From the Guidelines
Anal skin tags are typically benign growths that can be managed conservatively. The causes of anal skin tags can be attributed to various factors, including inadequate hygiene, minor incontinence, or perianal dermatitis 1. It is essential to note that anal skin tags can be mistaken for other conditions, such as hemorrhoids, and a careful anorectal evaluation is warranted to determine the underlying cause of symptoms 1.
- Treatment options for anal skin tags include:
- Topical treatments, such as hydrocortisone cream 1% applied twice daily for 2-4 weeks
- Surgical excision, which can be performed under local anesthesia with a procedure time of approximately 15-30 minutes, although this is not recommended for patients with Crohn's disease due to a high rate of postoperative complications 1
- Post-procedure care for surgical excision typically involves applying a topical antibiotic ointment, such as bacitracin, 2-3 times daily for 7-10 days to promote wound healing and prevent infection. However, it is crucial to approach the treatment of anal skin tags with caution, especially in patients with underlying conditions such as Crohn's disease, where excision is not recommended due to the risk of poor wound healing and subsequent proctectomy 1.
From the Research
Causes of Anal Skin Tags
- Anal skin tags are a common finding, and are found in one-third of patients with benign anal disorders 2
- They can be associated with Crohn's disease, as granulomas were found in both anal skin tags and rectal biopsies in some patients with the disease 3
- Anal skin tags can also be associated with metabolic syndrome and its components, such as high waist circumference, low high-density lipoproteins (HDLs), diabetes, and hypertension 4
Treatments of Anal Skin Tags
- A simple method of anal skin tag removal during stapled anopexy has been described, which involves utilizing the circular anal dilator provided with the stapling kit 2
- Excision of anal skin tags can be performed under local anesthesia as an outpatient procedure, and can provide a simple technique for obtaining histological confirmation of Crohn's disease 3
- Hemorrhoidectomy and excision of skin tags can be safely performed in patients with inflammatory bowel disease (IBD), with minimal risk of long-term complications 5
- Topical treatments may not be directly applicable to anal skin tags, but can be used for other skin conditions such as skin cancer 6