How long does it take for a thrombosed external hemorrhoid lump to soften?

Written by Yu Xu Chao
Colorectal Surgery
Updated on June 25, 2025
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The lumps of thrombosed external hemorrhoids cannot be eliminated and can only be removed surgically by stripping the thrombus. After surgery, medications such as anal washes, red oil gauze strips, and golden ointment are used for dressing changes to completely cure thrombosed external hemorrhoids. Since the thrombus has already formed, local medications cannot dissolve it; stripping it surgically is the only option.

Moreover, thrombosed external hemorrhoids cause patients to experience a distinct sensation of a foreign body in the anus as well as pain and swelling. Patients should pay adequate attention to these symptoms, otherwise, the thrombus might grow larger and may even lead to necrosis of the hemorrhoids.

Patients should also develop good bowel habits, avoiding excessive straining or prolonged durations on the toilet, as these practices can easily trigger thrombosed external hemorrhoids or inflammatory external hemorrhoids, leading to significant pain and swelling in the anus.

(Use medications under the guidance of a doctor)

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How long does it take to recover after external hemorrhoidectomy?

External hemorrhoids are mainly classified into inflammatory external hemorrhoids, thrombotic external hemorrhoids, connective tissue external hemorrhoids, and varicose vein external hemorrhoids. Regardless of the type, the primary treatment method is surgical removal. After the hemorrhoids are excised, the perianal area generally does not bleed when passing stools for the first two to three days, and the patient can usually go home in about 7 days. For complete recovery to the pre-condition state, it is estimated to take between 20 days to a month.

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Thrombotic external hemorrhoids: how many days to relieve pain?

The duration of pain associated with thrombosed external hemorrhoids mainly depends on the size of the thrombosis formed. If medications are not actively used, the pain may not be significantly alleviated. Options include using traditional Chinese medicine washes as hot compresses or applying hemorrhoid cream locally to relieve symptoms. After pharmacological treatment, pain generally subsides in about a week. However, certain thrombosed external hemorrhoids may not shrink on their own due to significant local congestion or thrombosis, thus medication alone may not completely relieve pain or produce significant clinical effects. The primary treatment method still required is surgical intervention, mainly using thrombectomy. (Medications should be used under the guidance of a doctor according to the specific situation.)

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What should I do if a thrombosed external hemorrhoid is bleeding?

After the skin of a thrombosed external hemorrhoid ruptures, small blood clots may be exposed, leading to bleeding. Generally, resting, diet adjustment, and maintaining soft and smooth bowel movements can be effective. Additionally, local use of hemorrhoid creams and suppositories can typically help achieve healing and stop the bleeding. Thrombosed external hemorrhoids often occur after intense physical activity or straining during bowel movements due to the sudden rupture of subcutaneous veins around the anal margin, forming an oval lump. (The use of medications should be carried out under the guidance of a professional doctor.)

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Colorectal Surgery
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How to reduce swelling of thrombosed external hemorrhoids

During the acute flare of thrombotic external hemorrhoids, the primary issue is the filling of the hemorrhoidal nucleus with blood clots, leading to congestion and swelling of the hemorrhoids. Due to edema or excessive pressure inside the hemorrhoidal nucleus, the patient may experience local discomfort or even severe pain. Therefore, the treatment of thrombotic external hemorrhoids first needs to reduce swelling. The methods mainly include local hot compresses, along with the oral administration of medicines that cool the blood, reduce swelling, and relieve pain. However, in some cases of thrombotic external hemorrhoids, where the blood clots are large or cannot be absorbed on their own after repeated attacks, surgery to excise the clots may be necessary to achieve the purpose of reducing swelling. During the acute flare of thrombotic external hemorrhoids, it is recommended that the patient seek medical attention as soon as possible to avoid complications such as repeated attacks or local blood supply disturbances, which could lead to necrosis of the external hemorrhoids.

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Do minor external hemorrhoids itch?

Mild external hemorrhoids can also cause localized itching in the anal area, but the itching is not pronounced. This is because the external hemorrhoids themselves stimulate the perianal skin, causing mild itching and a sensation of a foreign body in the anus. Moreover, external hemorrhoids can lead to increased secretions around the anus, further irritating the perianal skin and, in severe cases, causing anal eczema. Thus, in most cases, mild external hemorrhoids can cause itching, although it is not intense. For such situations, it is primarily important for patients to keep the perianal area dry and hygienic, wear loose, breathable cotton underwear, and avoid friction against the hemorrhoids. For mild itching, topical treatments such as calamine lotion can be used, along with keeping the perianal area dry. Additionally, a light diet should be maintained.