Health Conditions A-Z Digestive Disorders What Are External Hemorrhoids? By Lindsay Curtis Lindsay Curtis Lindsay Curtis is a freelance health & medical writer in South Florida. Prior to becoming a freelancer, she worked as a communications professional for health nonprofits and the University of Toronto’s Faculty of Medicine and Faculty of Nursing. health's editorial guidelines Published on October 6, 2023 Medically reviewed by Robert Burakoff, MD Medically reviewed by Robert Burakoff, MD Robert Burakoff, MD, MPH, is a board-certified gastroenterologist who serves as vice chair of Ambulatory Services at Lower Manhattan Hospital and professor of medicine at the Weill Cornell Medical College. learn more In This Article View All In This Article Symptoms Causes Diagnosis Treatment Prevention Complications FAQs External hemorrhoids are swollen veins under the skin around the anus. With external hemorrhoids, you may notice swelling or a lump or have symptoms like itchiness and pain near your anus. Hemorrhoids form when there is increased pressure on the veins in your rectal area. Straining during bowel movements or chronic constipation are common causes. Most external hemorrhoids can be treated with lifestyle modifications and home remedies, though surgery may be recommended for more severe cases. Hemorrhoids can affect people of all ages but are most common in adults between the ages of 45 to 65. It is estimated that about 5% of all people have hemorrhoids, although they likely affect about 50% of people over age 50. Illustration by Dennis Madamba for Health External Hemorrhoid Symptoms Symptoms of external hemorrhoids vary from person to person. Many people with external hemorrhoids do not have any symptoms. Others may experience common symptoms such as: Anal itching Pain or aching, which may worsen during bowel movements or when sitting down One or more lumps on the skin near the anus that may be felt or seen Bleeding during bowel movements (you may notice blood on toilet paper or in the toilet bowl after pooping) What Causes External Hemorrhoids? External hemorrhoids are enlarged and swollen veins around the anus that develop due to increased pressure. Several factors can put additional pressure on the anal and rectal veins, including: Chronic constipation or straining during bowel movements Pregnancy, due to pressure from the enlarged uterus, developing baby, and increased blood flow to the pelvic area Chronic diarrhea Sitting on the toilet for long periods Engaging in repetitive heavy lifting Risk Factors Certain risk factors can make you more prone to developing external hemorrhoids, including: Having a family history of hemorrhoids Eating a low-fiber diet A sedentary lifestyle (sitting for long periods) Having obesityAging, due to weakened tissues in the anus and rectum How 7 Common Diet Plans Can Affect Your Poop, According to Experts Diagnosis To diagnose external hemorrhoids, your healthcare provider will begin by asking about your symptoms and medical history. They will also perform a physical examination. They can usually diagnose external hemorrhoids by visually inspecting your anal area to look for signs of external hemorrhoids, such as red, irritated anal skin, a visible lump, and skin tags, which are left behind when external hemorrhoids dissolve. Your healthcare provider may perform a digital rectal examination to check for internal hemorrhoids. This involves inserting a lubricated, gloved finger into your rectum to check for internal lumps. If they feel any lumps inside your rectum, they may order a test called an anoscopy. During an anoscopy, a small instrument with a light attached (anoscope) is inserted into the anus, which helps them see the anal canal and lower rectum to look for internal hemorrhoids or other potential causes of your symptoms. Treatments for External Hemorrhoids Most external hemorrhoids heal on their own, and the pain usually goes away within a few days. But the hemorrhoid may take up to three weeks to heal completely. Home Remedies Your healthcare provider may recommend self-care measures and over-the-counter (OTC) treatments to relieve symptoms and promote healing. Ways to treat hemorrhoids at home include: Using a sitz bath or sitting in a warm bath to relieve pain Eating a diet high in fiber and drinking plenty of fluids (e.g., water) to soften the stool and ease bowel movements Avoiding straining during bowel movements, and do not sit on the toilet for long periods Using a stool softener or taking a fiber supplement, such as Citrucel (methylcellulose) or Metamucil (psyllium) Over-The-Counter Medications OTC external hemorrhoid treatments may temporarily relieve itching, pain, and inflammation. These include: Topical creams and ointments: Creams containing ingredients like hydrocortisone or lidocaine are applied directly to the affected area to soothe pain and itching Medicated wipes or pads: Cleaning the anal area with these products can soothe discomfort after bowel movements Pain relievers: OTC pain relievers, such as Advil (ibuprofen), Tylenol (acetaminophen), or Aleve (naproxen), can help reduce pain and