External Hemorrhoids Guide 101: A Full Guide to External Hemorrhoids
Posted on 06 December 2017
Check out this external hemorrhoids guide! Hemorrhoids develop when the veins in your rectum become enlarged. Hemorrhoids are very common today.
In fact, three out of four adults report having hemorrhoids at one point in their life.
What Are External Hemorrhoids?
Hemorrhoids, also called piles, are clusters of veins that lie beneath the lining of the rectum and anus. When these veins become swollen, you experience what people commonly call hemorrhoids.
External hemorrhoids are the most uncomfortable and painful type of hemorrhoid.
They are found under the skin that surrounds the anus.
External hemorrhoids are often more symptomatic than internal hemorrhoids.
The are located underneath the skin that surrounds the anus. Because of their location, external hemorrhoids come with a great deal of discomfort or pain.
While external hemorrhoids are often much more obvious, understanding their causes, symptoms, and treatments is still important.
How Do I Know if I Have External Hemorrhoids?
Depending on the severity of your external hemorrhoids, symptoms are more obvious than that of internal hemorrhoids.
If you have hemorrhoid itching and burning, or pain around the anus, lumps near the anus, or blood in your stool, these are indications that you may have external hemorrhoids.
Another sign of external hemorrhoids is a feeling of pressure on the bowel. If you suspect you have external hemorrhoids, a hemorrhoid doctor can perform a rectal exam to verify your diagnosis.
If you have internal hemorrhoids, check out our internal hemorrhoids guide for more information.
External Hemorrhoid Treatment
External hemorrhoids often require treatment to help patients handle the bothersome symptoms that come with them. External treatment includes:
- Change in diet. Increasing your daily fiber intake is an effective way to treat external hemorrhoids. Having proper fiber intake helps to keep bowel movements regular and stool soft. In addition, increasing your water intake helps to keep fiber moving through your digestive system. If you cannot increase your fiber intake through food consumption, fiber supplements are also an effective means of treatment for the avoidance of constipation.
- Sitz baths. Soaking in a warm bath or a sitz bath can help alleviate a lot of the symptoms associated with external hemorrhoids. Sitting in a few inches of warm water for ten to fifteen minutes a few times a day can help reduce swelling, alleviate irritation, and sooth discomfort.
- Proper hygiene. Improving your bowel habits, especially hygiene efforts, can be a great help in treating external hemorrhoids (1). Bathe or shower daily to keep the skin around your anus clean. Avoid perfumed wipes or alcohol-based wipes. Be sure to thoroughly clean the area. Moist towelettes or wet toilet paper may be a better means of cleaning.
- Topical treatments. Over-the-counter hemorrhoid creams, ointments, and suppositories contain anti-inflammatory agents that are a great way to treat external hemorrhoids. Many also contain a numbing agent that can soothe the discomfort associated with external hemorrhoids. Topical treatments effectively treat the bothersome symptoms that are often associated with external hemorrhoids.
- Cold compresses. Applying ice packs or cold compresses to your anal area can help with the pain and swelling of external hemorrhoids.
- Medical treatment. If over-the-counter and at-home remedies do not effectively treat your external hemorrhoids, it may be time to visit your medical provider. Your health care can prescribe a prescription strength medication that will more aggressively treat your external hemorrhoids.
- Medical procedures. If you still experience symptoms of external hemorrhoids after these efforts, there are medical procedures available to treat external hemorrhoids. Minimally invasive procedures can be performed in a doctor’s office without anesthesia. These include rubber band ligation, sclerotherapy, and infrared coagulation. For extreme cases, a hemorrhoidectomy may need to be performed in a hospital under anesthesia (2). Hemorrhoidectomy involves surgical removal of the hemorrhoid through incision.
Can External Hemorrhoids Cause Constipation?
While external hemorrhoids do not cause constipation, they can add to it.
More severe external hemorrhoids can cause an obstruction as you try to pass a bowel movement.
This can make it difficult for stool to pass through your rectum and anus. Constipation is more often than not a cause of hemorrhoids, not the other way around.
Why Do External Hemorrhoids Itch?
External hemorrhoids often cause moderate to severe itching around the anus. The itching comes from the inflammation of your anal area.
As inflammation increases due to external hemorrhoids, the intensity of your itching will increase as well.
For a list of products that can help, take a look at our guides below.
Can External Hemorrhoids Get Infected?
While hemorrhoids rarely get infected, it is possible. Hemorrhoids that are infected cause severe hemorrhoid pain and can lead to complications that cause death in the tissue surrounding your anus.
Infected external hemorrhoids can be severely painful during bowel movements, even unbearable at times.
Other symptoms of infected external hemorrhoids include fever, chills, and difficulty sitting. Hemorrhoid bleeding may also occur as a result of infected hemorrhoids.
