What are anal skin tags?

Anal skin tags are a common and benign skin issue. They may feel like small bumps or raised areas on the anus. It’s common to have multiple skin tags at once. Anal skin tags are growths of excess skin around the anus. They are often caused by straining or inflammation. They are not cancerous. Still, they can be itchy or sensitive to the touch.

These common skin growths can be diagnosed and removed easily. Depending on the cause, some may be prevented with simple lifestyle changes.

What are Symptoms of anal skin tags?

An anal skin tag appears as a piece of excess tissue around your anus or in the surrounding area. It shouldn’t lead to pain or bleeding, but an anal skin tag can become bothersome, itchy, and uncomfortable due to the presence of extra skin tissue. These skin tags usually start small but might grow over time. The reasons for growth include repeated trauma from cleaning or recovering from clotted haemorrhoids or anal fissures.

Anal skin tags can get caught on your underwear. They may also become itchy and inflamed when you clean or wipe the area.

Anal skin tags vs. haemorrhoids: How to tell the difference

Grade 1 and 2 haemorrhoids are internal. However, when these become enlarged (grade 3 or4), they risk prolapsing, which means that they protrude from the anus.

Due to their location, it’s easy to confuse them with anal skin tags. There are key differences between the two that help people tell them apart:

• Pain level. Anal skin tags are generally painless. On the other hand, Prolapsed haemorrhoids can be extremely painful (although they aren’t always).
• Bleeding. Haemorrhoids bleed after even light contact, but anal skin tags won’t usually bleed.
• Colour. Haemorrhoids tend to be red or purple. Skin tags tend to be the same colour as your skin.

Anal skin tags vs. warts: How to tell the difference

Warts can also occur on the anus, often due to infection by human papillomavirus (HPV). Here’s how to differentiate them from anal skin tags:

• Size. Anal skin tags reach a size of few centimeters at their largest. Warts can grow larger than this over time and cover the entire area around the anus. They can also spread to the genitals.
• Burning. Anal skin tags might cause discomfort and itching due to the extra skin tissue. But anal warts often causing a burning itch and might bleed after skin contact.
• Surface. Larger warts have a rough surface, similar to cauliflower. Skin tags have a similar surface to your skin, although they may be slightly wrinkled.

If you’re still unsure as to whether bumps on your anus are the result of skin tags or another condition, it’s best to consult with our specialists.

What causes anal skin tags?

The skin around the anus is often looser than the skin on other parts of the body. That’s because the skin in this area needs to expand during bowel movements so stool can pass. Skin tags may develop from prior external haemorrhoids. These are swollen, enlarged veins in the anal area.

When the swelling goes down, the skin around the haemorrhoid may not tighten back up. The loose skin may become a skin tag.

Common causes of external haemorrhoids include:

• Constipation: Straining to pass a bowel movement can put pressure on blood vessels in the anal area. This can cause them to swell.
• Heavy lifting: This can also put pressure on the veins in your rectum and anal area. This may lead to swelling.
• Pregnancy: Pregnant people are more prone to haemorrhoids and skin tags. This is partly because of hormonal changes. It is also due to the weight of the baby on the veins behind the uterus.

Anal skin tags are also common in people with Crohn’s disease. This is a type of inflammatory bowel disease.

In people with Crohn’s disease, anal skin tags are caused by inflammation. In some cases, they are the first sign of this condition.

Skin tags may also form as a result of wetness, irritation, and excessive wiping from diarrhoea. They could also form because of long-term friction from wearing tight underwear. Excess skin that forms after repeated scarring may also cause anal skin tags. This might happen, for example, after healing from an anal fissure. An anal fissure is a tear in the lining of the anus.

People with certain genetic disorders like Birt-Hogg-Dubé (BHD) syndrome may also be more prone to developing skin tags. In these cases, skin tags mainly form on other areas of the body.

Diagnosing anal skin tags

Although anal skin tags are benign, they can still be a cause for concern. That’s why it’s a good idea to ask your doctor to confirm that the bump or bulge you feel is the result of a skin tag and not something else, such as a tumour or blood clot. To make a diagnosis, your doctor will likely conduct a physical exam. Your doctor may perform a visual exam and look at the anus for signs of a skin tag.

