Anal skin tag: Picture, causes, symptoms, and treatment

While cleaning up after defecating, you may notice a swelling or outgrowth of skin from your anal area. This may be discomforting and worrisome at the same time as you may wonder what the outgrowth is and if it will increase with time and how large it can grow. Not to worry, you most likely have an anal skin tag. This is similar and yet different from a regular skin tag. Below are things you should know about skin tags, including anal skin tag.

What is a skin tag?

Skin tags are also called acrochordons. They are benign, small outgrowths of skin that hang off the skin. This means they are not cancerous and will not become cancerous.  Skin tags are very common and it is estimated that almost half of adults have at least one of these harmless growths. They occur more commonly in obese or diabetic individuals and in people with a family history of skin tags. Hormonal changes in pregnancy can also predispose some women to developing a skin tag. It affects men and women with equal frequency. Older people are also more prone to developing skin tags although new skin tags typically do not develop in individuals after 70 years of age.

What is the structure and common location of skin tags?

Skin tags are composed of loose body collagen fibers (same protein found in normal skin) and blood vessels surrounded by skin. The colour is usually varied but are typically skin colored or brown ovoid growths attached to a fleshy stalk of skin. Usually they are small, measuring between 2-5 mm, and can grow up to 5cm, though not commonly.  They generally tend to grow in areas where the skin rubs against itself and friction is high, as in skin folds. These areas include the eyelids, neck, armpits or groin. Among the areas in the groin where skin tags can appear includes the anal region.

What is anal skin tag and what causes it?

Just like other skin tags, an anal skin tag is a piece of excess skin located around the anal area. Its origin is slightly different from other skin tags. It often arises as a result of healed thrombosed external hemorrhoid or anal fissure. External hemorrhoids or ‘piles’ occur when the group of pillow-like veins which are located in the wall of the anus become swollen. The overlying skin can become swollen, irritated, and itchy. A blood clot can also occur (thrombose) in it which is usually painful, though resolves spontaneously. Anal fissures are cuts or tears in the anus usually due to passage of hard stools. Both of these condition lead to scars in the area around the opening of the anus. These scars or piece of extra tissue near or in the anal area is exacerbated by friction caused by excess cleaning or rubbing. It can gradually start increasing in size with more cleaning and rubbing of the area.

What are the symptoms of Anal skin tag?

Just like other skin tags, it can be multiple, painless and harmless, especially for smaller tags. Larger tags are more frequently associated with swelling, anal itching, heaviness, poor anal hygiene, and a skin rash.

How do you treat anal skin tag?

Unlike skin tags in other locations, anal tags usually point to an underlying cause like external hemorrhoids or anal fissures. Therefore, before any treatment for anal tags is commenced, your doctor would first tackle the underlying cause of the tags. There is usually a need for dietary modification, where more fluids, fruits, and foods rich in fiber are prescribed so the stool can be soft to prevent constipation and straining during defecation. Laxatives and stool softeners can also be given.

A proper rectal examination to confirm there are no other rectal or anal masses or cancer will need to be performed before the anal tags are removed by the doctor. Tests like anoscopy or sigmoidoscopy will also need to be done.

Leaving the skin tag without removal may also be a treatment option and depending on several factors, your doctor can recommend this option. Removal of the tag is another option which may also be recommended by your doctor. It is an office procedure and does not require hospital admission.

The options for removal are:

Excision where the doctor surgically cuts it off after numbing the area with a local anesthetic and using sutures to close the wound.

Cryotherapy is also another option where liquid nitrogen is used to freeze the skin tag and it falls off on its own.

Laser removal involves burning it off with laser, and the skin tag falls off.

The skin around the anus has many nerves and blood vessels and is very sensitive so pain is a common complaint after anal skin tag removal and bleeding may occur in the first few days after, especially with defecation. Swelling and discomfort around that area are also expected after the procedure. You will also need to rest for a few days, increase fluid intake with foods rich in fiber, and avoid straining to allow the area heal very well. Antibiotics may also be prescribed to prevent the risk of infection because of the ease of contamination with stool.

So if you have an anal skin tag and want to remove it, avoid the temptation of removing it yourself at home with a sharp object and visit your doctor for proper evaluation and care.

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