If you are concerned about an infected hemorrhoid make sure you get to your doctor immediately (3).
Can External Hemorrhoids Go Away on Their Own?
Do external hemorrhoids ever go away? If your hemorrhoids are small, they can go away on their own in a couple of days. Most hemorrhoids go away on their own, but it will take some time.
If your hemorrhoids are causing you severe pain or discomfort, it is best to seek treatment for your hemorrhoids.
Changes to your diet and lifestyle can help resolve the issue of external hemorrhoids in some cases.
Women who experience external hemorrhoids during pregnancy often notice they go away once they give birth. Make sure you take a look at what causes hemorrhoids for you when determining treatment.
External Hemorrhoids Guide Video
What Gets Rid of External Hemorrhoids?
Sometimes, getting rid of external hemorrhoids is as simple as increasing your water intake and adding fiber to your diet.
If you experience constipation, a stool softener can help rid the occurrence of external hemorrhoids.
Other things you can do to get rid of them is limit the amount of time you sit on the toilet and refrained from holding in bowel movements.
Practice good hygiene and be sure to keep the area around your anus clean.
If you are prone to get external hemorrhoids, try using moist hemorrhoid wipes to clean your anus after you pass a bowel movement.
Using a sitz bath or sitting in a warm tub can help alleviate irritation from external hemorrhoids.
You may also use over-the-counter medications to ease discomfort and reduce swelling.
If you are prone to external hemorrhoids and they become increasingly painful or uncomfortable, or you notice continuous bleeding, you may want to talk to a doctor about more advanced treatment options.
How Do Doctors Get Rid of External Hemorrhoids?
If you have exhausted all the efforts mentioned above, your doctor may recommend you get a minimally invasive procedure to treat your hemorrhoids.
Outpatient treatments are generally performed in a doctor’s office.
The most common non-surgical doctor treatment for external hemorrhoids is called a rubber band ligation.
Your doctor will tie a tight band around the base of your hemorrhoid. This will cut off the blood supply and cause the surrounding tissue to scar as it heals.
In most cases, it takes two to four procedures separated by six to eight weeks to eliminate the hemorrhoid completely.
Coagulation is another method of treatment used by doctors (4). This involves the used of infrared light, heat, or cold to shrink the hemorrhoid.
Sclerotherapy is another non-surgical procedure to treat external hemorrhoids. In sclerotherapy, your doctor will inject a chemical that will shrink the hemorrhoid.
For severe external hemorrhoids that do not respond to outpatient treatment, your doctor may suggest a hemorrhoidectomy. This is a surgical procedure that cures most cases of protruding or persistent external hemorrhoids. During the surgery, a small incision will be made around the hemorrhoid tissue. The swollen and inflamed blood vessels, that are causing the hemorrhoid, will be removed.
Another option is laser hemorrhoid surgery.
Hemorrhoid supplements can also help provide external hemorrhoid relief. Check out these hemorrhoid supplement reviews to see which ones can help you.
What Type of Doctor Treats External Hemorrhoids?
Your primary care physician can treat smaller, less severe external hemorrhoids. In some cases, they can prescribe a stronger hemorrhoid cream or suppository. If you have a more serious case of hemorrhoids, or your external hemorrhoids are persistent, your doctor may refer you to a specialist called a gastroenterologist. If you require a surgical procedure for your hemorrhoids, you will want to find a colon and rectal surgeon.
External hemorrhoids are the most bothersome type of hemorrhoids. Although they can be painful and uncomfortable, they are treatable and can often be resolved without a surgical procedure.
External Hemorrhoids Guide 101-Continued
Why Does It Still Look Like I Have External Hemorrhoids After Hemorrhoid Surgery?
After a hemorrhoidectomy, it is completely normal to experience a great deal of swelling. In many cases, swelling will put those who have recently had a hemorrhoidectomy into alert.
It is important to understand that post-operation swelling is not the continued occurrence of external hemorrhoids. Recovery time for hemorrhoidectomy varies from patient to patient. Some patients can take as long as two to three months to completely recover.
External Hemorrhoid Healing Time
For small external hemorrhoids, healing time can be as little as a few days even without treatment.
Prolapsed hemorrhoids have a longer healing time and may require doctor treatment.
Depending on the course of treatment, healing time can be as little as a week or as long as a few months.
For women who experience hemorrhoids during pregnancy, they will usually last until after you give birth.
Because every patient is different, and there are several different types of hemorrhoids, healing time for external hemorrhoids will vary based on specific case and specific individual.
How to Get Rid of External Hemorrhoids Permanently
There are a few different ways to get rid of external hemorrhoids permanently. For some patients, hemorrhoids only occur during pregnancy.
