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Anal (Skin)Tags & Pruritis Ani


Loose or redundant peri-anal skin

Anal (skin) tags

Anal skin tags are folds of loose peri-anal skin.

They are common and benign and often associated with haemorrhoids.

Symptoms include discomfort, itch and difficulty with anal cleaning leading to itch (pruritus).

Anal tags do not cause bleeding.

Conservative management

Tags will mostly be managed conservatively with reassurance and advice.

Rectal examination should be performed to exclude an anal or low rectal malignancy.

Advice can be given regarding anal hygiene (pruritus ani) and avoidance of soap, shower gel and other topical agents to the anal skin.

See pruritus ani golden rules:

  • Keep the area as clean as possible, carefully washing and gently drying the area at least once a day and after each bowel movement.
  • Don’t use soap as it can sting. It is best to use water on your hand rather than a flannel.
  • Use soft toilet paper or damp cotton wool if this is more comfortable.
  • If your leakage continues after cleaning into the anus, use a small plug of cotton wool in the anus to prevent the faeces or mucus from coming out and irritating the skin.
  • Dry the area by gently patting with a soft towel or tissue. Avoid rubbing.
  • Do not use any creams, deodorants, talcum powder, antiseptics or anything else on your anus, apart from the treatment suggested by your specialist.
  • Do not put anything in bath water – avoid all antiseptics, bath salts, bath oils and bubble bath.
  • Wear loose cotton underwear and change this every day. Avoid man-made fabrics coming into contact with the skin around your bottom. Women should wear stockings or open-crotch tights rather than regular tights to reduce sweating.
  • You should also avoid tight trousers or jeans and sitting on plastic chairs for long periods of time.
  • Wash your underwear in non- biological washing powder and make sure that all traces of detergent are rinsed out.
  • A diet that is high in fibre makes the faeces softer and more likely to cause leakage
  • Avoid lagers and flat beers as these can make the problem worse.
  • Avoid coffee, chocolate and fruit juices high in citric acid as these too make the pruritis worse.

Surgical management

If conservative measures fail to adequately control symptoms then anal tags can be excised surgically.

This is usually done as a day case under GA and requires a referral to colo-rectal surgery.


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