Understanding Anal Skin Tags: A Guide to Recognition and Relief

Discovering any kind of growth in the area around the anus can be unsettling, and it isn’t the kind of affliction most people are eager to discuss with a doctor. Though anal skin tags are fairly common and generally harmless, they can still cause discomfort and create challenges with regular hygiene practices. Moreover, these benign tissue formations tend to appear in the same area as hemorrhoids and other similar problems, leading to potential confusion and misdiagnosis. While some skin tags go away on their own, others may require treatment to address an underlying issue or to relieve persistent discomfort.

What Are Anal Skin Tags?

Anal skin tags are small, benign growths of excess skin that form around the anus. These soft, flesh-colored protrusions typically range from a few millimeters to about a centimeter in size and often have a narrow base where they connect to the surrounding skin. They generally appear as smooth, elongated flaps that match the surrounding skin tone, though they may occasionally be slightly darker. Unlike other skin conditions in this area, anal skin tags don’t typically change in size or color over time once fully formed. While generally painless, they may become irritated during routine activities like cleaning or bowel movements, particularly when multiple skin tags are present.

Though anal skin tags themselves are harmless, they can occasionally cause discomfort through friction with clothing or toilet paper. Some people may also experience hygiene challenges, as the additional skin folds can make thorough cleaning more difficult and potentially trap moisture or stool particles. This can sometimes lead to itching, irritation, or mild infections in the affected area. While they typically don’t cause pain or bleeding on their own, they may become tender if repeatedly irritated through daily activities. Despite their benign nature, many people seek medical advice about anal skin tags due to physical discomfort, aesthetic concerns, or uncertainty about whether the growth might indicate a more serious condition.¹

Common Causes of Anal Skin Tags

Anal skin tags develop when skin in the anal area stretches and fails to return to its normal position, often following trauma or chronic irritation. While these small growths are typically harmless, they stem from several distinct causes that affect the delicate tissues in this region:

• External hemorrhoids: The most common precursor to anal skin tags occurs when hemorrhoids resolve but leave behind excess skin tissue. When swollen hemorrhoidal blood vessels shrink after treatment or healing, the stretched skin sometimes fails to retract completely, forming a small tag in its place.
• Anal fissures and tears: Small tears in the lining of the anus often heal with additional scar tissue that can develop into skin tags. The body’s natural healing process sometimes produces excess tissue at the site of these tears, creating flaps of skin that extend from the anal opening.
• Chronic inflammatory conditions: Digestive disorders like Crohn’s disease and ulcerative colitis cause persistent inflammation in the digestive tract, including the anal region. This ongoing inflammation can trigger excess skin growth and prevent normal tissue healing, often resulting in multiple skin tags that may be larger than those from other causes.
• Constipation and straining: Regular straining during difficult bowel movements increases pressure on anal tissues, potentially causing small tears or hemorrhoids that later develop into skin tags. This repeated pressure stretches the skin beyond its normal capacity, increasing the likelihood of tag formation.
• Childbirth: The significant pressure and stretching that occurs during vaginal delivery can traumatize anal tissues, sometimes leading to skin tag development as these tissues heal. Many women notice skin tags appearing after childbirth as part of the body’s recovery process.
• Lifestyle factors: Being overweight, sitting for long periods, or using harsh hygiene practices can increase the likelihood of developing anal skin tags. Excess weight puts added pressure on the anal region, while prolonged sitting may limit circulation and impair tissue healing. Repeated irritation from aggressive wiping can further inflame sensitive skin, encouraging the formation of excess tissue as the body tries to repair itself.

Differentiating Anal Skin Tags from Other Conditions

Proper identification of anal skin tags is important because they can be confused with other conditions that require different treatments. While a definitive diagnosis should always come from a healthcare professional, several key characteristics can help distinguish anal skin tags from similar-appearing conditions:

• Hemorrhoids: While both may appear in the anal area, hemorrhoids contain swollen blood vessels and may bleed, throb, or cause pain. Skin tags, by contrast, consist only of skin tissue without engorged blood vessels, typically don’t bleed on their own, and cause discomfort mainly through friction or irritation rather than pain from within the tissue itself.
• Genital warts: Warts caused by an HPV infection typically appear in clusters, have a rougher, cauliflower-like texture, and may grow or spread over time. Skin tags maintain a consistent size once formed, have a smooth texture, and don't multiply unless new trauma occurs in different areas of the anal tissue.
• Anal fissures: Fissures are actual tears in the anal lining that cause sharp pain during bowel movements and may result in bright red bleeding. Skin tags don’t open during bowel movements and any discomfort they cause remains relatively constant rather than intensifying during defecation.
• Polyps: Polyps generally form inside the rectum rather than at the anal opening, require medical instruments to visualize, and may have different tissue characteristics when examined microscopically. Skin tags are visible externally and maintain a skin-like appearance and texture.
• Abscesses or boils: These infections typically appear as red, swollen, painful lumps that may contain pus and feel warm to the touch. Skin tags match surrounding skin color unless irritated and don’t contain fluid or show signs of infection unless secondarily infected due to hygiene issues.

Treatment Options for Anal Skin Tags

Most anal skin tags don’t require medical treatment unless they cause persistent discomfort or hygiene difficulties. For many people, learning that these growths are benign provides sufficient reassurance. However, when treatment is desired, several options exist ranging from conservative home care to medical procedures:

• Conservative management: Many anal skin tags can be managed with gentle cleansing practices, including using soft, moistened toilet paper or alcohol-free wipes after bowel movements. Keeping the area clean and dry helps prevent irritation while avoiding harsh soaps reduces further inflammation.
• Topical treatments: Over-the-counter creams containing witch hazel or hydrocortisone may temporarily reduce irritation and swelling around anal skin tags. However, these products don’t remove the tags themselves and should be used sparingly as directed.
• Surgical excision: For larger or particularly bothersome skin tags, a minor surgical removal can be quickly and easily performed. This procedure typically involves numbing the area with local anesthetic before carefully cutting the tag off with surgical scissors or a scalpel.
• Cryotherapy: Some dermatologists and colorectal specialists offer freezing techniques similar to those used for warts. Liquid nitrogen is applied to the skin tag, causing the tissue to die and eventually fall off.
• Minimally invasive procedures: These minimally invasive procedures use either infrared light or a controlled electrical current to remove the skin tag and seal nearby blood vessels. Both are brief, outpatient treatments performed under local anesthesia, with minimal bleeding and little to no scarring.²

Request an Appointment With Cary Gastro

While anal skin tags can be uncomfortable and a little weird, the good news is that they’re harmless. If you have a skin tag or any growth you’re unsure about, the physicians at Cary Gastro are here to help. We offer discreet, professional evaluation of anal health concerns with a focus on patient comfort. Whether you’re seeking relief from discomfort or simply want reassurance, our team can help determine if treatment is necessary and recommend the most appropriate next step. Contact our office today to request an appointment.

¹https://hemorrhoidcentersamerica.com/anal-rectal-problems/anal-skin-tags/
²https://www.usz.ch/en/department/visceral-and-transplantation/service/treatment-of-anal-skin-tags/