inflammation Medical Procedures If at-home treatments don’t help, you have heavy bleeding, or a blood clot has developed in the hemorrhoid, your healthcare provider may recommend medical procedures or surgery to shrink or remove external hemorrhoids. Common medical treatments include: Rubber band ligation: This procedure involves placing rubber bands at the base of the hemorrhoid to cut off its blood supply. Eventually, the hemorrhoid shrinks and falls off.Sclerotherapy: A chemical solution is injected into the hemorrhoid to shrink and scar it. This is a quick and painless procedure for mild to moderate hemorrhoids.Hemorrhoidectomy: Surgical hemorrhoid removal may be necessary for large, thrombosed, or recurrent hemorrhoids. Prevention Certain lifestyle modifications may help prevent external hemorrhoids. You can lower your risk of developing hemorrhoids by: Eating fiber-rich foods, such as fruits, vegetables, and whole grains Drinking plenty of non-alcoholic fluids Avoiding prolonged straining or pushing during bowel movements Using OTC stool softeners or fiber supplements (as needed) Complications Sometimes external hemorrhoids can lead to complications that require medical attention. Possible complications include: Blood clot: Known as a thrombosed external hemorrhoid, a blood clot can cause severe pain, swelling, and a hard lump that makes it difficult to sit, stand, or walk. Skin tags: When a thrombosed external hemorrhoid dissolves, it can leave a small flap of skin (skin tag) Anemia: A condition characterized by low levels of iron in the blood, which can occur from excess bleeding Infection: If an external hemorrhoid is injured due to scratching or inadequate hygiene, bacteria can enter the affected area and cause an infection. A Quick Review External hemorrhoids are swollen veins around the anus. They can cause itching, pain, swelling, and bleeding. Factors like chronic constipation, straining during bowel movements, pregnancy, and obesity contribute to their development. Most external hemorrhoids go away with self-care measures; over-the-counter treatments can help relieve symptoms and promote healing. Eating fiber-rich foods and avoiding straining during bowel movements can help prevent hemorrhoids. If left untreated, external hemorrhoids can lead to complications such as a blood clot in the hemorrhoid, infection, or anemia. If you have symptoms of an external hemorrhoid, see a healthcare provider for diagnosis and treatment recommendations. Frequently Asked Questions Are external hemorrhoids serious? External hemorrhoids are common and are usually not considered serious. Though they can cause pain, itching, and general discomfort, most resolve on their own or with appropriate self-care measures or treatment. Can you push external hemorrhoids back in? No, it is not recommended to push external hemorrhoids inside the anus. Unlike internal hemorrhoids that form inside the rectum, external hemorrhoids develop under the skin outside the anus. Attempting to push them into the anus can cause further irritation or injury. Do external hemorrhoids go away? Most external hemorrhoids can go away on their own. Symptoms usually subside within a few days; most are healed completely within three weeks. Self-care measures—such as sitz baths, eating high-fiber foods, and using over-the-counter remedies—can help relieve symptoms and promote healing. Severe or persistent cases may require medical intervention. Can you touch external hemorrhoids? You can touch external hemorrhoids, but it is important to do so with gentle and clean hands. Avoid excessive touching or scratching of external hemorrhoids to prevent further irritation or potential infection. Was this page helpful? Thanks for your feedback! Tell us why! Other Submit 12 Sources Health.com uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. American Society of Colon & Rectal Surgeons. Hemorrhoids. MedlinePlus. Hemorrhoids. Sun Z, Migaly J. Review of hemorrhoid disease: Presentation and management. Clin Colon Rectal Surg. 2016;29(1):22-29. doi:10.1055/s-0035-1568144 National Institute of Diabetes and Digestive and Kidney Diseases. Definition and facts of hemorrhoids. National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms & causes of hemorrhoids. Poskus T, Sabonyte-Balsaitiene Z, Jakubauskiene L, et al. Preventing hemorrhoids during pregnancy: a multicenter, randomized clinical trial. BMC Pregnancy Childbirth. 2022;22(1):374. doi:10.1186/s12884-022-04688-x Kibret AA, Oumer M, Moges AM. Prevalence and associated factors of hemorrhoids among adult patients visiting the surgical outpatient department in the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. PLoS One. 2021;16(4):e0249736. doi:10.1371/journal.pone.0249736 National Institute of Diabetes and Digestive and Kidney Diseases. Diagnosis of hemorrhoids. American Family Physician. Hemorrhoids. National Institute of Diabetes and Digestive and Kidney Diseases. Treatment of hemorrhoids. U.S. Food and Drug Administration. CFR - Code of federal regulations title 21. American Society of Colon & Rectal Surgeons. Hemorrhoids - expanded version.