An anal skin tag is a small, soft flap of excess skin that forms on or around the opening of the anus. These growths are benign, meaning they aren’t cancerous, and they’re surprisingly common. They can range from a few millimeters to several centimeters in size, typically match your surrounding skin color or appear slightly darker, and attach to the body by a narrow stalk called a peduncle. Most anal skin tags cause no symptoms at all, but they can become a nuisance when they interfere with hygiene or cause irritation.
What Causes Anal Skin Tags
The most common cause is hemorrhoids. When a blood vessel near the anus swells, the stretched skin around it doesn’t always shrink back once the swelling resolves. That leftover skin becomes a tag. This is especially true after a thrombosed hemorrhoid, where a blood clot forms inside the swollen vessel and then gradually heals, leaving a permanent flap behind.
Several factors can trigger the swelling that leads to skin tags in the first place:
- Straining from constipation, the single most common trigger
- Chronic diarrhea, which irritates the skin repeatedly
- Pregnancy, due to increased pressure on pelvic blood vessels
- Heavy lifting or intense exercise
- Anal fissures, small tears that cause repeated healing and scarring
- Excessive friction or wiping in the perianal area
Crohn’s disease and other inflammatory bowel conditions also carry a notable link. In a study of 103 hospital patients with Crohn’s disease, about 29% had anal skin tags. In patients with specifically perianal Crohn’s disease, one surgical series found skin tags in 68% of cases at diagnosis, and most of those tags were still present a decade later. Skin tags related to Crohn’s disease may develop from chronic inflammation, swelling of the lymphatic tissue, or as a byproduct of fissures and fistulas associated with the disease.
What They Feel Like
Most anal skin tags produce no symptoms. In one study of perianal Crohn’s patients, 86% of those with skin tags reported no discomfort from them at all. When symptoms do occur, they tend to involve itching, mild irritation, or difficulty cleaning thoroughly after a bowel movement. Larger tags can trap small amounts of stool or moisture against the skin, which leads to irritation, odor, or a feeling of incomplete cleaning. Some people first notice a tag simply by touch during wiping and mistake it for a hemorrhoid or something more concerning.
Skin Tags vs. Genital Warts
This is a common worry, and the two look different on close inspection. Anal skin tags are soft, smooth, and hang from a narrow stalk. Genital warts, caused by HPV, tend to feel rough or bumpy to the touch and can appear raised or flat. Warts often grow in clusters with a texture sometimes described as cauliflower-like, while skin tags are isolated, floppy growths. Both can be flesh-colored, so texture and shape are the more reliable distinguishing features. If you’re unsure, a doctor can tell the difference quickly during a visual exam.
How They’re Diagnosed
When a skin tag is visible on the outside of the anus, a doctor can diagnose it with a simple physical exam. No testing is needed in most cases. If the tag isn’t clearly visible or there’s a concern about internal growths, a doctor may perform an anoscopy, inserting a small, lighted scope into the anus to view the rectal lining. In rarer situations where polyps or other bowel issues are suspected, a sigmoidoscopy (using a thin, flexible camera tube) can examine the lower colon. These additional steps aren’t routine for a straightforward skin tag but may be warranted if you have other symptoms like bleeding or changes in bowel habits.
One important note: skin tags can occasionally be misclassified as internal hemorrhoids. This distinction matters because unnecessary hemorrhoid surgery in someone who only has a skin tag can lead to serious complications.
Removal Options
Because anal skin tags are benign and usually painless, removal is optional. Most people choose to have them removed for comfort, hygiene reasons, or cosmetic preference. The two main approaches are surgical excision and laser removal.
Surgical excision involves cutting the tag away with a scalpel under local anesthesia. It’s a brief outpatient procedure. Laser removal is a newer, minimally invasive alternative that uses targeted laser energy to remove the tag with less damage to surrounding tissue. Laser procedures generally offer a quicker recovery than scalpel excision. Both are done on an outpatient basis, meaning you go home the same day.
You should not attempt to remove an anal skin tag yourself. The perianal area has a rich blood supply and is highly prone to infection, making at-home cutting, tying off, or freezing dangerous.
What Recovery Looks Like
After surgical removal, pain typically peaks around day three and begins to settle by day five. The area may bleed lightly for the first day or so. Warm baths with Epsom salt can help relieve the muscle spasms that sometimes follow bowel movements during healing. Applying a wrapped ice pack for ten minutes at a time can reduce swelling.
Keeping the wound clean is straightforward: shower or bathe as normal, then pat the area dry rather than rubbing. If the wound feels dry or tight, a simple antibiotic ointment from the pharmacy can help. Most wounds heal fully within a few weeks. The main complication to watch for is a non-healing wound, sometimes called a fissure, which is defined as a wound that hasn’t closed by six weeks and still causes pain. Signs of infection, including increasing heat, swelling, or pus, would need antibiotic treatment.
Reducing Your Risk
Since most anal skin tags start with hemorrhoids or fissures, prevention centers on the same habits that prevent those conditions. Eating enough fiber to keep stools soft and easy to pass is the most effective single step. Staying hydrated works alongside fiber to prevent the hard stools that lead to straining. Avoid sitting on the toilet longer than necessary, and don’t push or strain during bowel movements.
Gentle cleaning after bowel movements also matters. Rough or excessive wiping irritates the perianal skin repeatedly, and that repeated trauma is itself a recognized cause of skin tag formation. A bidet, moistened wipes (fragrance-free), or simply patting rather than scrubbing can reduce friction. For people with Crohn’s disease or other inflammatory bowel conditions, managing the underlying disease effectively is the best way to prevent perianal complications, including skin tags.