Anal Skin Tags: Symptoms, Concerns, and When to Seek Help - Surgery

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External anal skin tag


Hello Doctor, about two years ago, I felt a small lump between my anus and vagina.
There was no bleeding after bowel movements, but it felt a bit itchy when touched.
I have already consulted a colorectal surgeon at the hospital, who performed a physical examination and said it was just a polyp caused by straining during bowel movements.
The doctor prescribed some topical medication for me and I asked if I needed to return for a follow-up if it didn't go away.
The doctor said it was unnecessary.
Since then, the lump has been fluctuating; sometimes it swells and I can feel it when I strain, while other times it is very flat and I wouldn't even notice it unless I touched that area.

In the past two days, I have been experiencing constipation, which has caused me to strain more during bowel movements.
As a result, the lump has become quite large, and its color is flesh-colored.
Initially, I wasn't worried, but over the past few years, I have noticed an unexplained trend of weight loss.
This month, I have had my blood drawn three times to test for hyperthyroidism (which has been ruled out), elevated immune response, and allergies (which have been confirmed), and I am currently being tested for allergens.
The doctors are aware of my unexplained weight loss but none have suggested that I undergo cancer screening, which makes me very anxious about the possibility of having cancer.
I would greatly appreciate your guidance on this matter.
Thank you!

Liang Nu, 20~29 year old female. Ask Date: 2023/08/26

Dr. Zhang Shuhao reply Surgery


The colorectal surgeon diagnosed the polyps caused by excessive straining during bowel movements, which are actually anal skin tags commonly associated with anal fissures.
They typically do not present any symptoms, but may occasionally become swollen and painful due to external irritation.
Anal skin tags are not related to cancer and have a low risk of malignant transformation over time.
Unless you have a strong family history of cancer, your risk of developing cancer is low.
If you are concerned, you can consult with a family medicine specialist to assess whether further examination is necessary.

Reply Date: 2023/08/26

More Info


Understanding anal skin tags can be a source of concern for many individuals, especially when accompanied by symptoms such as itching or changes in size. Based on your description, it seems that you have been experiencing a skin tag located between the anus and vagina for about two years. Skin tags, or acrochordons, are benign growths that can occur in various areas of the body, including the anal region. They are typically small, soft, and flesh-colored, and they can sometimes become irritated, especially if they are subjected to friction or pressure during bowel movements.

From your account, it appears that your skin tag has fluctuated in size and has become more prominent following episodes of constipation, which can lead to straining during bowel movements. This is a common scenario, as increased pressure can cause existing skin tags to swell or become more noticeable. The fact that you have previously consulted with a colorectal surgeon who diagnosed it as a benign growth and advised you that it does not require further follow-up unless it changes significantly is reassuring.
However, your recent concerns about unexplained weight loss and the need for further medical evaluation are valid. Weight loss, especially when unexplained, can be a symptom of various underlying health issues, including gastrointestinal disorders, metabolic conditions, or even malignancies. While the skin tag itself is unlikely to be related to cancer, the combination of your symptoms warrants a thorough evaluation. It is essential to communicate your concerns about weight loss to your healthcare provider, as they may recommend additional tests, including imaging studies or a colonoscopy, to rule out any serious conditions.

In terms of managing your skin tag, if it becomes bothersome or painful, there are several treatment options available. These can include:
1. Observation: If the skin tag is not causing significant discomfort, you may choose to leave it alone, as many people do.

2. Topical Treatments: Your doctor may prescribe topical treatments that can help reduce irritation or inflammation.

3. Surgical Removal: If the skin tag becomes painful or bothersome, it can be removed in a minor outpatient procedure. This is typically a quick process and can be done under local anesthesia.

4. Lifestyle Modifications: To prevent further irritation, consider dietary changes to manage constipation, such as increasing fiber intake, staying hydrated, and incorporating regular physical activity.

It is also important to monitor any changes in the skin tag, such as changes in color, size, or if it begins to bleed. If you notice any of these changes, or if you experience new symptoms, it is advisable to seek medical attention promptly.

In conclusion, while your skin tag is likely benign, your concerns about weight loss and ongoing symptoms should be addressed with your healthcare provider. Open communication about your symptoms and concerns is crucial in ensuring you receive appropriate care and peace of mind. Remember, it’s always better to err on the side of caution when it comes to your health.

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