Once you give birth, your hemorrhoids may resolve permanently.
For other patients, lifestyle changes may be the resolution needed to say goodbye to hemorrhoids forever.
Lifestyle changes can include eating healthier foods, avoiding straining during bowel movements, exercising, and avoiding prolonged sitting.
For those with more severe external hemorrhoids, a surgery called a hemorrhoidectomy may be necessary to permanently resolve the symptoms of hemorrhoids.
External Hemorrhoid Itch Relief
External hemorrhoids can become extremely itchy. The itching may even affect your quality of life.
There are ways to relieve and soothe the symptoms of itching. One way is to have a sitz bath.
A sitz bath involves sitting in a few inches of warm water for 15 minutes several times a day.
This reduces swelling that causes itching.
Additionally, applying a cold pack or ice pack like hemorrwedge can numb the area and bring down swelling that causes itching.
Types of External Hemorrhoids
Hemorrhoids are classified as either internal or external. While most hemorrhoids fall under one of these two categories, prolapsed or thrombosed hemorrhoids can have qualities of both.
A prolapsed hemorrhoid is an internal hemorrhoid that can protrude out of the anus, appearing to be an external hemorrhoid.
A thrombosed hemorrhoid is an external hemorrhoid that has prolapsed and formed a blood clot. This is the most painful type of hemorrhoid.
Hemorrhoids also fall into four different stages based on size, severity of symptoms, and required treatments.
To discover the most common cause of hemorrhoids be sure to take a look at this post.
Internal vs. External Hemorrhoids - Which Do I Have?
Internal and external hemorrhoids are the two main categories most hemorrhoids fall into.
While they are very much the same when it comes to causes and treatment, the characteristics and symptoms of internal and external hemorrhoids differ.
Internal hemorrhoids are not generally associated with any symptoms until they become prolapsed.
The most common symptom of internal hemorrhoids is painless bleeding. Because they are located further in the anal canal, internal hemorrhoids cannot be seen or felt. T
hey are in an area that lacks pain-sensing nerves, so they aren’t associated with the pain and discomfort of external hemorrhoids.
Depending on the severity of your condition, you may require different treatments.
Because internal hemorrhoids are not associated with many symptoms, they may require no treatment at all.
External hemorrhoids come with more bothersome symptoms. These include:
- Lumps near the anal opening
External hemorrhoids can be seen and felt.
They are located at the opening of the anus and may get worse when you have bowel movements.
The treatments for external hemorrhoids vary depending on the severity and size of your hemorrhoids.
These include at-home treatments, over-the-counter medications, prescription medications, minimally invasive procedures, and surgery.
Thrombosed External Hemorrhoids
Thrombosed external hemorrhoids are characterized by the formation of a blood clot inside an external hemorrhoid.
While the condition is not dangerous, it is often very painful. It usually requires prompt medical care to alleviate the symptoms associated with the condition.
With thrombosed external hemorrhoids, it can hurt to walk, sit, and have a bowel movement.
The causes of thrombosed external hemorrhoids vary but are like the causes of regular external hemorrhoids. These include:
- Straining during a bowel movement
- Chronic diarrhea
- Irregular bowel movements, like bouts of constipation then bouts of frequent bowel movements
- Sitting for prolonged periods
The most common treatment for thrombosed external hemorrhoids is a procedure called an external thrombectomy.
During this procedure, your doctor will make a small incision in the clot, allowing it to drain.
The procedure is done in a hospital under local anesthesia.
Because of the pain associated with thrombosed hemorrhoids, this procedure is usually performed within three days of the onset of the condition.
Will Preparation H Get Rid of External Hemorrhoids?
Preparation H is not a product that will get rid of hemorrhoids, but it will reduce the occurrence of symptoms and provide relief while hemorrhoids resolve.
The benefits of preparation H on external hemorrhoids can include:
- Numbing pain, itch, and discomfort
- Create a protective barrier to prevent irritation
- Promote the healing of skin around the anus
- Provide temporary relief from the symptoms of external hemorrhoids
There are several types of Preparation H products:
- Preparation H Cooling Gel and Pain Relief Cream
- Preparation H Hemorrhoid Ointment
- Preparation H Medicated Wipes
- Preparation H Maximum Strength Cream with Aloe
External Hemorrhoid Treatment During Pregnancy
In most cases, external hemorrhoids resolve once you give birth.
During your pregnancy, external hemorrhoid treatment can include:
- The use of witch hazel or over-the-counter creams to relieve symptoms
- Regular sitz baths
- Medicated hemorrhoid wipes or pads
- Good hygiene practices
- Avoiding sitting for long periods of time
- Eating a healthy, balanced diet
How to Remove External Hemorrhoids Without Surgery
Although some external hemorrhoids will require surgery, there are many ways to treat hemorrhoids without surgery.
