A perianal skin tag is an excess growth of skin that is located near the anus. The growth projects away from the surface of the skin, assuming a tag-like appearance. Although some patients do not experience any symptoms in association with these skin growths, others can experience pain and itchiness. The treatment for a skin tag focuses on removing the growth and ensuring that it does not represent a more malignant disease process, such as a cancer.
Although they are considered to be abnormal growths, perianal skin tags are not malignant or cancerous in nature, and the skin cells present within the tags are completely normal. These growths can develop at any location around the anus, but more commonly occur toward the back of the anus, closer to the tailbone. They can range in size from less than 1 inch (2.54 cm) to approximately 2 inches (5.08 cm).
Patients can experience a variety of symptoms as a result of having a skin tag. They could have itchiness or pain at the site of the skin growth. Occasionally, fecal matter can accumulate around the skin tag, causing irritation. Other patients have no symptoms resulting from their skin tags, and might only notice their presence incidentally.
Although sometimes perianal skin tags develop for no apparent reason, in other cases they appear as complications from other disease. Patients with hemorrhoids can develop these growths as a result of straining and irritation. Often the skin tags develop associated with an anal fissure, which is a superficial tear in the external surface of the anal skin tissue. People suffering from inflammatory bowel disease are at an increased risk for developing these growths.
Diagnosing a patient with a skin tag is typically done on the basis of visual inspection. Other diseases that could mimic anal tags include anal warts, skin cancer, and hemorrhoids. It is important for the health care professional examining the perianal skin tag to thoroughly examine the surrounding area to look for other abnormalities including anal fissures and fistulas, which are abnormal connections between the gastrointestinal tract and external skin that can result in leakage of fecal matter and an increased risk for infection.
The mainstay of treatment of a perianal skin tag is surgical removal. Sometimes this procedure can be performed as an in-office procedure not requiring hospitalization or general anesthesia. Often the skin tag that has been removed is sent to a pathologist for a microscopic review of cells making up the skin tag to assure that it does not represent another more dangerous pathologic process, such as a skin cancer.
What Causes Anal Skin Tags
The anal skin tag cause varies from person to person, but what each case has in common is pressure. Many medical conditions can cause excessive pressure when defecating, not all of which result in skin tags. However, repeated issues increase the likelihood of developing skin tags.
Crohn's Disease
Crohn's disease affects the digestive tract. Individuals with this condition experience the following:
- Malnutrition
- Fatigue
- Severe diarrhea
- Abdominal pain
The inflammation can make it difficult and painful to empty the bowel. Straining to do so can create skin tags.
Hemorrhoids
About 75% of adults experience hemorrhoids, making them incredibly common. Skin tags form after hemorrhoids heal, and the inflammation goes down, leaving stretched-out skin.
Excessive Friction
Surprisingly, skin tags may not be the product of a medical condition at all. Everyday friction is also a common cause.
Tight clothing, extended periods of sitting and exercise can all create friction along the perineum. If irritation persists, skin tags may form.
Blood Clots
Blood clots are a normal part of the healing process, as they stop bleeding. However, they can cause problems when they don't dissolve properly or appear where they shouldn't. If you get blood clots near the anus, the swelling can lead to perianal skin tags.
Pregnancy
Skin tags are common during pregnancy for several reasons. For one, many pregnant people get hemorrhoids. Additionally, hormones may cause dermatological changes leading to skin tags on several parts of the body. Finally, the weight gain that naturally accompanies pregnancy may cause skin tags when stretched skin remains afterward.
Heavy Lifting
Though you may not know it, heavy lifting can hurt more than your back. If you strain while lifting a heavy object, you can put pressure on the blood vessels in your rectum, leading to swelling.
Diarrhea
Diarrhea is a significant source of irritation to the anus and perineum, as individuals may repeatedly wipe to clean themselves. To make matters worse, stool is acidic and can cause a burning sensation when loose. Together, these factors can cause enough friction to form skin tags.
Constipation
On the other end of the spectrum, constipation can cause skin tags when people strain to have a bowel movement. The anus and perineum are naturally stretchy to allow stool to pass, but hard stools can cause irritation and excessive stretching. They can even cause vein inflammation if they put pressure on blood vessels.
Scarring
Anal fissures are tears in the lining of the anus, and when they heal, they may leave scar tissue. This excess tissue can then form skin tags.
How To Remove Perianal Skin Tag
The good news is, getting rid of perianal skin tags is relatively easy. The procedure is non-invasive, and most people can return to work within a day.
In most cases, physicians perform the procedure in their offices. On the day of the appointment, you'll need to disrobe. Your doctor will help you find a comfortable position that provides access to the skin tag.
Cleaning
The first step is to clean the area. The area near the anus is at a high risk of holding bacteria, which can cause infection. Your physician will use a sterile, one-use wipe to clean the tag and surrounding skin.
Sedation
If you're anxious about the procedure, your physician may offer you a sedative. This medication will help you relax.
Numbing
Next, your physician will numb the area around the skin tag. Removing skin tags usually involves cutting, which would be painful without some numbing agent. Your physician may use a local anesthetic or a numbing cream to ensure you don't experience any discomfort. The effects can last up to five hours.
Removal
There are a few ways to remove skin tags, and which your doctor uses depends on the size of the tag, its location and other concerns, such as underlying medical conditions. Laser removal is a common approach, as it's quick and doesn't involve cutting. During this procedure, a medical laser targets the skin tag and burns it away.
Another popular approach is cryotherapy, which freezes the skin tag using liquid nitrogen. Unlike other options, this procedure takes a few days to see results, as you have to wait for the excess skin to fall off.
Finally, your doctor may choose to simply cut off the skin tag using surgical-grade scissors. You won't need stitches in most cases since the tag is snipped at the base. However, larger tags may need sutures to ensure proper healing.
Antibiotics
After the procedure, your physician will prescribe antibiotics to limit the likelihood of infection. If you have concerns about pain, your doctor can recommend an over-the-counter medication.
