As the name suggests, perianal skin tags are soft growths that form around the anus. They are quite common and usually harmless. They may happen after hemorrhoids heal or from cleaning that area too hard. People with inflammatory bowel disease, especially Crohn's, are more likely to get them, too.
"They're not harmful or cancerous," says Bernadette R. Anderson, MD, MPH, a primary care physician at Faith Family Health in Columbus, Ohio. "Most of the time, they're tiny, painless, and feel like little flaps or folds of skin."
Skin tags occur naturally as you age. They're mostly found in areas where there are skin folds, such as the groin and armpits. Although skin tags are noncancerous growths, they may be sensitive.
What Causes Perianal Skin Tags?
"The most common cause is hemorrhoids," Anderson says. "When hemorrhoids shrink back down, the skin that was stretched out can stay behind as a tag."
Perianal skin tags also can develop when the skin around the anus gets irritated over and over again, she notes. That irritation can come from:
- Chronic constipation or straining
- Ongoing diarrhea
- Anal fissures, which are small tears in the skin
- Too much friction or moisture in the area
- Swollen blood vessels around the anus
- Inflammatory bowel disease, especially Crohn's disease
Too much rubbing and cleaning are known ways to worsen anal skin tags. "In short, anything that causes swelling, stretching, or frequent irritation around the anus can lead to a skin tag," Anderson says.
Perianal skin tags have been linked to several conditions, such as diabetes (or insulin resistance), obesity, and skin irritation from friction.
Perianal skin tags can happen to anyone, regardless of age and gender. Conditions such as Crohn's disease, obesity, pregnancy, and other bowel issues may put you at a higher risk of getting them. And family history may make you more likely to get them as they're hereditary.
Perianal skin tags during pregnancy
Pregnancy can raise your chances of developing perianal skin tags. That's because there's more pressure in your pelvic area as the baby grows. Also, hormones change during pregnancy, and these changes can make the tissues in the body more relaxed.
"Constipation is common in pregnancy, and straining can affect the skin around the anus," Anderson adds. "The intestines move more slowly, which can also lead to constipation and extra pressure."
During pregnancy, perianal skin tags may:
- Get more irritated because of swelling or friction
- Grow in size
- Be harder to keep clean if they become big
"The good news? They usually do not cause any complications for the pregnancy itself," Anderson says.
What Are the Symptoms of a Perianal Skin Tag?
When a perianal skin tag develops, you may begin to feel a piece of skin around the anus. This type of skin tag causes no pain in most situations. However, you may get a little uncomfortable due to the excess skin. Perianal skin tags don't cause bleeding and pain.
You can easily mistake a skin tag for a hemorrhoid due to their similar symptoms. Hemorrhoids, also called "piles," occur when the veins around the anus swell and become distended.
The difference between hemorrhoids and perianal skin tags is that hemorrhoids are painful. Also, perianal skin tags usually don't bleed, while hemorrhoids bleed when even mildly irritated.
Perianal skin tags should also not be confused with warts. Warts are associated with human papillomavirus, and have a whitish, reddish, or grey-brown color. They only grow to a size of a few centimeters. Warts cause burning itchiness and may bleed a little when touched.
How Do You Diagnose Perianal Skin Tags?
Your doctor will ask you to lie on your side to look at the anus and examine skin tags. They may look for signs of irritated skin, hemorrhoids, tender red areas, fistula (an abscess), or contact dermatitis. They may also inspect inside your anus using their finger and a proctoscope.
Your doctor may ask you:
- The amount of time you spend on the toilet
- The number of times you have a bowel movement daily
- Whether you are experiencing other anal issues (such as bleeding and pain)
- Whether your stool is soft, hard, or watery
- What you use to clean your anus and how you do it
- If you do other activities while using the toilet (such as using your phone)
- If you are taking any fiber supplements
If your symptoms come and go, a photo can help your doctor see what the skin tag looks like, Anderson suggests.
A biopsy, which means testing a tiny piece of tissue, is rarely needed unless something looks unusual.
What Are Treatment Options for Perianal Skin Tags?
The primary way to treat perianal skin tags is by managing the underlying condition causing the tags. Some conditions, such as hemorrhoids and anal fissures, are known to cause them. To control the skin tags, you have to treat these conditions first.
Most of the time, perianal skin tags are harmless, and more of a nuisance than anything serious, Anderson says. They don't need to be removed unless they cause problems.
"You can take steps at home to keep the area comfortable, but you should not try to remove a skin tag yourself, especially in the perianal area," she says.
Helpful self-care options include:
- Warm sitz baths to soothe the skin
- Eating a high-fiber diet and drinking plenty of water
- Using stool softeners to avoid straining
- Applying barrier creams, such as petroleum jelly or zinc oxide, to reduce irritation
- Using witch hazel pads for gentle soothing (not for removal)
- Keeping the area dry and clean by patting instead of rubbing
Takeaways
- A perianal skin tag can be uncomfortable, but it's not harmful. If you begin to feel a mass in your anus, visit your doctor for a proper examination and clinical advice.
- If they come and go, take a picture to show your doctor.
- You should never remove a perianal skin tag yourself. However, many self-care steps help manage them, such as drinking lots of water and soothing them with witch hazel pads.
Perianal Skin Tags FAQs
Can perianal skin tags be a sign of an underlying medical condition?
Yes. They show up in up to 70% of people with perianal Crohn's disease. They can also appear before an intestinal disease diagnosis. It's key to remember that a perianal skin tag doesn't necessarily mean you have a serious medical condition, though.
Are perianal skin tags a sign of poor hygiene?
No, not generally. They're more likely to happen when the perianal area is cleaned too often or too harshly.
Can you remove perianal skin tags at home?
No. Don't cut them, don't try to tie the skin tag off, and don't use acids or "skin tag removers" that are sold online, Anderson says. These methods can lead to infection, bleeding, or misdiagnosis, as some growths can look like skin tags but are actually something else.
