Anal Skin Tags

Anal skin tags are found in many patients upon anorectal examinations. The term in itself is non specific and several anorectal disease processes may cause “tags.” Because of this, evaluation by an experienced proctologist is recommended for appropriate diagnosis and treatment.

Anal tags are a common complaint often associated with hemorrhoids. They are typically soft or fleshy skin tags of tissue that form around the opening of the anus. They may form and persist following a flare up of hemorrhoid disease. Often they can swell and result in hygienic challenges in the affected area. Though they rarely bleed or cause pain, due to hygiene and cosmetics, patients may wish to have them removed. This can usually be achieved in an office visit.

It is important to note, however, that not all tags around the anus are due to hemorrhoids. Another common source is anal fissures or tears. These result in a firm tag which is usually associated with painful bowel movements and bleeding. When a tag is associated with a fissure, it is termed a tab. Anal fissures typically require ongoing management often with topical therapy, but in some cases, surgery may be required.

Anal condyloma may often present as anal tags or bumps which are relatively insensate (lacking physical sensation). They are caused by the human papilloma virus (HPV). As more develop, bleeding or discharge as well at itching may ensue. Proper evaluation is essential in timely diagnosis. Topical or surgical therapy is usually indicated.

Anal skin tags are sometimes caused by medical conditions that trigger inflammation, swelling, and irritation of the perianal region of the body. Crohn’s Disease, which is a chronic inflammatory disorder that can affect any portion of a person’s gastrointestinal tract, is often accompanied by anal skin tags that are a consequence of long-term inflammation of the anorectal area of the body.

Other less common causes are other infectious processes such as molluscum contagiosum (viral infection of the skin), anal fistulas, and prior surgical procedures like hemorrhoidectomy.

In summary, anal tags can be associated with a variety of disorders. Most common, however, is the formation of redundant skin as the result of hemorrhoids. Proper evaluation by an experienced proctologist is important in distinguishing the reason for the tag(s). Appropriate treatment may range from observation and topical creams to a simple office excision or in rare cases, surgery.