LEARN ABOUT ANAL SKIN TAGS
FROM THE EXPERTS AT BESPOKE SURGICAL
What is an anal skin tag?
Skin tags are extra-folds of anal tissue. They may develop from the stretched overlying skin of a thrombosed external hemorrhoid or the way in which the tissue in an anal fissure fails to heal properly.
Causes of Anal Skin Tags
Anal skin tags stem from many different sources:
- Anal tears (fissures)
- Dilated veins (hemorrhoids)
- Anal abscesses/infections
- Anal gland tunnels (fistulas)
- Anal intercourse
- And more
But the main impetus lies with some type of localized injury. Skin, and its healing capacity, has limitations, specifically as it relates to the anal region. Defecation and intercourse are high pressure actions that continuously irritate a wound, especially as it is attempting to close. And clearly we have to defecate.
Because of this persistent trauma and the skin attempting to heal, it gets frustrated. It basically lays down a scar as best as it can and then grows out with extra skin — hence the anal skin tag. This healing is beyond common, with anal tears or fissures that attempt to mend with a skin tag in the region (many think it’s actually from a hemorrhoid, but in fact it’s how that tear healed.)
Anal Skin Tags vs Hemorrhoids
Anal skin tags are different from hemorrhoids. As stated above, skin tags are just extra tissue, whereas hemorrhoids are swollen veins. While not the same thing, they are related–skin tags can be caused by hemorrhoids. With hemorrhoids (or dilated veins), the blood actually stretches the skin and, after the hemorrhoid resolves itself, the skin does not rebound back to its original shape, leaving a skin tag. So unfortunately, there are many different ways to wind up with a skin tag in the anal region and many have functional and/or aesthetic limitations that require surgical attention.
What are the symptoms of an anal skin tag?
Anal skin tags can cause localized irritation, discomfort, itching, and can be considered aesthetically unpleasant. They may cause hygiene problems, and also interfere with anal intercourse.
How are anal skin tags diagnosed?
Anal skin tags are diagnosed through visual inspection. An anosocopy is performed as well to ensure there are no other associated issues, specifically a connection to hemorrhoids that may change the surgical approach.
What is the treatment for anal skin tags?
Some skin tags may resolve on their own over time, while utilizing sitz baths and Proctozone 2.5%, a prescription topical ointment. In most cases, however, anal skin tag surgery is required.
Anal Skin Tag Surgical Treatment
Skin tags are either removed via laser/electrocautery or surgical excision, with thought given to both functional and cosmetic goals.
Recovering From Anal Skin Tag Surgery
The recovery of anal skin tag surgery is similar to any other anal procedure. Operating on that region clearly is sensitive. With that said, anal skin tags can be removed in numerous ways and, as stated above, are usually connected to other associated pathology. Lasering, cutting, cauterizing ,or freezing are all options.
Don’t let other surgeons or physicians tell you it can’t be done or that it will heal right back with another skin tag. If it’s done correctly and with someone who has the proper knowledge, this won’t happen. Another disclaimer: don’t let someone simply excise the tag if there are other associated issues. One needs to take care of the primary pathology first in order to ensure an appropriate outcome.
Anal surgery post-procedure recovery is usually 2-3 days of more constant annoyance, followed by 1-2 weeks of discomfort during bowel movements. Using a bidet during this time can be a gentler method of cleansing the area. Everything heals over 4-6 weeks and you will be back to full engagement after that. However, some skin tags are quite small and would have an easier recovery, whereas others are connected to large tears or hemorrhoids that need more extensive treatments.
Some skin tags may even need 2-3 surgeries to accomplish the task at hand. Form, function, and aesthetics go hand-in-hand and should be weighed equally in the decision making process.
Preventing Anal Skin Tags
This is such a multifactorial answer as it relates to all ailments that can occur anally. However, one answer that is not true is to stop having anal intercourse. Why would anyone ever suggest that to you? The key is to understand the science of both defecation and anal sex with the hopes of minimizing trauma to the region. This will of course decrease the incidence of any associated pathology that may cause anal skin tags.
Some other ways to help avoid the development of anal skin tags include:
- Regular soft stools through an increase in fiber intake
- Not sitting on the toilet bowl for too long
- Taking standing breaks or working at a standing desk at work
- Doing squats or leg exercises (and making sure to only contract your glutes and not your asshole)
The final suggestion is to see a physician soon after an injury or if the symptoms are persisting. It’s key to see a physician who understands our community and has the knowledge to support appropriate treatments. Early interventions can help with a complete resolution or at least minimize any long term consequences.
“I am a bottom through and through and can only climax when penetrated. However, lately, I have noticed more and more hesitation (and even a gasp or two) when my sexual partners get sight of my hole. Thinking it was just my imagination, my worst fears were confirmed when a recent partner made a more direct comment about what was going on back there aesthetically. I immediately went to my *straight* primary care physician for advice and was told it was simply a skin tag and that it should be left alone as it didn’t pose a major health concern. Obviously, it was something I couldn’t shake and because of that, I fell into a sexual depression thinking that I would have to live with it forever. And without that confidence, it was unlikely I could ever fully enjoy bottoming again.
Regardless of whatever I felt, the sexual partners I encountered may or may not be comfortable with my skin tag. Everyone is so focused on aesthetics and so anything that may not look perfect is met with disgust or hesitation. As you can imagine, I started to withdraw from pleasurable acts and naturally began down a path towards sexual isolation.
Some may see this as a purely superficial issue, but sexual health has everything to do with total mind and body wellness for me. That’s when I found Dr. Goldstein and was quickly assured that not only could he help me, but there was a simple, straightforward procedure available. With a same-day procedure, which entailed not only strategic removal and closure of those extra skin folds in the region, but also laser use to resurface, Dr. Goldstein resolved all of my related psychological and medical issues. On top of this, with the associated tightening, it has also allowed heightened sexual pleasures for both me and my sexual partners. I should have gone to Bespoke Surgical years prior, but am still grateful for its completion.”
Dr. Evan Goldstein, D.O.
Dr. Evan Goldstein is the founder and President of Bespoke Surgical, a surgical practice for modern males based in New York and Los Angeles. He received his medical doctorate from the University of Medicine and Dentistry School of Osteopathic Medicine in 2002. Receiving the highest osteopathic education was pivotal in shaping his holistic whole-life approach towards his practice of private surgical care.