Addressing Cosmetic Concerns: Options for External Hemorrhoid Removal

Aesthetic concerns regarding hemorrhoids..?

Hello, doctor.
I have an external hemorrhoid that isn't serious and doesn't significantly affect my daily life, but I am concerned about its appearance and feel it's quite "ugly." 😅 I visited a large hospital yesterday, and after diagnosis, it was classified as grade two.
I initially told the doctor that I wanted to have it surgically removed to address both the hemorrhoid and cosmetic concerns, but the doctor mentioned that I am still young and that it isn't severe, so they only prescribed me an ointment and a stool softener for treatment.
It seems that the doctor was not very inclined to recommend surgery.
I felt uncomfortable directly telling the doctor that my main concern was cosmetic.
The doctor also mentioned that the ointment treatment wouldn't make the external hemorrhoid completely disappear, but could only reduce the swelling.
I would like to know if there are any other options for removal or methods to completely eliminate that "bulb" if I am still concerned about its appearance.

Chen Chongyu, 10~19 year old female. Ask Date: 2023/10/24

Dr. Ke Fangxu reply Surgery

If the desire to address external hemorrhoids is purely for aesthetic reasons, the only option is surgical excision.
Physicians may be reluctant to perform this procedure because, firstly, it is not medically necessary, and secondly, there may still be residual skin tags post-surgery that do not meet your aesthetic expectations.
Please consider this carefully before making a decision, as health insurance is not intended to cover cosmetic needs, and out-of-pocket surgery may not guarantee complete satisfaction.

Reply Date: 2023/10/24

More Info

When it comes to addressing cosmetic concerns related to external hemorrhoids, it's important to understand both the medical and aesthetic aspects of the condition. External hemorrhoids, while often benign and not causing significant discomfort, can be a source of self-consciousness for many individuals due to their appearance.
Firstly, it's essential to recognize that the decision to undergo surgical removal of external hemorrhoids should be made in consultation with a qualified healthcare professional. The fact that your doctor has recommended conservative treatment options, such as topical ointments and stool softeners, suggests that they believe the hemorrhoid is not severe enough to warrant surgical intervention at this time. This is a common approach, especially for patients who are younger and have mild symptoms.

If you are primarily concerned about the cosmetic aspect, there are a few options to consider:
1. Surgical Removal: If the external hemorrhoid is bothersome enough to you, and you feel that it significantly impacts your self-esteem, you might want to seek a second opinion from a different colorectal surgeon or a specialist in cosmetic procedures. Some doctors may be more open to discussing surgical options for cosmetic reasons, especially if the hemorrhoid is prominent.

2. Minimally Invasive Procedures: There are less invasive techniques than traditional surgery that can be considered. These include procedures like rubber band ligation, sclerotherapy, or infrared coagulation, which may reduce the size of the hemorrhoid without the need for a full surgical procedure. However, these methods may not completely eliminate the external hemorrhoid, so it's important to discuss your expectations with your doctor.

3. Topical Treatments: While your doctor mentioned that topical treatments may not eliminate the hemorrhoid, they can help reduce swelling and discomfort. Some patients find that consistent use of these treatments can improve the appearance of the area over time, although results can vary.

4. Lifestyle Modifications: Maintaining a healthy diet rich in fiber, staying hydrated, and avoiding prolonged sitting can help prevent the worsening of hemorrhoids. This may not directly address the cosmetic issue, but it can help manage symptoms and prevent new hemorrhoids from forming.

5. Cosmetic Procedures: In some cases, dermatological procedures such as laser therapy or cryotherapy may be explored to improve the appearance of the skin around the hemorrhoid. These options should be discussed with a dermatologist or a cosmetic surgeon who understands the nuances of treating such conditions.

6. Psychological Considerations: It's also worth considering the psychological aspect of your concern. If the appearance of the hemorrhoid is significantly impacting your self-esteem, discussing these feelings with a mental health professional may provide additional support and coping strategies.

In conclusion, while your current doctor may not recommend surgical removal for cosmetic reasons, it is entirely reasonable to seek a second opinion or explore other treatment options if the appearance of the external hemorrhoid is a significant concern for you. Always ensure that any procedure you consider is performed by a qualified and experienced professional to minimize risks and complications. Remember, your comfort and confidence in your body are important, and there are pathways to address your concerns effectively.

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