Anal skin tags, haemorrhoids or warts
How to tell them apart, and why it matters
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Not sure which of the three you are looking at? Dr Corjos will tell you at your consultation.
Three different things, often confused for one another, treated in three completely different ways. This page explains how they differ and how we tell them apart at consultation.
Most people who come to us convinced they have an anal skin tag have looked at a search-results page and a mirror and made a reasonable guess. Quite often they are right. Sometimes they are not, and the difference matters a great deal, because a skin tag, a haemorrhoid and an anal wart are managed in three entirely different ways.
Nothing here replaces being examined. It is here so you know what the possibilities are and what questions to ask.
The differences at a glance
Three columns – swipe the table sideways to see them all
| Anal skin tag | Haemorrhoid | Anal wart | |
|---|---|---|---|
| What it is | A soft flap of excess skin at the anal margin | A swollen vascular cushion inside or at the edge of the anal canal | A growth caused by human papillomavirus (HPV) |
| How it looks | Skin-coloured, soft, flat or slightly raised | A lump, swelling or bulge; may look purple or blue if a clot has formed | Often several, small, sometimes described as cauliflower-like, sometimes flat |
| How it feels | Usually nothing, until it catches or makes cleaning difficult | Itching, aching, a dragging sensation, sometimes sharp pain | Often nothing; sometimes itching or irritation |
| Bleeding | Not usually | Common, typically bright red on the paper or in the pan | Can bleed if caught or irritated |
| Passed to others | No | No | Yes. HPV is passed on by skin-to-skin contact |
| Does it change | No. Once formed it stays | Often flares and settles again | Can spread or multiply over time |
| Usual treatment | Minor surgical removal under local anaesthetic, if it is causing symptoms | Conservative measures, banding or surgery, depending on grade | Topical treatment or ablation, alongside sexual health advice |
Why skin tags and haemorrhoids get confused so often
Because they are frequently the same story at different points in time. When an external haemorrhoid swells and then settles, the skin that was stretched over it does not always shrink back. What is left behind is a skin tag.
So a patient who says I have had piles for years and now there is a lump that never goes away is often describing exactly that: the haemorrhoid has resolved, and a tag has been left in its place. The tag is not a haemorrhoid, it will not flare, and treating it as one will not help.
The practical difference is this. A haemorrhoid may respond to conservative treatment. A skin tag will not. It is skin, and it stays until it is removed.
The one not to self-diagnose
Anal warts are caused by HPV. They can be passed on by skin-to-skin contact, they can multiply, and they are treated quite differently from a skin tag. Removing what turns out to be a wart without recognising what it is means the underlying infection goes unaddressed, and anybody else at risk goes uninformed.
This is the single strongest argument for having anything in this area looked at by a doctor before deciding what it is. It takes a few minutes, and it is the difference between treating the right thing and the wrong one.
How we tell them apart
Most of the distinction is visual to a doctor who looks at this area regularly. The examination itself takes a couple of minutes, with a female chaperone present, and it is the difference between treating the right thing and the wrong one.
A private, calm setting, for your comfort and your discretion. You are seen in a private consulting room with a female chaperone present throughout, you are never asked to explain why you are here in front of anybody else, and our Belgravia clinic has no shopfront and no signage on the street.
History first. How long it has been there, whether it changes, whether there is bleeding or pain, whether there has been a history of haemorrhoids, constipation, straining or childbirth, and your general medical history.
Examination. A brief, direct examination with a female chaperone present. Most of the distinction is visual to a doctor who looks at these regularly.
A plan, not a sale. If it is a simple skin tag and it is bothering you, removal is straightforward. If it is a haemorrhoid, or a wart, or something that needs a colorectal opinion, we will say so and explain what should happen instead.
When to be seen sooner rather than later
Most things in this area are benign and unhurried. Some are not. Please arrange to be seen promptly, by us or by your GP, if you have:
- bleeding that is dark, or mixed through the stool rather than on the surface or the paper
- pain that is persistent rather than occasional
- a lump that is growing, hardening or changing in appearance
- a change in your bowel habit that has lasted more than a few weeks
- unexplained weight loss
None of these mean something serious is happening. They do mean it should be looked at rather than watched.
If it is a skin tag
Removal is a minor procedure under local anaesthetic, taking around 30 minutes, performed at Bodyvie by Dr Vadim Corjos (GMC 7822977), a cosmetic surgeon with fifteen years of surgical practice across general, trauma and reconstructive surgery, with a female chaperone present throughout.
The cost
From £495, plus £100 per additional tag. The £100 surgical consultation is redeemable against treatment.
Related reading
Crohn’s disease
Why skin tags matter in Crohn’s, and why removal is usually the wrong answer.
After pregnancy
What settles on its own, how long to wait, and when removal makes sense.
Belgravia
Discreet treatment at 11A West Halkin Street, SW1. No street signage.
Frequently asked questions
How can I tell if I have a haemorrhoid or an anal skin tag?
The most useful clue is whether it changes. A haemorrhoid tends to flare and settle, often with bleeding and aching. A skin tag is constant. It does not come and go, it does not usually bleed, and it does not usually hurt. It is also very common to have had both, because an external haemorrhoid that settles can leave a skin tag behind.
Are anal skin tags the same as piles?
No, although they are often related. Piles, or haemorrhoids, are swollen vascular cushions. A skin tag is excess skin, frequently left behind after an external haemorrhoid has resolved. The tag will not respond to haemorrhoid treatment because it is skin, not a swollen blood vessel.
How do I know it is not a wart?
You often cannot, which is the point of being examined. Anal warts are caused by HPV, tend to be multiple, can spread, and are treated differently. A doctor who looks at these regularly can usually tell the difference on examination in a few minutes.
Are anal skin tags sexually transmitted?
No. Anal skin tags are not infectious and cannot be passed to anybody. Anal warts can be, which is another reason to have the diagnosis confirmed rather than assumed.
Will anal skin tags go away on their own?
No. Once a skin tag has formed it is established skin and it will not shrink away. Haemorrhoids can settle by themselves; skin tags do not.
Do anal skin tags need to be removed?
Not for their own sake. They are benign. Removal is worth considering when a tag causes ongoing irritation, catches, becomes repeatedly inflamed or makes the area difficult to keep clean.
Can the NHS remove anal skin tags?
Generally not. NHS commissioning policies treat removal of benign skin lesions as not routinely funded, and removal is usually only commissioned where there are clinical features that require investigation.
What happens if I just leave it?
For most people, nothing. A benign skin tag that is not causing symptoms can reasonably be left alone. What should not be left alone is anything that bleeds, hurts, or is changing, because that needs a diagnosis rather than a decision.
Related reading
Wart removal, for common and plantar warts elsewhere on the body. Genital skin tag removal, the same procedure in a neighbouring area.
Not sure what you are looking at? Book a consultation with Dr Vadim Corjos at Richmond or Belgravia. The surgical consultation is £100, paid when you book online and redeemable in full against treatment. Your appointment is booked as 50 minutes, so where Dr Corjos is satisfied it is appropriate, the tag is assessed and removed at that same visit and you only need to come in once. A female chaperone is present throughout.
020 7100 0744
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