How to Differentiate Between Pimples and Hemorrhoids Near the Anus? - Surgery

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What are the differences between acne and hemorrhoids?


How can a doctor determine whether a bump near the anus is a pimple or hemorrhoids? Today, when I used the restroom and wiped, I noticed some bleeding.
My daily routine is normal, and I have regular bowel movements without constipation.
The bleeding resembles that of a typical pimple, and it feels similar in shape.
There is a slight pain, but I only feel it when I touch it.
The bump is located about 1-2 cm from the anus, and there is hair in that area.
Could this be a pimple? If it is a pimple, how can I help it heal faster, considering that this area seems to have more bacteria? Thank you, doctor.

JEN, 20~29 year old female. Ask Date: 2010/02/05

Dr. Ke Fangxu reply Surgery


Hello, in response to your question: The so-called pimples are mostly folliculitis or sebaceous cysts located on the sides of the buttocks.
Hemorrhoids, on the other hand, only occur at the anal opening.
If there is a distance from the anal opening and the skin in between is normal, then it is unlikely to be hemorrhoids.
If you notice blood when wiping after using the restroom, it is important to determine whether the blood is coming from the anus or from the so-called "pimples." It is generally recommended to gently press the anus and buttocks with clean toilet paper to see where the blood is coming from, which can help identify the source of the bleeding.
Based on your description, it seems that both conditions are present: mild hemorrhoidal bleeding and skin lesions on the buttocks.
It is advisable to maintain local cleanliness and hygiene, and if necessary, to consider oral and topical antibiotic treatment.
However, it is still recommended to visit a hospital for a proper examination by a physician to obtain an accurate diagnosis and appropriate treatment.
Otherwise, neglecting medical advice may lead to more serious consequences.
It is also not advisable to self-medicate with over-the-counter drugs.
If symptoms worsen, seek medical attention as soon as possible.
Sincerely, Dr.
Ke Fangxu, Keelung Hospital.

Reply Date: 2010/02/05

More Info


When trying to differentiate between pimples and hemorrhoids near the anus, it's important to consider several factors, including the appearance, location, symptoms, and underlying causes of the lesions.
Pimples, or acne lesions, can occur anywhere on the body, including the skin around the anus. They are typically characterized by a raised, red bump that may contain pus, and they can be painful or tender to the touch. Pimples are often caused by clogged hair follicles, bacteria, or excess oil production. In the anal area, they can be exacerbated by friction, sweating, or irritation from clothing or hygiene products.

On the other hand, hemorrhoids are swollen veins in the lower rectum or anus. They can be classified as either internal or external. External hemorrhoids are located under the skin around the anus and can cause pain, itching, and bleeding, especially during bowel movements. They may appear as a lump or swelling near the anus and can be sensitive to touch. Hemorrhoids are often caused by increased pressure in the rectal area due to factors such as straining during bowel movements, prolonged sitting, pregnancy, or obesity.

In your case, the presence of blood when wiping after a bowel movement is a significant symptom that could indicate hemorrhoids. The fact that you mentioned the lesion is located about 1-2 cm from the anus and has a bit of pain when touched also leans towards the possibility of hemorrhoids, especially if the bleeding is associated with bowel movements.
To further differentiate between the two, consider the following:
1. Appearance: Pimples may appear as red bumps with a white or yellow center (pus), while hemorrhoids may look like swollen lumps or bumps that are bluish in color.

2. Symptoms: If you experience itching, burning, or pain during bowel movements, it may suggest hemorrhoids. Pimples may be painful but typically do not cause the same level of discomfort during bowel movements.

3. Location: While both can occur near the anus, hemorrhoids are more likely to be found at the anal margin, while pimples can occur anywhere in the surrounding skin.

4. Bleeding: If you notice bright red blood on the toilet paper or in the stool, this is more characteristic of hemorrhoids. Pimples may not typically cause bleeding unless they are ruptured or severely inflamed.

If you suspect that the lesion is a pimple, maintaining good hygiene is essential. You can gently cleanse the area with mild soap and water, and avoid using harsh products that may irritate the skin further. Applying a warm compress can help reduce inflammation and promote healing. Over-the-counter topical treatments containing benzoyl peroxide or salicylic acid may also be beneficial for treating acne.

However, if you suspect that it is a hemorrhoid, it is advisable to manage it with lifestyle changes such as increasing fiber intake, staying hydrated, and avoiding straining during bowel movements. Over-the-counter treatments like hydrocortisone creams or witch hazel pads can provide relief from symptoms.

In any case, if the symptoms persist, worsen, or if you experience significant pain or bleeding, it is crucial to consult a healthcare professional for a proper diagnosis and treatment plan. They may perform a physical examination and, if necessary, recommend further tests to ensure that there are no underlying conditions that need to be addressed.

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