External Pile (Hemorrhoids) Appearance and Pictures, Causes & Treatment

External piles, also known as external hemorrhoids, are a common yet often misunderstood condition that affects millions of people worldwide. This comprehensive guide explores the appearance, symptoms, causes, and treatment options for external hemorrhoids, supported by visual references and medical insights.

Table of Contents

Sore Throat on One Side of the Mouth – Causes, Symptoms, and Treatments

How Much MiraLAX Can I Take for Severe Constipation?

What Are External Piles?

External piles are swollen veins located under the skin around the anus. Unlike internal hemorrhoids, which occur inside the rectum, external hemorrhoids are visible and often painful. They may appear as lumps or bulges and can cause significant discomfort during daily activities.

External Hemorrhoid Pictures & Appearance

Typically appear as soft, bluish or purplish lumps near the anal opening
May be tender to the touch or feel firm if thrombosed (clotted)
Can vary in size from a small bump to a larger protrusion
In some cases, skin tags may remain after healing

For visual references, you can explore Healthline’s hemorrhoid overview.

Common Symptoms of External Hemorrhoids

The symptoms of external piles can range from mild irritation to severe pain, depending on the severity and presence of complications like thrombosis.

Typical Symptoms Include:

Pain or discomfort during bowel movements
Itching or irritation around the anus
Swelling or lumps near the anal opening
Bright red blood on toilet paper or stool
Difficulty sitting due to tenderness

Thrombosed external hemorrhoids may cause intense pain and appear darker due to blood clots beneath the skin.

Causes and Risk Factors

External hemorrhoids develop when pressure increases in the lower rectum, causing veins to swell and protrude. Several lifestyle and physiological factors contribute to this condition.

Leading Causes of External Piles:

Straining during bowel movements
Chronic constipation or diarrhea
Prolonged sitting, especially on the toilet
Heavy lifting or physical exertion
Pregnancy and childbirth
Obesity and low-fiber diets
Aging and weakened anal tissues

Genetics and certain habits, such as frequent anal intercourse or overuse of laxatives, may also increase the risk.

Diagnosis and Medical Evaluation

External hemorrhoids are typically diagnosed through a physical examination. A healthcare provider may visually inspect the anal area and perform a digital rectal exam to rule out internal hemorrhoids or other conditions.

In cases of bleeding or persistent symptoms, further tests like anoscopy or colonoscopy may be recommended to exclude colorectal cancer or anal fissures.

External Pile Treatment Options

Treatment for external hemorrhoids depends on the severity of symptoms and whether complications like thrombosis are present. Most cases resolve with conservative care, but medical procedures may be necessary for persistent or painful hemorrhoids.

Home Remedies and Conservative Care

Warm sitz baths for 15–20 minutes several times daily
Over-the-counter creams with hydrocortisone or lidocaine
Witch hazel pads to reduce inflammation
Ice packs to relieve swelling
High-fiber diet and increased water intake
Stool softeners to prevent straining

These methods often provide relief within a few days to a week.

Medical and Surgical Treatments

Thrombectomy: Removal of clotted blood from a thrombosed hemorrhoid under local anesthesia
Hemorrhoidectomy: Surgical removal of the entire hemorrhoid, typically for severe or recurrent cases
Laser or cautery procedures: Used to shrink hemorrhoidal tissue
Prescription medications: Topical nifedipine or nitroglycerin may be used in some cases

Surgical options are generally reserved for large, painful, or persistent hemorrhoids that do not respond to conservative treatment.

Prevention Tips

Preventing external piles involves maintaining healthy bowel habits and reducing pressure on the rectal veins.

Key Prevention Strategies:

Eat a fiber-rich diet (25–30 grams daily)
Stay hydrated with 6–8 glasses of water per day
Avoid prolonged sitting or straining on the toilet
Exercise regularly to promote bowel function
Respond promptly to the urge to defecate
Avoid heavy lifting and excessive use of laxatives

Final Thoughts

External hemorrhoids are a manageable condition with a wide range of treatment options. Early intervention and lifestyle changes can significantly reduce symptoms and prevent recurrence. If you experience persistent pain, bleeding, or swelling, consult a healthcare provider for proper diagnosis and care.