External Anal Masses: Are They Hemorrhoids?

Perianal mass

Yesterday, while taking a shower, I noticed a round, soft lump around the anal area.
Today, during my shower, I found that the lump has increased in number and there are now many small ones located at the anal opening.
Usually, there is no pain, but I feel a bit of discomfort when I touch it or when my buttocks are clenched.
There is no pain or bleeding during bowel movements.
Could this be hemorrhoids? Should I see a doctor at a clinic?

Niming, 10~19 year old female. Ask Date: 2021/03/16

Dr. Ke Fangxu reply Surgery

Although your description seems more like a thrombosed external hemorrhoid, it is impossible to make an accurate diagnosis without a physician's personal examination.
Conditions such as anal fissures, hemorrhoids, fistulas, abscesses, or pilonidal cysts are all possibilities.
It is advisable to consult a physician for an examination to avoid delays in treatment that could worsen the condition.

Reply Date: 2021/03/16

More Info

When it comes to external anal masses, the first thing that comes to mind is the possibility of hemorrhoids, which are swollen veins in the lower rectum or anus. Based on your description of a soft, round protrusion that has multiplied and is located at the anal opening, it is indeed possible that you are experiencing external hemorrhoids. Hemorrhoids can be classified into two types: internal and external. Internal hemorrhoids are located inside the rectum and are usually not visible, while external hemorrhoids occur under the skin around the anus and can be felt or seen.

The symptoms you've described—soft lumps that are not painful during bowel movements but may cause discomfort when touched or when the buttocks are clenched—are consistent with external hemorrhoids. They can sometimes cause itching, swelling, and discomfort, especially if they become thrombosed (when a blood clot forms inside the hemorrhoid), which can lead to more significant pain and swelling.

However, it is essential to consider other potential causes for anal masses, such as skin tags, anal warts, or even more serious conditions like anal fissures or tumors. Skin tags are often harmless and can occur after the resolution of hemorrhoids. Anal warts, caused by the human papillomavirus (HPV), can also present as soft growths around the anus. In rare cases, anal tumors can present as masses and may require further evaluation.

Given that you have noticed multiple lumps and some discomfort, it is advisable to consult a healthcare professional for a proper evaluation. A doctor can perform a physical examination and, if necessary, additional diagnostic tests to determine the exact nature of the masses. They can also provide guidance on treatment options, which may include lifestyle changes, over-the-counter medications, or procedures to remove or reduce the hemorrhoids if they are causing significant discomfort.

In summary, while your symptoms are suggestive of external hemorrhoids, it is crucial to seek medical advice to rule out other potential conditions and to receive appropriate treatment. Early intervention can help prevent complications and improve your quality of life. If you are experiencing any additional symptoms such as bleeding, severe pain, or changes in bowel habits, it is even more critical to seek medical attention promptly.

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