Understanding Anal Skin Tags

What is an Anal Skin Tag?

Skin tags are benign extra-folds of anal tissue. Anal skin tags can be caused by injuries near the anus, like hemorrhoids or fissures. They are also commonly referred to in the medical community as sentinel, rectal, and perianal skin tags. They may develop from the stretched overlying skin of a thrombosed external hemorrhoid or the way in which the tissue in an anal fissure fails to heal properly.

Artistic image depicting the skin tags caused by an anal fissure.Artistic image depicting the skin tags caused by hemorrhoids.

Causes of Anal Skin Tags

Anal skin tags stem from many different sources:

• Anal tears (fissures)
• Dilated veins (hemorrhoids)
• Anal abscesses/infections
• Anal gland tunnels (fistulas)
• Anal intercourse
• Irritation and friction near the anus
• Intense exercise, like weightlifting
• Blood clots around the anus
• And more

But the main impetus lies with some type of localized injury. Skin, and its healing capacity, has limitations, specifically as it relates to the anal region. Defecation and intercourse are high-pressure actions that continuously irritate a wound, especially as it is attempting to close. And clearly, we have to defecate.

Because of this persistent trauma and the skin attempting to heal, it gets frustrated. It basically lays down a scar as best as it can and then grows out with extra skin, hence the anal skin tag. This healing is beyond common, with anal tears or fissures that attempt to mend with a skin tag in the region (many think it’s actually from a hemorrhoid, but in fact it’s how that tear healed.)

Is it a Hemorrhoid or Skin Tag?

The difference between hemorrhoids and anal skin tags is that skin tags are just extra tissue, whereas hemorrhoids are swollen veins. Skin tags typically don’t bleed and are skin-colored, while hemorrhoids bleed easily and tend to be reddened.

Hemorrhoids, on the other hand, take on a blue hue due to pooled blood and may bleed. Thrombosed external hemorrhoids stretch the skin, which may lead to bursting and bleeding in some cases. However, internal hemorrhoids tend to be more prone to bleeding than external hemorrhoids.

While not the same thing, they are related, and skin tags can be caused by hemorrhoids. With hemorrhoids (or dilated veins), the blood actually stretches the skin and, after the hemorrhoid resolves itself, the skin does not rebound back to its original shape, leaving a tag. So unfortunately, there are many different ways to wind up with a skin tag in the anal region, and many have functional and/or aesthetic limitations that require surgical attention. Luckily, there are multiple options for anal skin tag treatment.

Both hemorrhoids and skin tags can be painful—especially during anal sex. Thrombosed, clotted hemorrhoids that acutely stretch the skin can be temporarily painful, whereas flimsy remnant tags are more irritated or annoying than outright painful. Both conditions can lead to some bleeding, but this is typically due to friction from wiping or general irritation rather than heavy, active bleeding.

What are the Symptoms of an Anal Skin Tag?

Anal skin tags can cause localized irritation, discomfort, and itching and can be considered aesthetically unpleasant. They may cause hygiene problems and also interfere with anal intercourse. Primarily, you’ll feel the raised bump of skin. The skin may be discolored. The main difference between hemorrhoids and skin tag bumps is the pain level; however, hemorrhoids are painful and bleed, while skin tags tend not to bleed.

How are Anal Skin Tags Diagnosed?

Anal skin tags are diagnosed by a doctor through visual inspection. An anoscopy is performed as well to ensure there are no other associated issues, specifically a connection to hemorrhoids or cysts, that may change the surgical approach. Because of this, a thorough internal and external inspection is necessary. Many times, people remove only the external skin tag without addressing the underlying problem, which leads to recurrence or poor healing. Once your anal skin tag has been diagnosed, you can look into anal skin tag removal options.

Related Conditions and Misdiagnoses

Anal skin tags are often associated with conditions like hemorrhoids and anal fissures because they can develop once those conditions are treated. Correctly diagnosing whether you’re dealing with a skin tag, hemorrhoid, or fissure is crucial for proper treatment and to avoid unnecessary discomfort.

How to Treat Anal Skin Tags

Generally speaking, there are two ways you can treat anal skin tags:

Non-Surgical Anal Skin Tag Treatment

Although most anal skin tags require surgical removal, you may be able to treat smaller skin tags through non-surgical methods. Some smaller tags may resolve on their own over time, but you can also try sitz baths and Proctozone 2.5%. Sitz baths can provide relief by soothing the area, reducing inflammation, and shrinking the skin tag. Proctozone 2.5% is a prescription topical ointment that reduces itching and discomfort while easing irritation around the tag. While these treatments can be helpful in some cases, it’s important to consult with a healthcare professional to determine the best approach for your condition.

Anal Skin Tag Surgical Treatment at Bespoke Surgical

Most anal skin tags will require surgical removal, especially if they’re larger. This excision procedure is typically quick, minimally invasive, and performed under anesthesia.

If the skin tag is small enough, we can remove it in-office under local anesthesia using either a laser or cautery to excise it. In many cases, we leave the wound open rather than suturing it closed, as stitches in the area can sometimes lead to new scars or tag formation. Larger tags, or those associated with other conditions, are typically removed in our surgical center with both local anesthesia and sedation. The same techniques—cautery, excision, leaving open to heal, or selective closure—apply, depending on the individual case.

