Anal skin tags are excess folds of skin that develop around the anus. These growths are benign and non-cancerous. They often form when perianal skin is stretched and fails to retract completely, frequently occurring after a swollen hemorrhoid resolves or due to chronic irritation from anal fissures or inflammation. While typically painless, skin tags can cause discomfort, psychological distress, or hygiene difficulties, prompting people to seek professional removal.
Who Are the Appropriate Medical Specialists?
The most appropriate specialist for evaluating and removing anal skin tags is a Colorectal Surgeon, also known as a Proctologist. These physicians have specialized training in conditions affecting the colon, rectum, and anus, ensuring correct diagnosis and safe execution of the removal procedure. Gastroenterologists are also equipped to diagnose anal skin tags, as they specialize in disorders of the digestive tract, which is often the underlying cause of the tags. For tags that are purely cosmetic and not linked to internal anorectal issues, a Dermatologist may be a suitable option, particularly if the tag is small and presents no complex symptoms. The first step is often a visit to a Primary Care Physician or General Practitioner, who provides an initial assessment and refers the patient to the most relevant specialist.
Differentiating Anal Skin Tags From Other Conditions
A professional diagnosis is necessary because anal skin tags can easily be confused with other, more serious perianal conditions that require different treatments. Anal skin tags are composed only of excess skin tissue, usually matching the surrounding skin color, and they generally do not bleed or cause significant pain; discomfort usually arises from friction or hygiene difficulty. In contrast, thrombosed external hemorrhoids are lumps containing swollen blood vessels, which are often painful, firm, and may appear red or purple, frequently bleeding with light contact. Anal warts, or condyloma, are caused by the Human Papillomavirus (HPV); unlike simple skin tags, warts often have a rough, cauliflower-like texture, can spread rapidly, and may be accompanied by a burning itch. Anal fissures are small tears in the anal lining that cause sharp pain during defecation and bright red bleeding.
Professional Removal Techniques
When removal is deemed appropriate, the procedure is typically a quick, outpatient process performed under local anesthesia to numb the area.
Surgical Excision
The most common method is surgical excision, which involves using a scalpel or surgical scissors to physically cut the skin tag away from the body. This technique is effective for larger or multiple tags and allows the removed tissue to be sent for biopsy if the physician has any diagnostic concerns.
Electrocautery and Cryotherapy
Another effective technique is electrocautery, where a heated instrument uses an electric current to burn the skin tag off and seal the blood vessels simultaneously, which helps to minimize bleeding. Cryotherapy involves freezing the tag using liquid nitrogen, causing the tissue to die and fall off over several days, though this is often best for smaller tags.
Post-Procedure Care
Post-procedure care is focused on keeping the area clean and managing discomfort, which is usually mild. Patients are typically able to resume light daily activities within 24 to 48 hours, with full healing occurring within one to two weeks. Surgeons often advise against closing the wound with stitches due to the high risk of infection, preferring a small wound that heals naturally.
When Removal Is Recommended and Safety Warnings
The decision to remove an anal skin tag is usually elective, as they are medically harmless. Removal is generally recommended when tags cause persistent hygiene issues, making thorough cleaning difficult and leading to chronic irritation or itching. Other common indications include discomfort from friction with clothing and psychological distress due to the tag’s appearance.
A strong warning must be issued against any form of self-treatment or at-home removal, such as cutting, tying off the base with string, or using over-the-counter freezing kits. Attempting removal without professional medical guidance carries a significant risk of severe complications. These risks include uncontrolled bleeding, serious infection due to the presence of bacteria, and permanent scarring. Only a qualified physician can safely perform the procedure in a sterile environment and ensure the growth is correctly diagnosed.