From the Research
For an inflamed, painful anal skin tag with excessive bleeding while awaiting surgical removal, I recommend a multi-faceted approach to manage symptoms, prioritizing the use of topical lidocaine for pain relief, as supported by recent studies such as 1. This approach should include taking sitz baths in warm water for 10-15 minutes, 2-3 times daily to reduce inflammation and pain.
- Apply a topical anesthetic containing lidocaine (such as Preparation H with lidocaine or RectiCare) to the area up to 4 times daily for pain relief, as lidocaine has been shown to be effective in managing pain with minimal systemic adverse events 2, 3.
- Use gentle, alcohol-free baby wipes instead of toilet paper, and pat dry rather than rubbing to prevent further irritation.
- Take over-the-counter pain relievers like acetaminophen (Tylenol) 500-1000mg every 6 hours or ibuprofen 400-600mg every 6-8 hours as needed for pain and inflammation.
- For excessive bleeding, apply gentle pressure with clean gauze and seek immediate medical attention if bleeding is heavy or doesn't stop.
- Avoid constipation by increasing fiber intake to 25-30g daily, drinking plenty of water, and considering a stool softener like docusate sodium (Colace) 100mg twice daily. It's also important to be aware of potential allergic reactions to topical medicaments, including lidocaine, as reported in studies like 4, although the benefits of lidocaine in pain management are well-documented and supported by more recent and higher quality evidence 1.