Why does external hemorrhoids itch?

Written by Ren Zheng Xin
Gastroenterology
Updated on June 28, 2025
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If there are external hemorrhoids around the anus, it can cause the area to become damp and moist, leading to an itching sensation. This condition can be alleviated by frequently taking warm sitz baths, applying hemorrhoid cream, and actively changing poor dietary habits. It is advised to eat light foods, drink plenty of water, consume more vegetables and fruits, and reduce the intake of spicy and greasy foods. Avoid sitting or standing for long periods. External hemorrhoids can easily lead to thrombosed external hemorrhoids, which should be promptly treated surgically. There are many cases of recurrence after hemorrhoid treatment, hence adjusting your diet and developing good living habits is the first choice for preventing hemorrhoids.

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Can thrombotic external hemorrhoids be lanced?

Thrombosed external hemorrhoids, as the most common clinical symptom of external hemorrhoids, exhibit significant local pain during acute attacks and are accompanied by a feeling of constriction. If during an acute attack, dark red hemorrhoidal prolapse occurs around the anal area and cannot be absorbed or retracted, a professional doctor can use specialized techniques to crush the local hemorrhoid node or surgically excise it. However, it is not advisable for patients to burst it themselves because if done without proper sterilization and hygiene, it can easily lead to local infection, thereby exacerbating the condition or complicating future surgical treatments. Therefore, if thrombosed external hemorrhoids are detected, it is crucial to seek prompt and active treatment at a hospital.

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What causes external hemorrhoids to itch?

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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Can external hemorrhoids be treated without surgery?

Some external hemorrhoids do not require surgical treatment, as they come in three types. The first type, connective tissue external hemorrhoids, mainly presents as a mild foreign body sensation, generally painless, thus surgery is not necessary. Varicose vein type external hemorrhoids typically cause a feeling of heaviness and discomfort around the anus, and if symptoms are not severe, surgery is not required either. Only thrombosed external hemorrhoids, which usually involve severe pain, may resolve significantly on their own within two to three days if the lump is not large. Surgery is only needed for large, thrombosed external hemorrhoids.

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Can external hemorrhoids be eliminated?

External hemorrhoids are generally divided into skin tag-type external hemorrhoids, thrombotic external hemorrhoids, and inflammatory edematous external hemorrhoids; each type presents different clinical symptoms. If the condition is skin tag-type external hemorrhoids or connective tissue-type external hemorrhoids, the patient generally does not feel obvious symptoms, but these will not resolve on their own and require surgical removal. If skin tag-type or connective tissue-type external hemorrhoids do not affect the patient's normal life, it is possible to avoid excessive intervention and treatment. However, if it is thrombotic external hemorrhoids or inflammatory edematous external hemorrhoids, since there is significant pain during flare-ups that affects the patient’s normal life, surgical removal and treatment should be performed as soon as possible.

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Thrombotic external hemorrhoids clinical characteristics

The clinical features of thrombosed external hemorrhoids primarily include acute episodes of localized swelling and pain in the anal area, with thrombosis forming in the local hemorrhoidal tissue. This condition is primarily due to dry stools and excessive straining during bowel movements, leading to congestion and edema in the local hemorrhoidal tissue and subsequent disruption of local blood circulation, resulting in thrombosis. After an attack, the anal hemorrhoidal tissue may display dark red or purplish clots, enclosed by the local skin and mucous membrane. Treatment options include the application of topical medications and hot compresses to promote absorption of the hemorrhoids, as well as local surgical excision. It is important to note that if rupture or bleeding occurs, considering the possibility of local thrombus rupture, it is essential to perform proper local cleaning and disinfection and to promptly proceed with surgical excision to prevent infection.