While some patients may experience mild discomfort following the procedure, most can return to their normal activities within a few days. While many recoveries are straightforward, the reality is that we defecate, sit, and exercise regularly—meaning that anything involving the anal area takes time to heal. Many patients may not be in pain, but a follow-up visit about a month post-procedure is essential to check on healing progress. In some cases, additional in-office treatment is necessary to ensure full healing.

Learn more about professional surgical treatments for anal skin tags from Bespoke Surgical on our Anal Skin Tag services page.

Recovering from Anal Skin Tag Surgery

Many times, we add Botox to help aid the healing process because this relaxes the muscle sphincters. Additionally, there are times when we leave the wound open (meaning we do not suture it closed) for two reasons: first, it heals quite well when left open, and secondly, in many people, we do not want to make the hole any tighter because this may limit normal defecation and/or sexual activity in the future.

Regardless of how the area is left after surgery, the healing process is similar. The first 3-5 days will be the most difficult, with feelings of constant annoyance and/or a sense of local spasm. Pain can be controlled with narcotics and ibuprofen, combined with suppositories, lotions, and daily Epsom salt baths. Using a bidet during this time can be a gentler method of cleansing the area.

After this period comes 1-2 weeks of more localized pain during bowel movements. This time, using non-narcotic pain meds and continuing with the other aforementioned remedies will aid in recovery and minimize discomfort. After another 2-3 weeks, the pain should be mostly resolved, though full healing will come after roughly 6-8 weeks post-surgery.

As for getting back to normal daily activities, clients can start exercising after 5 days and begin topping or engaging in non-anal play after one week. If used, the stitches are dissolvable; however, if the wound is left open, in-office cauterization of the wound with silver nitrate will aid in healing. At the eight-week mark, we start using anal dilators to assist in healing and restoring the anal architecture. This fully allows our clients to achieve their anal desires, if that’s part of their goal.

Preventing Anal Skin Tags

This is such a multifactorial answer as it relates to all ailments that can occur anally. However, one answer that is not true is to stop having anal intercourse. Why would anyone ever suggest that to you? The key is to understand the science of both defecation and anal sex with the hopes of minimizing trauma to the region. This will, of course, decrease the incidence of any associated pathology that may cause anal tags.

Some other ways to help avoid the development of anal skin tags include:

• Regular soft stools through an increase in fiber intake
• Not sitting on the toilet bowl for too long
• Taking standing breaks or working at a standing desk at work
• Doing squats or leg exercises (and making sure to only contract your glutes and not your asshole)

A lot of our anal skin tag prevention tips can also help prevent hemorrhoids. For a complete guide, check out our blog post How To Prevent Hemorrhoids. The final suggestion is to see a physician soon after an injury or if the symptoms are persisting. It’s key to see a physician who understands our community and has the knowledge to support appropriate treatments. Early interventions can help with a complete resolution or at least minimize any long-term consequences.

Emotional and Psychological Impact of Anal Skin Tags

Anal skin tags can have a significant emotional impact, especially for individuals who engage in anal sex. Many patients feel self-conscious about their skin tags, which can affect their confidence, relationships, and overall sexual well-being, as concerns about discomfort or how a partner might react to the skin tag often weigh heavily on their minds. Skin tags may also cause discomfort during anal sex, amplifying feelings of frustration or distress.

It’s important to recognize that these emotional and physical impacts are valid and deserve attention. Consulting with a medical professional who is understanding and experienced in addressing these concerns can help patients regain comfort and confidence in their bodies.

Anal Skin Tag Care & Services

Become a patient today if you need professional help and care for anal skin tags at:
https://bespokesurgical.com/register/

Anal Skin Tag FAQs

How do you remove an anal skin tag?

Anal skin tag removal is typically done through a minor surgical procedure where the tag is carefully excised using a scalpel or scissors under local anesthesia. The procedure is quick and minimally invasive.

What is an anal skin tag?

An anal skin tag is a small, soft piece of excess skin that forms around the anus. They are harmless but can cause discomfort and irritation during bowel movements and wiping, exercise, and anal sex.

What does an anal skin tag look like?

Anal skin tags look like a small, flesh-colored or slightly darker flap of skin around the anus. It may be soft to the touch and can vary in size.

Who does anal skin tag removal procedures?

Anal skin tag removal procedures are typically performed by a colorectal surgeon or a trained healthcare provider specializing in anal and rectal conditions, like those at Bespoke Surgical.

What are anal skin tag symptoms?

Anal skin tag symptoms typically include mild anal discomfort or irritation during defecation and wiping, exercising, prolonged sitting, and anal intercourse. While generally painless, some people experience itching or difficulty maintaining hygiene due to the tag’s location.

What causes anal skin tags?

Anal skin tags are often caused by friction or skin stretching around the anus. They are a common result of hemorrhoids, chronic constipation, or anal fissures. They may also develop after inflammation or injury to the area as the skin heals and forms excess tissue.

Should I have an anal skin tag removed?

Whether you should have an anal skin tag removed depends on your symptoms and personal comfort. If the skin tag causes irritation, discomfort, or hygiene challenges, removal may be best. Consult with a healthcare provider to assess your situation and discuss the pros and cons of removal based on your individual needs.