External Anal Masses: Symptoms and Concerns

Perianal mass

Hello, doctor.
I would like to ask about something I noticed in the past couple of days.
While cleaning my buttocks, I felt a small round ball, about the size of a pearl, outside my anus.
It feels hard and is not painful when I sit or during bowel movements.
However, I do feel some pain when pulling on the hair around the anus.
I am a bit worried and wanted to ask what this symptom might be.
Thank you, doctor.

Xiao Luo, 10~19 year old female. Ask Date: 2016/05/27

Dr. Ke Fangxu reply Surgery

This condition is likely acute thrombosed hemorrhoids.
As long as there is no pain or further enlargement, it should not be a concern.
It is recommended to avoid constipation during this period and to shorten the time spent on bowel movements.
Warm sitz baths may also help alleviate symptoms.
Over-the-counter hemorrhoid suppositories can be used as well.
It is best to avoid using stool softeners indiscriminately; at this age, increasing dietary fiber and hydration should be sufficient.
If symptoms persist without improvement, it is advisable to consult a physician for evaluation.

Reply Date: 2016/05/27

More Info

When it comes to external anal masses, there are several potential causes that could explain the symptoms you are experiencing. The small, hard, round mass you described, which is about the size of a pearl and is not painful unless you pull on the surrounding hair, could be indicative of a few different conditions. It's important to consider the characteristics of the mass, any associated symptoms, and your medical history when evaluating the situation.

1. Hemorrhoids: One of the most common causes of external anal masses is hemorrhoids. These are swollen veins in the lower rectum and anus that can become inflamed and form a lump. External hemorrhoids are located under the skin around the anus and can be painful, especially when irritated. However, if your mass is not painful and you only feel discomfort when pulling on the hair, it may not be a hemorrhoid.

2. Anal Skin Tags: Another possibility is an anal skin tag, which is a small, benign growth of skin that can occur around the anal area. Skin tags are usually painless and can vary in size. They often develop after episodes of hemorrhoids or irritation.

3. Anal Warts: Genital warts, caused by the human papillomavirus (HPV), can also appear around the anal region. These can be small, firm, and may not cause pain unless they are irritated. If you have had any changes in sexual activity or have concerns about sexually transmitted infections, this could be a consideration.

4. Abscess or Fistula: An anal abscess is a collection of pus that can occur due to infection, and it can feel like a hard lump. This would typically be associated with pain, swelling, and possibly fever. An anal fistula is a small tunnel that can develop between the end of the bowel and the skin near the anus, often following an abscess. These conditions usually require medical evaluation and treatment.

5. Other Conditions: While less common, other conditions such as anal cancer or other tumors could present as a mass in the anal area. These would typically be associated with other symptoms such as bleeding, changes in bowel habits, or significant pain.

Given your description, it is advisable to consult a healthcare professional for a thorough examination. They may perform a physical examination and possibly recommend imaging studies or a biopsy if necessary. It’s important to address any concerns you have, especially if the mass changes in size, becomes painful, or if you experience any other symptoms such as bleeding or changes in bowel habits.

In summary, while the mass you are feeling could be benign, such as a skin tag or hemorrhoid, it is essential to have it evaluated by a healthcare provider to rule out any serious conditions. Early diagnosis and treatment are key to managing any potential issues effectively. Please do not hesitate to seek medical advice, as it can provide you with peace of mind and appropriate care.

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