Hemorrhoids are prolapsed, engorged, or protruding veins in the perianal region. Prolapsed internal hemorrhoids may require medical attention due to blood flow concerns.
Sometimes people can mistake pimples and other conditions around the perianal area for hemorrhoids. This post provides a comprehensive overview of the differences between pimples and hemorrhoids, their causes, risk factors, and possible treatment.
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Hemorrhoids are swollen veins in your rectum or anus. But there are instances when a blood clot forms inside these hemorrhoids in your rectum or anus, causing swelling and discomfort. If the swelling is sensitive or painful, there is a likelihood it is hemorrhoid.
Often, hemorrhoids occur as bulging, enlarged blood vessels around the lower rectum and anus. The rectum is the rear section of the large intestine that opens up to the anus and the outside. The tissues around the vessels enlarge, and the walls thin out, which may result in bleeding.
When the pressure and stretching continue, the compromised vessels may protrude. You can then experience internal and external hemorrhoids. The skin around hemorrhoids may also become sensitive as they form near the anus. These lesions are usually painless but can be very painful when they become large enough and form blood clots (thrombosis).¹
Thrombosed external hemorrhoids can cause severe pain. The blood clots form on the outer section of hemorrhoids in the anal area, forming a painful mass that appears abruptly and may worsen within 48 hours. Some people experience relief as time progresses, while the hemorrhoids may bleed if the skin ruptures.
Internal hemorrhoids often occur within the anus, under the skin’s lining. Some most common symptoms include protrusion during bowel movement and painless bleeding. Internal hemorrhoids may also cause significant pain if they prolapse.
Pimples on the perianal area are similar to those that people develop on other body parts, including the face. Folliculitis is the term for pimples that develop on the face, back, and chest.
Most whiteheads have the same color as the skin, but some may be slightly lighter and occur when bacteria and debris clog the pore, resulting in the formation of a bump. If it looks swollen, inflamed, or feels sandpapery, you may have papules in the anal region.
Some people develop pus-filled pustules with a white or yellow center. We recommend not popping pimples as they could tear the skin and cause scarring or an infection.
Often, pimples in the anal area are not painful. However, you may experience irritation when passing stools. This is primarily associated with hemorrhoids that are large or swollen.
Physicians may diagnose the possibility of growths around the anus, such as warts, abscesses, or hemorrhoids, which may resemble pimples that require specialized treatment and care.
Folliculitis can affect any hair-bearing body part and can present as a papule or pustule around the hair follicle. Some causes that may result in pimple formation around the anus may include the following:
Shaving hairy regions can facilitate infection of the hair follicle, possibly by breaching the skin barrier and spreading bacteria.
Topical steroids used to alleviate itch associated with hemorrhoids may predispose to folliculitis.
Moisture and sweat may also get trapped beneath your skin around the armpits, anus, or anywhere else, increasing the chances of pimple formation.
As you age, your chances of developing hemorrhoids increase because the tissues supporting your anal and rectal veins stretch and become weak. This may also happen during and after pregnancy, as the baby adds extra pressure on your anal region.
Other risk factors may include the following:
Inflammatory bowel disease (IBD)
Strangulated or severely and heavily bleeding hemorrhoids may constitute a medical emergency. We recommend visiting your healthcare provider for a proper diagnosis or referral to an experienced and able medical expert to assess and treat your condition.
Visit the emergency room if you are experiencing the following symptoms:
Cold, clammy skin
Fainting and dizziness
Severe anal pain
Continuous rectal bleeding
Technological advancements in the medical field indicate that physicians can treat some types of hemorrhoids through less painful procedures. The following is an overview of current treatment approaches for hemorrhoids.
If you experience unbearable pain from a thrombosed hemorrhoid, your doctor may recommend removing the clot or hemorrhoid through a tiny incision. The procedure occurs at the hospital under local anesthesia or at the doctor’s office.
This is the surgical procedure for removing the extra tissue that causes protrusion and bleeding. It works best for both external and internal hemorrhoids under anesthesia using sutures. Some patients may require hospitalization and rest, depending on the severity of the condition.
Hemorrhoidectomy is appropriate when:
You are experiencing chronic bleeding
It is impossible to reduce the protruding hemorrhoid
Rubber band ligation proves ineffective as a treatment option for internal hemorrhoids
External hemorrhoids are constantly filled with clots
This procedure works best on hemorrhoids that stick out during bowel movements. The physician fastens a small rubber band over hemorrhoid to shut off the blood supply.
The rubber band falls off in several days and may heal in one to two weeks. You may experience mild bleeding or discomfort during the healing process. The doctor may repeat the procedure, depending on the recurrence rate and severity of the hemorrhoids.
Physicians recommend this method for internal hemorrhoids that have not prolapsed. Both techniques are relatively painless and effectively shrink the hemorrhoids. You may also need several treatments to get rid of the hemorrhoids altogether.
Have a colon and rectal surgeon assess your symptoms before self-treatment. The physician will perform a thorough examination and recommend an appropriate treatment procedure.
Some people will experience relief from mild symptoms without surgery. Swelling and pain decrease about two to seven days after non-surgical treatment, while the firm lump recedes within six weeks.
The treatment includes:
Taking over-the-counter fiber supplements and switching to a fiber-rich diet to soften stools, around 25–35 grams of fiber per day
Reducing pressure on the anal area by avoiding excessive straining to prevent protrusion
Spending an average of 1–2 minutes on the toilet to avoid excessive straining and protrusion
Drinking plenty of water to prevent protrusion and hard stools
Taking sitz baths (warm tub baths) for 10–20 minutes several times daily to aid the healing process
Consult your doctor if you do not experience relief in the specified timelines.
If you are uncertain whether you have a hemorrhoid or pimple, bump, or any other condition around the perianal region, consult your doctor for a proper diagnosis. Using the wrong treatments or remedies for hemorrhoids or pimples may make them last longer or result in undesired side effects.
Most anal health issues are associated with poor fiber intake and poor bathroom and bowel habits. With an increased understanding and awareness from your doctor, you should experience relief from anal health issues. Accurate diagnosis and treatment are essential to avoid complications.
Thrombosis | Johns Hopkins Medicine
Folliculitis and skin abscesses | MSD Manual
Hemorrhoids | American Society of Colon and Rectal Surgeons