Anal skin tag treatment options

Medically reviewed by: Liza M. Capiendo, MD

Anal skin tags are a common, benign condition that many people get removed due to cosmetic reasons. However, sometimes they can become sensitive and cause pain or itching

If you’re suffering from anal skin tags and wondering what your treatment options are, read on to find out what exactly anal tags are, who gets them, what they mean for you, how they’re usually treated, and how you can prevent them from developing again.

What are anal skin tags?

An anal skin tag is excessive skin growth in the peri-anal area. You can think of them as “overstretched” skin. 

Anal skin tags are benign, which means they don’t have the potential to become cancerous, something many people worry about regarding the condition.

There are many reasons why anal skin tags develop. 

Many cases of anal tags are idiopathic, which means the cause is unclear. However, generally, anything that irritates the anal skin can lead to skin tag development. For example, tight clothes, exercise, and extended periods of sitting can all irritate the anal skin and cause skin tags.

Similarly, chronic diarrhea can irritate the skin around the anus due to its chronic liquid nature. This is another potential cause of skin tag development.

Constipation has also been shown to lead to anal skin tag development because hard stools and straining stretch the skin around the anus, causing blood vessels to become engorged and bulge out.

If the skin over these blood vessels fails to return to its normal size, an anal skin tag can develop.

This is why people with Crohn’s disease are particularly prone to anal skin tag development. Crohn’s is a type of Inflammatory Bowel Disease and leads to chronic diarrhea or constipation, both of which are independent risk factors for anal skin tags.

You should note that other conditions that lead to chronic inflammation of the bowel or perianal skin can also lead to the development of skin tags.

Some more causes of anal skin tags include heavy lifting, pregnancy, and hemorrhoids. All of these lead to the engorgement of blood vessels around the anus, increasing the risk for skin tag development. 

Anal tags are usually diagnosed by history and examination. 

When you visit a doctor with the complaint of an anal skin tag, your appointment will usually begin with a thorough history and a physical exam. 

While taking your history, your doctor will ask you questions to rule out any underlying disease that could be contributing to your condition — for example, people with Crohn’s disease (which is a risk factor for anal skin tags) might also complain of chronic, bloody diarrhea and pain in the belly. 

The examination can consist of three things — a digital rectal exam, anoscopy, and sigmoidoscopy.

Digital Rectal Exam

A digital rectal exam (DRE) involves the doctor inserting a gloved, lubricated finger into your anal canal. 

One major use of a DRE is to check for abnormalities of the prostate gland in males, which is found just in front of the rectum and can be felt through its wall. However, in this case, your doctor will perform a DRE to check for any tags in areas that are less visible.

Anoscopy 

If your doctor is not satisfied with a DRE, he might decide to perform anoscopy, which involves inserting a small scope inside your anal canal to check for growths visually. You should feel next to little discomfort.

Sigmoidoscopy

During history taking, if the doctor suspects that your symptoms might mean an underlying growth in your bowels, a sigmoidoscopy may be performed.. These symptoms can include bleeding from the rectum, painful defecation, or systemic signs like fever and weight loss.

You can think of a sigmoidoscopy as an advanced anoscopy — it involves looking further into the bowel than what would be seen at an anoscopy.

The doctor will insert a short tube with a camera and a light source to visualize your rectum and the lower portion of your large intestine. If a growth is found, the doctor might biopsy it for microscopic examination.  You should note that sigmoidoscopy is not used to diagnose anal skin tags in all cases. Once the doctor completes the history and examination, a diagnosis of anal skin tags will be made.  

What is the best way to deal with anal skin tags?

The answer to this question will differ for each individual with anal skin tags. Some anal skin tags are small and don’t cause functional disturbance like pain and itching. Your doctor might recommend leaving these intact or delaying removal.

Some tags can also be managed just by lifestyle modifications like increasing your dietary fiber and water intake, which are going to help you in case you have constipation. 

However, if your skin tags are causing you significant discomfort or look cosmetically unpleasing to you, they can be removed. Let’s take a look at the options you have for skin tag removal. 

Anal Skin Tags — Treatment Options

There are several options for skin tag removal and all are carried under local anesthesia. Your doctor will inject pain-reducing medication around the tag to minimize discomfort during removal.

Anal skin tags may be removed at the doctor’s office — you may not need to visit the hospital. 

Excision 

Smaller tags can be easily removed using surgical scissors. Because the area left behind is small, it will heal on its own. For larger tags, excision might not be the best option because the area left behind would require stitches for closure. 

Electrodesiccation 

Electrodesiccation has a variety of uses, including removal of precancerous skin conditions, and might be an appropriate option for certain types of tags.

The procedure involves applying an electrical current to the skin tag, which leads to the drying out of the lesion. Because there are no open wounds left behind, chances of infection are minor.

Cryotherapy 

Cryotherapy is another popular treatment choice for anal skin tags. It involves freezing the tag off with liquid nitrogen. Most tags will fall off over the next few days. 

Laser the procedure so you should not feel any pain. 

Most people return home the same day after anal skin tag removal… 

However, your doctor will recommend you avoid strenuous activity after you return home. Light activity can be started the next day but generally, the more you rest, the quicker you’ll recover.

Keeping the surrounding area clean after removal is of prime importance!

This is especially true if you’ve had removal by excision. You need to keep the peri-anal area free of bacteria and your doctor might prescribe you a topical cream for that. 

You also need to clean the anal area after each bowel movement, which can be achieved using wipes or soap and water. 

Finally, your doctor might also prescribe stool softeners, which make the passage of stool easy and keep you from straining. Excessive straining while passing stool can damage the wound site and delay healing or lead to further complications. 

You may be able to prevent anal skin tags!

Many idiopathic cases of anal skin tags cannot be prevented. But if you have a known risk factor for skin tag development, you can work to minimize it and thus reduce your risk of getting anal skin tags in the future.

Some things that you can work on include:

Wearing proper underwear. Underwear that is too tight can irritate the anal area and lead to skin tag development.

Keeping your bowels healthy. This includes taking adequate dietary fiber as well as having good water intake. If you have chronic inflammatory condition of the bowel, make sure it’s adequately treated. Hemorrhoids should also be treated promptly.

Using moist wipes after bowel movements to reduce irritation of the peri-anal skin.

Lubricating the rectum to allow for easy passage of stools.

You should note, however, that none of these measures are fool-proof, and if you develop a skin tag despite taking precautions, you should see a doctor.