Painful Bumps Near the Anus: Possible Causes and Treatments

There is a pimple on the left side of the anus?

Hello, doctor! On April 15th, while taking a shower, I felt a small hard lump on the left side of my anus.
It only hurts when I touch it.
Over the next few days, it slightly swelled up, about the size of a small green bean.
It still only hurts when I touch it or when I sit in certain positions.
On the night of April 20th, I thought it resembled an anal fistula based on my online research, but it felt more like a regular pimple, so I applied acne medication.
Suddenly, the pain became more pronounced, but there was no pus at that time, just redness.
The next morning, I noticed that walking caused pain, and upon checking in the mirror, there was still no pus.
However, when I checked again that evening after returning home, I found pus, which looked very much like the pus from a pimple.
I researched online and found that I could try using antibiotics, so I applied some eye ointment, thinking it might have a higher antibiotic content.
This morning, when I checked again, I noticed that the pus-filled bump had changed, but I didn’t find any pus on my underwear, so I believe the bump hasn’t burst.
I applied the ointment again, and when I got home from school in the afternoon, I noticed it had flattened out more, with just a small whitehead remaining, so I applied the medication again.
I would like to ask you, doctor, what kind of issue does this seem to be? Is it an anal abscess, or is it just a case of folliculitis? Or could it be something else? Thank you, doctor!

ww, 10~19 year old female. Ask Date: 2024/04/22

Dr. Zhang Shuhao reply Surgery

If it is an anal abscess, it is usually located closer to the anal opening, and topical ointments are often ineffective.
Once it ruptures, there will be purulent discharge.
Your description is more similar to general folliculitis.
If you are concerned, you can visit a colorectal or dermatology clinic for an examination.

Reply Date: 2024/04/22

More Info

Hello! Thank you for reaching out with your concerns regarding the painful bump near your anus. Based on your description, it seems like you may be dealing with a few potential conditions, including a perianal abscess, a pilonidal cyst, or folliculitis. Let’s break down these possibilities and discuss appropriate treatments.

Possible Causes
1. Perianal Abscess: This is a localized collection of pus that can occur near the anus. It often results from an infection of the anal glands. Symptoms typically include pain, swelling, and sometimes fever. The area may feel hard and tender, and you might notice redness and warmth.

2. Pilonidal Cyst: This is a cyst that can occur near the tailbone but can also appear in the perianal area. It often contains hair and skin debris and can become infected, leading to pain and swelling.

3. Folliculitis: This is an infection of the hair follicles, which can occur anywhere on the body, including the anal area. It may present as small, red bumps that can be painful and may contain pus.

4. Hemorrhoids: While not exactly what you described, hemorrhoids can also cause bumps around the anal area and can be painful, especially when sitting or during bowel movements.

Treatment Options
1. Warm Compresses: Applying warm compresses to the area can help reduce pain and promote drainage if there is an abscess. This can be done several times a day.

2. Topical Antibiotics: Since you have already used an antibiotic ointment, continue to apply it as directed. This can help if the bump is due to folliculitis or a minor skin infection.

3. Oral Antibiotics: If the bump is indeed an abscess and shows signs of spreading infection (like increased redness, swelling, or fever), you may need to see a healthcare provider for oral antibiotics.

4. Avoid Squeezing: It’s important not to squeeze or pop the bump, as this can lead to further infection or complications.

5. Consult a Healthcare Provider: If the bump does not improve with home treatment, or if it worsens, it’s crucial to see a healthcare provider. They may need to drain the abscess or provide a more potent antibiotic treatment.

When to Seek Immediate Care
- If you experience increasing pain, fever, or if the bump starts to drain pus, you should seek medical attention promptly.
- If you notice any signs of systemic infection, such as chills or a rapid heartbeat, this is also a reason to seek immediate care.

Conclusion
Based on your description, it sounds like you may be dealing with a perianal abscess or possibly folliculitis. The fact that you noticed pus is significant and suggests that an infection may be present. While home treatments like warm compresses and topical antibiotics can be beneficial, it’s essential to monitor the situation closely. If symptoms persist or worsen, please consult a healthcare provider for a thorough evaluation and appropriate treatment.
Take care, and I hope you find relief soon!

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