How is the anal skin identified and removed?

Article by Master, Doctor Mai Vien Phuong - Department of Examination & Internal Medicine - Vinmec Central Park International General Hospital.

Anal excess skin is benign skin and is of common origin. Excess anal skin looks like small bumps or raised areas on the anus. Excess anal skin can be many at once. Although the extra skin in the anus can be sensitive, it is rarely painful. However, it can be very uncomfortable and itchy. So how to identify and remove the anal skin?

The skin around the anus is often more sensitive than the skin on other parts of the body. Because the skin in the anal area needs to stretch during bowel movements. If a blood vessel near the anus swells or enlarges, it can lead to a wound in the skin. This is because excess skin remains even after the swelling is gone.
The cause of blood vessels to swell or swell is usually due to:
Straining to have a bowel movement due to constipation Diarrhea Heavy lifting Strenuous exercise Hemorrhoids Pregnancy Blood clots If the patient has hemorrhoids or other diseases other vascular conditions around the anus, may be more likely to have anal milia.
If you have Crohn's disease or another inflammatory condition, the skin may form due to inflammation. In a review article on this condition, up to 37% of people with Crohn's disease developed anal milia.

Although anal fasciitis is benign, they can still be a cause for concern. That's why you should see your doctor to confirm the bump or bulge you feel is the result of an injury to the skin and not a tumor or blood clot.
To make a diagnosis, your doctor will likely conduct a physical exam. During the exam, you may be asked to remove your underwear and lie on your side. The doctor may perform a visual examination and look at the anus for signs of skin injury. They may also perform a rectal exam and insert a finger into the rectum to feel for masses or bulges.
If the doctor needs more information to make a diagnosis, he or she may also use either procedure to look inside the anal opening and the rectum. Both anoscopy and sigmoidoscopy can help rule out any underlying anorectal conditions or concerns, such as cancer.
The doctor may also take a tissue sample or biopsy and send it to a lab for testing.
Once a diagnosis is made, your doctor can begin to discuss your treatment options. Removal of excess anal skin can sometimes be recommended, but in some cases no intervention is needed. This will depend on the form and cause of the excess anal skin.

Anal skin removal is usually an operating room or minor surgery procedure. Excess anal skin on the outside of the anus can be easily accessed and removed by doctors.
For this procedure, the doctor will inject a numbing medicine around the skin to lessen the feeling of pain. You may also be given a sedative to help you relax. Before removing excess skin, your doctor will clean the area with antibacterial soap.
The process of removing excess anal skin is very quick and simple. The doctor will use a scalpel to cut off the excess skin, then use dissolving sutures or sutures to close the incision.
Some doctors may use a laser or liquid nitrogen instead of surgical removal. Cryotherapy, using liquid nitrogen, freezes the skin. In a few days, the excess skin will fall off on its own. The laser burns off excess anal skin and any remaining skin falls off.
To prevent complications, the doctor may only remove part of the anal skin at a time. This gives the area time to heal and reduces the risk of a fecal or bacterial infection.

Recovery time after anal skin removal is quick. After the procedure, you will need to stay home and relax. You should not lift heavy objects or exercise.
You can return to work the next day and resume normal activities within a week.
Your doctor may prescribe a course of antibiotics to reduce the risk of infection. They may also prescribe an antifungal cream and a topical pain reliever to apply to the anus. These creams can help promote healing and reduce pain or sensitivity in the days following ablation.
What to expect during recovery
Recovery from anal sclerotherapy is usually easy, but it is important that you follow your doctor's aftercare advice. The infection can delay healing and you may need further treatment to stop the bacteria from spreading.
During the first days after the procedure, your doctor may suggest that you take a laxative or try a diet. This will make bowel movements easier and reduce your chances of becoming constipated.
Pressure on the anus can cause pain near the ablation site. If you are experiencing pain or other discomfort, using a topical pain reliever can help ease your symptoms.

After anal skin has been removed, talk with your doctor about strategies to prevent future anal excess skin. Being aware of conditions that can cause excess anal skin can help you avoid them.
Try these home precautions to avoid more anal skin injuries:
Take a laxative or fiber supplement to make stools softer and easier to pass. Apply lubricant or grease to the rectum before having a bowel movement to make it easier to pass stools. Clean and sanitize the anus after each bowel movement to help avoid friction and irritation that can lead to skin lesions. These measures may not always be enough to prevent an anal skin wound. If you suspect you have one or have developed another, talk to your doctor to confirm the suspicious location.

If you develop an anal excess skin, it is probably not cause for concern. For most people, excess anal skin is just a nuisance. If they don't bother you and you are sure of the diagnosis, you can leave it alone and no intervention is needed. Remember that where you have excess anal skin, other anal skin may appear.
Some anal excess skin does not go away. You may need more than one treatment to get rid of them. If excess anal skin is frozen or peeled off, it may take several weeks for the excess skin to fall off. In some cases, the excess anal skin will grow back and need to be removed again.
Conclusion
If you have an area of ​​skin that develops that bleeds, itch, or changes color, contact your doctor immediately. They will need to rule out a serious condition such as skin cancer.
Common and harmless — anorectal prolapses are small bumps on the anus that can feel itchy. Causes include hemorrhoids, diarrhea, and inflammation. Your doctor can remove excess anal skin with a procedure in the operating room. Laxatives and a liquid diet can help with recovery, and lubricants can prevent more cards from forming.

References
Bonheur JL, et al. (2008). Anal skin tags in inflammatory bowel disease: New observations and a clinical review. DOI: 10.1002/ibd.20458 Deep vein thrombosis. (2017). medlineplus.gov/deepveinthrombosis.html Hemorrhoids. (2017). familydoctor.org/condition/hemorrhoids/ Mayo Clinic Staff. (2017). Anal fist. mayoclinic.org/diseases-conditions/anal-fissure/symptoms-causes/syc-20351424 Safar B, et al. (2007). Perianal Crohn's disease. DOI: 10.1055/2Fs-2007-991027 Spanos CP. (2012). Anal skin tags: Removal made simple. DOI: 10.1111/j.1463-1318.20122.03087.x