What causes external hemorrhoids to itch?

Written by Deng Heng
Colorectal Surgery
Updated on March 15, 2025
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External hemorrhoids are hypertrophic skin tags at the anal margin and surrounding skin, or dilation of the subcutaneous venous plexus leading to blood stasis and thrombus formation, resulting in protruding lesions. According to their characteristics, they can be divided into connective tissue external hemorrhoids, thrombotic external hemorrhoids, varicose external hemorrhoids, and inflammatory external hemorrhoids. In particular, inflammatory external hemorrhoids can cause the surrounding skin to become moist. This moisture can lead to the formation of eczema and pruritic diseases in the surrounding skin, causing skin lesions. One of the main features after skin lesions is itching around the skin surrounding the external hemorrhoids.

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Written by Chen Tian Jing
Colorectal Surgery
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Can thrombotic external hemorrhoids be ruptured?

If a patient experiences an acute episode of thrombosed external hemorrhoids, the local pressure on the external hemorrhoids is generally high, and there are thromboses wrapped in the hemorrhoid nucleus. However, it is not advisable for patients to burst it on their own, as under unhygienic conditions, doing so could easily lead to local infection of the hemorrhoids, further exacerbating the condition. The treatment of thrombosed external hemorrhoids requires the professional management of a proctologist. Generally speaking, for mild symptoms, local use of Chinese herbal wash solutions or hemorrhoid creams can be chosen to press on the area, which helps promote the absorption of local thromboses. Alternatively, a professional proctologist can use specialized techniques to crush and press the local thromboses. If the thromboses are large or the local symptoms are severe, causing significant pain and severely affecting normal life, surgical excision might also be considered.

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Written by Chen Tian Jing
Colorectal Surgery
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How long does surgery for thrombotic external hemorrhoids take?

Thrombotic external hemorrhoid surgery primarily involves the excision of thrombotic external hemorrhoids. If it's simply an excision of external hemorrhoids, the surgery generally takes about half an hour. The recovery time post-surgery requires two to three weeks, mainly depending on the severity of the patient's condition and individual tissue healing rates, which can vary. After the excision surgery for thrombotic external hemorrhoids, a local wound is left, necessitating daily disinfection and dressing changes. When necessary, hemorrhoid ointment or muscle-generating Yuhong ointment may also be applied to promote healing and treatment.

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Written by Chen Tian Jing
Colorectal Surgery
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How to eliminate the flesh balls of external hemorrhoids

External hemorrhoids primarily manifest as local skin tags or connective tissue protrusions, which may also be due to transient congestion and edema caused by acute episodes. If the hemorrhoids are skin tag-type or connective tissue-type and do not present any clinical symptoms or affect the patient's normal life, excessive treatment is generally not required. It is only necessary to maintain good dietary and defecation habits to prevent the condition from worsening. If the external hemorrhoids involve congestion, edema, or pain caused by thrombosis, complete removal can only be achieved through surgical excision. Merely using topical medications, applying heat, or using hemorrhoid creams can only reduce the size of the masses or alleviate symptoms, but cannot completely remove the masses.

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Written by Yu Xu Chao
Colorectal Surgery
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Can external hemorrhoids heal by themselves?

External hemorrhoids can be classified into cutaneous flap hemorrhoids, varicose vein hemorrhoids, thrombotic hemorrhoids, and inflammatory hemorrhoids. These are mostly caused by poor defecation habits of the patient, such as prolonged defecation time or excessive straining during bowel movements, which then lead to the growth of excess skin flaps, varicose veins, or rupture of venous blood vessels, resulting in various types of external hemorrhoids. Therefore, these types of hemorrhoids cannot heal on their own and require treatment with medication or surgery. For cutaneous flap hemorrhoids, if the patient does not experience significant discomfort, specific treatment is generally not necessary, just attention to hygiene around the anal area is needed. However, for inflammatory or thrombotic hemorrhoids, since they can cause anal pain and a feeling of prolapse, it is advisable to opt for surgical stripping of the hemorrhoids as soon as possible. Post-surgery, treatments such as anal washes, red oil gauze strips, and golden ointment should be used for dressing changes, while also maintaining cleanliness of the anal region.

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How to deal with external hemorrhoids bleeding?

If external hemorrhoids bleed without apparent reason, it may be due to the rupture of thrombosed external hemorrhoids, leading to bleeding. Firstly, it is necessary to disinfect and clean the local wound to avoid accumulation of blood or contaminants and feces, which may cause infection of the wound. If the bleeding does not stop, topical hemostatic drugs or oral hemostatic drugs should be used for symptomatic treatment. If external hemorrhoids bleed and are accompanied by severe prolapse of internal hemorrhoids, it is recommended that the patient undergo surgical treatment to remove and ligate both external and internal hemorrhoids at the same time. This can further prevent exacerbation of bleeding and fundamentally treat hemorrhoids. Patients with bleeding external hemorrhoids must have a light diet and avoid irritating foods such as chili peppers and seafood. (The use of medications should be under the guidance of a doctor.)