They may also perform a rectal exam and insert a finger into the rectum to feel for masses or bulges. If your doctor needs additional information to make a diagnosis, they may also use one of two procedures to look inside the anal opening and the rectum. Both an anoscopy and a sigmoidoscopy can help rule out any underlying rectal conditions or concerns, such as cancer.

Your doctor may also take a tissue sample, or biopsy, and send it to a lab for testing. Once a diagnosis is made, your doctor can begin discussing your treatment options. This will depend on the form and cause of the skin tag.

Are anal skin tags cancer?

Skin tags can appear anywhere on your body. Usually, anal skin tags are generally harmless and benign (noncancerous) Although a long-standing skin tag could be part of an ulcer or a cancerous growth. Only a specialist will be able to differentiate these after a detailed examination.

Anal Skin tags during pregnancy.

This is common for pregnant women. Skin tags during pregnancy become visible towards the end of the second and beginning of the third trimester. These are often due to pressure on rectal veins due to pressure from the uterus and associated constipation. These Skin tags are harmless and don’t post any health risk. It is advisable not to have any surgical treatment and these skin tags usually decrease in size after delivery which could take up to 6 months or more.

Treatment

Medical treatment

Over-the-counter creams containing hydrocortisone may be beneficial if these skin tags are swollen and inflamed. These creams / ointments may provide temporary relief, but should not be used for more than 2 weeks. Please consult a specialist if you continue to have symptoms.

Preventing pruritus ani (anal itching) golden rules:

• Keep the area as clean as possible, carefully washing and gently drying the area at least once a day and after each bowel movement.
• Don’t use soap as it can sting. It is best to use water on your hand rather than a flannel.
• Use soft toilet paper or damp cotton wool if this is more comfortable.
• If your leakage continues after cleaning into the anus, use a small plug of cotton wool in the anus to prevent the faeces or mucus from coming out and irritating the skin.
• Dry the area by gently patting with a soft towel or tissue. Avoid rubbing.
• Do not use any creams, deodorants, talcum powder, antiseptics or anything else on your anus, apart from the treatment suggested by your specialist.
• Do not put anything in bath water – avoid all antiseptics, bath salts, bath oils and bubble bath.
• Wear loose cotton underwear and change this every day. Avoid man-made fabrics coming into contact with the skin around your bottom. Women should wear stockings or open-crotch tights rather than regular tights to reduce sweating.
• You should also avoid tight trousers or jeans and sitting on plastic chairs for long periods of time.
• Wash your underwear in non- biological washing powder and make sure that all traces of detergent are rinsed out.
• A diet that is high in fibre makes the faeces softer and more likely to cause leakage
• Avoid lagers and flat beers as these can make the problem worse.
• Avoid coffee, chocolate and fruit juices high in citric acid as these too make the pruritis worse.

Surgery

Anal Skin Tag Removal

After a skin tag is diagnosed, you and your doctor will need to decide if it should be removed or left alone. If your skin tags are small or aren’t causing symptoms or discomfort, it might not be worth removing them right away, or at all.

What to expect during removal?

Anal skin tag removal is usually a day case procedure. Skin tags are on the exterior of the anus, which means your surgeon can access and remove them easily either under local anaesthesia and sedation or a general anaesthesia.

To prevent complications, your doctor may remove only one anal skin tag at a time. This gives the area time to heal and reduces the risk of infection from stool or bacteria.

The turnaround time after anal skin tag removal is fast. After the procedure, you’ll need to stay at home and relax. You shouldn’t lift any heavy objects or do exercise. You should be able to return to normal activities within a week. Your doctor will likely prescribe a course of antibiotics to reduce your risk of infection.

In the first days after the procedure, your doctor may recommend taking a laxative or trying a liquid diet. This will make using the restroom easier and reduce your risk of constipation.

How to prevent anal skin tags?

To prevent anal skin tags, you need to find out why you are developing them in the first place. If recurrent external haemorrhoids are the problem, you may need lifestyle changes.

Tips for preventing haemorrhoids include:

• Avoid straining.
• Limit time spent sitting on the toilet.
• Stay active every day.
• Drink six to eight glasses of water throughout the day.
• Eat a high-fibre diet or take fibre supplements, as recommended by your doctor.
• Maintain a healthy weight.

Book your appointment with our specialists at Piles clinic UK.