying Symptoms and When to Seek Medical Care
Common symptoms associated with hemorrhoids include itching, discomfort, pain, and occasionally bleeding, especially after bowel movements. If the white appearance is accompanied by persistent or worsening pain, significant bleeding, or any discharge such as pus, it warrants medical attention.
Signs of infection, like fever, chills, or increased redness and swelling around the area, are also concerning indicators. An inability to pass stool or severe abdominal pain alongside the white hemorrhoid also necessitate prompt medical evaluation.
Self-diagnosis can be misleading, and a doctor can differentiate between a harmless skin tag, a healing process, an infection, or another dermatological condition. Consulting a medical provider ensures appropriate assessment and guidance.
Management and Treatment Approaches
Managing hemorrhoid symptoms, including those with a white appearance, often begins with self-care measures aimed at promoting softer stools and reducing strain during bowel movements. Increasing dietary fiber intake through fruits, vegetables, and whole grains, along with adequate fluid consumption, can help achieve this. Regular exercise also supports healthy bowel function.
Sitz baths, which involve soaking the anal area in warm water for 10-15 minutes several times a day, can help soothe discomfort and promote healing. Over-the-counter creams, ointments, or medicated wipes containing ingredients like witch hazel or hydrocortisone can also provide temporary relief from itching and inflammation. Maintaining good perianal hygiene by gently cleaning the area after bowel movements is also important.
For cases where self-care is insufficient or if symptoms are severe, medical interventions may be necessary. Procedures such as rubber band ligation involve placing a small elastic band around the base of an internal hemorrhoid to cut off its blood supply, causing it to wither and fall off. Sclerotherapy involves injecting a solution into the hemorrhoid to shrink it. In more severe or persistent cases, surgical options like hemorrhoidectomy may be considered to remove the hemorrhoid tissue. Specific treatment depends on the underlying cause of the white appearance and the overall severity of symptoms, as determined by a healthcare provider.