Focusing on your hygiene is one way to relieve hemorrhoids.
Thoroughly cleaning your anus after a bowel movement, avoiding straining during bowel movements, and regular use of a stool softener can help with the healing process.
Keeping a close eye on your eating and drinking habits can help as well. You should have a healthy, balanced diet that is rich in fiber. Additionally, you should drink the right amount of water daily to keep yourself hydrated. Avoid prolonger periods of sitting as well.
When To Consider External Hemorrhoid Removal
The removal of external hemorrhoids depends mostly on their size and severity. In many cases, over-the-counter and at-home treatments are sufficient enough to reduce the swelling and provide relief from external hemorrhoids. These methods include:
- Sitz baths
- Diet changes
- Over-the-counter creams, ointments, and wipes
- Bowel habit improvement
- Prescription creams, ointments, and suppositories
In some cases, more aggressive medical treatment is required. Patients who do not respond to over-the-counter, or even prescription, treatments may need to seek the assistance of their medical provider.
There are several minimally invasive procedures that can be performed in a doctors’ office without anesthesia. These include the rubber band ligation, sclerotherapy, and infrared coagulation.
For severe cases, your medical provider may need to perform an external hemorrhoidectomy. This is performed in a hospital under anesthesia. Your doctor will make an incision in the hemorrhoid, draining it. Your hemorrhoid will then be stitched, and you will be sent home the same day for recovery.
External Hemorrhoid Surgery (Hemorrhoidectomy)
The hemorrhoidectomy is the main surgery doctors perform to treat external hemorrhoids. A hemorrhoidectomy is performed in a hospital under anesthesia.
During the surgery, the doctor makes a small incision around the anus to slice away the external hemorrhoids. The areas of the incision may need to be stitched because of the high sensitivity of the area in which the surgery is performed.
Complications are rare; therefore, most patients go home the same day as an outpatient procedure. Recovery time varies from patient to patient, but the average is two weeks. For some patients, it may take up to six weeks to feel back to normal.
What is the Difference Between Internal and External Hemorrhoids
Internal hemorrhoids and external hemorrhoids are different for many reasons. These reasons include, severity, symptoms, and treatment. Internal hemorrhoids don’t have many symptoms because of their location. They are far enough inside of the rectum that they can’t be felt or seen. The only sign of these may be hemorrhoid bleeding.
External hemorrhoids are under the skin around the anus. Because of their location, external hemorrhoids tend to come with a great deal of symptoms. They are in an area that has more pain-sensing nerves present. That is why hemorrhoid pain is more intense with external hemorrhoids. Check out this blog post for information on how to relieve hemorrhoid pain.
Where Do External Hemorrhoids Come From?
External hemorrhoids are caused by swelling in the anal or rectal veins. They become susceptible to irritation and display symptoms that cause discomfort. There are many causes of hemorrhoids in general. However, there are specific causes of external hemorrhoids as well. These include:
- Prolonged sitting
- Straining during bowel movements
- Chronic constipation or diarrhea
- Eating habits
I Have Had an External Hemorrhoid for Months. Is This Normal?
Hemorrhoids can last for a several days or several months. The existence of hemorrhoids varies depending on their severity and the treatment. Some hemorrhoids may require medical treatment or surgery.
Many people suffer from hemorrhoids without ever seeking treatment. Depending on how you treat your hemorrhoids will determine how long they last.
Apple Cider Vinegar on External Hemorrhoids, Does it Work?
Apple Cider Vinegar has been known to relieve the symptoms of external hemorrhoids. A topical solution of apple cider vinegar can reduce the symptoms in a few weeks. When applied to the affected area two or three times a day, it can temporarily reduce the symptoms of swelling and irritation.
It should be noted; apple cider vinegar is not a solution and will only provide temporary relief. Be careful as well! Apple cider vinegar can burn very bad and be harmful if too much is applied or it is ingested. Do not use if you haven't spoken with your doctor.
What to do With External Hemorrhoid Bleeding
Bleeding with external hemorrhoids is a normal symptom. As external hemorrhoids swell, the anal tissue is stretched. This causes the tissue to become thin as it stretched. Further irritation to the external hemorrhoid, such as having a bowel movement, can lead to bleeding.
While bleeding from external hemorrhoids is not a cause for concern, it is important to make sure that you have been checked by your medical provider. Because other sources of anal bleeding can be very concerning, make sure that your hemorrhoids have been determined to be the source of bleeding.
Are Bleeding External Hemorrhoids Dangerous?
Although you should contact a doctor immediately if you experience bleeding with external hemorrhoids, it is not usually dangerous. Hemorrhoid bleeding is a common symptom of hemorrhoids and can be accompanied with pain as well.