Anal Skin Tag Causes, Diagnosis, and Treatment

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Skin tags are raised areas or bumps on the outer surface of the skin. Anal skin tags are common, and while they might be sensitive, itchy, cause some discomfort, and make keeping clean more challenging, they are not usually painful or dangerous.

A doctor talking to his patient in hospital room
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It can be distressing to find a lump or a bump in the perianal area or to have symptoms such as itching. But skin tags are benign (meaning they're not cancerous) and typically small (sometimes only a few millimeters).

However, it’s important to get anything new you notice in the anal area looked at by a physician to be sure that it is a skin tag, even if an anal skin tag has been diagnosed in the past.

anal skin tags causes
Illustration by Cindy Chung, Verywell

Causes

Skin tags may be caused by blood vessels in the anal area swelling under the skin and then reducing in size again. When the swelling reduces, the skin may not reduce back down again to what it was before. The loose skin that results may become a skin tag.

Swollen blood vessels in the anus may be caused by blood clots, diarrhea, exercise, hemorrhoids, lifting heavy objects, pregnancy, or straining on the toilet bowl. Other causes include the following.

  • Constipation: Constipation is having bowel movements that are hard and difficult to pass. Straining to pass a bowel movement can put pressure on blood vessels in the anal area, causing them to swell.
  • Diarrhea: Diarrhea is considered three or more loose or watery stools a day. Frequent wiping, as well as the acidity of loose stools, can irritate the skin around the anus.
  • Hemorrhoids: People who have had hemorrhoids (which are veins in the anus or rectum that become inflamed) in the past may be at increased risk of developing skin tags. Hemorrhoids are quite common, especially in pregnant women and older people.
  • Crohn’s disease: People who have Crohn’s disease that affects the anal area are more prone to developing skin tags. One study published in 2008 showed that anal skin tags are more frequently associated with Crohn’s disease than ulcerative colitis (another form of inflammatory bowel disease), and that, in some cases, anal skin tags may be a precursor to the diagnosis of Crohn’s.
  • Pregnancy: Pregnant women are more prone to skin tags because of hormonal changes. In addition, hemorrhoids are common during pregnancy. These factors can lead to developing skin tags.

Diagnosis

Finding a lump or a bulge in the anal area should prompt a call to a doctor. There may not be any other symptoms from an anal skin tag, but a nonspecific lump could be a sign of a different condition.

Some potential problems in the anal area can be serious, so it’s better to know for sure if the bump is actually an anal skin tag. A primary care doctor can often make the diagnosis, or he or she may make a referral to a specialist (a gastroenterologist, dermatologist, or a colorectal surgeon) if necessary.

A doctor will look at the anal area in order to make a diagnosis. Patients will be asked to remove their pants and underwear and put on a hospital gown or cover up with a paper drape.

Next is lying on an exam table, usually on the left side, or standing up and leaning over the exam table. While wearing gloves, the doctor will look at the anal area and perform a diagnostic exam.

Rectal Exam

It might be necessary to do a rectal exam. This means that the doctor will lubricate one finger and insert it into the rectum. This is to feel if there are any abnormal structures inside the anus and also to see if the gloved finger comes away with any fluids on it (such as pus or blood).

Undergoing a visual exam of the rectal area may be uncomfortable, but it will be over as quickly as possible. It helps to remember that physicians are trained in giving exams, and it’s not unusual for them.

Anoscopy

An anoscopy is a test in which a doctor (usually a gastroenterologist or a colorectal surgeon) uses an instrument with a light on the end to look inside the anal canal. It can be done right in a doctor’s office, usually with no preparation.

The tool is lubricated and inserted a few centimeters into the anus. In some cases, it might be necessary to have an enema to clean out the rectum and get a better look. If a tissue sample (a biopsy) is needed, it can be taken at this time. There may be some discomfort when the anoscope is inserted and if a biopsy is taken, but it will be over quickly. 

Sigmoidoscopy

A sigmoidoscopy is a test performed to look at the rectum and the last part of the colon, which is called the sigmoid colon. It may not be needed for simple skin tags, but if there’s a suspicion that there is another cause for a lump in the anal area, it might be used.

This test is usually done by a gastroenterologist or a colorectal surgeon and might be done in the office without any preparation. However, in some cases, there might be a need to clear the colon of stool with laxatives or an enema.

The instrument used is called a sigmoidoscope, and it is inserted through the rectum and manipulated up into the large intestine. A physician can get a good look inside the last section of the colon and can also take biopsies if needed. This test might take a few minutes and may be uncomfortable if no sedation is given.

Treatment

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

In some cases, a physician might recommend that a skin tag be removed. Skin tags are on the outside of the body, so removal won’t require an invasive procedure. 

Numbing agents will be used before removing a skin tag surgically. A numbing medication will be used in the area of the tag to reduce pain while it’s being removed. In some cases, a sedative may be recommended in order to help you feel more comfortable during the procedure.

There are several ways in which a skin tag might be removed.

Excision

in some cases, it’s possible to remove smaller tags with surgical scissors. If small enough, the area might heal on its own. Larger tags that are removed surgically might leave a larger wound, which will be closed with stitches or staples.

After surgical removal, the area needs to be kept clean until it heals. Because this is an area that comes into contact with stool, which increases the risk of infection, excision may not be preferred by physicians for larger tags. 

Cryotherapy

Cryotherapy is the process of using liquid nitrogen to freeze off the skin tag. The area will be numbed, and liquid nitrogen applied to the tag. The tag will fall off over the next few days.

Electrodesiccation

Small skin tags may respond well to electrodesiccation, in which an electrical current is applied to the skin and dries them out.

Care Following Skin Tag Removal

After a procedure to remove a skin tag, most people will be able to go home. They'll likely receive the recommendation to rest the remainder of the day and returning to light or normal activities the following day. Your doctor may recommend avoiding strenuous activities for a period of time while the area heals, possibly for several days to several weeks.

Other instructions may be given for keeping the area clean after a bowel movement. It may be necessary to use wipes to remove any bacteria from the area or to clean thoroughly with soap and water. 

Stool softeners might also be prescribed after anal skin tag removal so that bowel movements are soft and easy to pass without straining. Sitting in a bathtub of a few inches of water or using a sitz bath on the toilet may also be recommended to promote healing.

Prevention

In many cases, it may not be possible to prevent anal skin tags. However, if you know you're prone to getting them, there are some steps you can take that may help prevent them in the future.

Tips for Avoiding Anal Skin Tags

  • Avoid tight clothing that can irritate the area
  • Keep bowel movements regular by eating enough fiber, drinking water, and exercising
  • See a doctor regularly for any digestive conditions such as Crohn’s disease
  • Maintain a healthy weight

However, you should consult your physician for specific instructions, which may depend on what's suspected of causing your skin tags in the first place.

A Word From Verywell

Skin tags are annoying and can cause discomfort, but they’re not usually a cause for concern and won’t progress into a more serious condition or become cancerous. They may or may not require removal, and there are a variety of ways to remove them based on the location and size of the tag as well as patient preference.

Preventing tags might not be possible, but some lifestyle changes may help prevent them. Always see a doctor about a lump or a bump in the anal area to rule out a more serious condition. 

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Article Sources
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