A perianal skin tag is an excess growth of skin that is located near the anus. The growth projects away from the surface of the skin, assuming a tag-like appearance. Although some patients do not experience any symptoms in association with these skin growths, others can experience pain and itchiness. The treatment for a skin tag focuses on removing the growth and ensuring that it does not represent a more malignant disease process, such as a cancer.
Although they are considered to be abnormal growths, perianal skin tags are not malignant or cancerous in nature, and the skin cells present within the tags are completely normal. These growths can develop at any location around the anus, but more commonly occur toward the back of the anus, closer to the tailbone. They can range in size from less than 1 inch (2.54 cm) to approximately 2 inches (5.08 cm).
Patients can experience a variety of symptoms as a result of having a skin tag. They could have itchiness or pain at the site of the skin growth. Occasionally, fecal matter can accumulate around the skin tag, causing irritation. Other patients have no symptoms resulting from their skin tags, and might only notice their presence incidentally.
Although sometimes perianal skin tags develop for no apparent reason, in other cases they appear as complications from other disease. Patients with hemorrhoids can develop these growths as a result of straining and irritation. Often the skin tags develop associated with an anal fissure, which is a superficial tear in the external surface of the anal skin tissue. People suffering from inflammatory bowel disease are at an increased risk for developing these growths.
Diagnosing a patient with a skin tag is typically done on the basis of visual inspection. Other diseases that could mimic anal tags include anal warts, skin cancer, and hemorrhoids. It is important for the health care professional examining the perianal skin tag to thoroughly examine the surrounding area to look for other abnormalities including anal fissures and fistulas, which are abnormal connections between the gastrointestinal tract and external skin that can result in leakage of fecal matter and an increased risk for infection.
The mainstay of treatment of a perianal skin tag is surgical removal. Sometimes this procedure can be performed as an in-office procedure not requiring hospitalization or general anesthesia. Often the skin tag that has been removed is sent to a pathologist for a microscopic review of cells making up the skin tag to assure that it does not represent another more dangerous pathologic process, such as a skin cancer.