What do hemorrhoids look like?
Quick Answer
Hemorrhoids appear as swollen, inflamed veins around the anus; external ones look like soft lumps, internal ones may cause bleeding. External hemorrhoids appear as tender, swollen bumps around the anal opening, while internal hemorrhoids are usually not visible but may prolapse.
Key Takeaways
- External hemorrhoids appear as soft, swollen lumps around the anus
- Internal hemorrhoids are usually not visible externally
- Colors can range from pink to dark purple, depending on severity
- Size varies from pea-sized to grape-sized or larger
- May be accompanied by bleeding, itching, or pain
- Thrombosed hemorrhoids appear dark blue or purple
Types of Hemorrhoids and Their Appearance
Hemorrhoids are classified into two main types based on their location, each with distinct visual characteristics:
External Hemorrhoids
These develop under the skin around the anal opening and are usually visible:
- Appearance: Soft, flesh-colored or pinkish lumps
- Size: Range from pea-sized to grape-sized or larger
- Texture: Soft and squishy when not thrombosed
- Location: Around the anal opening, easily visible
- Symptoms: May be itchy, painful, or tender to touch
Internal Hemorrhoids
These develop inside the rectum and are typically not visible:
- Visibility: Usually not visible from outside
- Prolapsed state: May protrude outside during bowel movements
- Grades: Classified into four grades based on prolapse severity
- Primary symptom: Painless bleeding during bowel movements
Visual Characteristics by Severity
Hemorrhoid appearance varies significantly depending on their severity and type:
Mild Hemorrhoids
- Size: Small, pea-sized swellings
- Color: Pink or flesh-colored
- Texture: Soft and relatively painless
- Visibility: May be barely noticeable
Moderate Hemorrhoids
- Size: More noticeable, grape-sized lumps
- Color: Darker pink to reddish
- Texture: Firmer and more tender
- Symptoms: May bleed and cause discomfort
Severe Hemorrhoids
- Size: Large, protruding masses
- Color: Dark red to purple
- Texture: Firm, swollen, and very painful
- Complications: May be thrombosed or strangulated
Thrombosed Hemorrhoids
Thrombosed hemorrhoids have a distinctive appearance due to blood clots forming within them:
Visual Characteristics
- Color: Dark blue, purple, or almost black
- Size: Often larger and more swollen than regular hemorrhoids
- Shape: Firm, round lumps that feel hard to touch
- Surface: May appear shiny or taut due to swelling
- Pain level: Typically very painful and tender
Internal Hemorrhoid Grades
Internal hemorrhoids are classified into four grades based on their prolapse:
Grade I (First Degree)
- Remain inside the rectum
- Not visible externally
- Main symptom is painless bleeding
Grade II (Second Degree)
- Prolapse during bowel movements
- Retract automatically afterward
- May be briefly visible during straining
Grade III (Third Degree)
- Prolapse during bowel movements
- Require manual pushing back inside
- Appear as pink or red protrusions
Grade IV (Fourth Degree)
- Permanently prolapsed
- Cannot be pushed back inside
- Visible as persistent external masses
Associated Symptoms and Signs
Beyond visual appearance, hemorrhoids may present with various symptoms:
Common Accompanying Signs
- Bleeding: Bright red blood on toilet paper or in toilet bowl
- Itching: Persistent anal itching and irritation
- Pain: Especially with external and thrombosed hemorrhoids
- Swelling: Noticeable swelling around the anal area
- Mucus discharge: Clear or whitish discharge
When to Seek Medical Attention
Certain visual characteristics and symptoms warrant immediate medical evaluation:
Urgent Medical Care Needed
- Severe, sudden-onset pain with dark purple/black coloration
- Heavy bleeding that doesn't stop
- Signs of infection (pus, fever, increasing redness)
- Large, protruding masses that can't be pushed back
- Changes in bowel habits along with hemorrhoid symptoms
Frequently Asked Questions
Can hemorrhoids be different colors?
Yes, hemorrhoids can range from pink to dark purple. Fresh hemorrhoids are typically pink or flesh-colored, while thrombosed hemorrhoids appear dark blue or purple due to blood clots. The color often indicates severity and type.
Do all hemorrhoids protrude outside the body?
No, only external hemorrhoids and prolapsed internal hemorrhoids are visible outside the body. Many internal hemorrhoids remain inside the rectum and are not visible, though they may cause bleeding.
How can I tell if it's a hemorrhoid or something else?
Hemorrhoids typically appear as soft, swollen lumps around the anus and may be associated with bleeding, itching, or pain. However, other conditions can cause similar symptoms, so medical evaluation is important for proper diagnosis.
Do hemorrhoids change appearance over time?
Yes, hemorrhoids can change in size, color, and symptoms over time. They may shrink with treatment, become more swollen during flare-ups, or change color if they become thrombosed.
Are hemorrhoids always painful?
No, internal hemorrhoids are often painless and may only cause bleeding. External hemorrhoids can be painful, especially when thrombosed. Pain levels vary significantly between individuals and hemorrhoid types.
Can hemorrhoids disappear on their own?
Small hemorrhoids may shrink and become less noticeable with conservative treatment and lifestyle changes. However, larger or more severe hemorrhoids typically require medical treatment and may not resolve completely without intervention.
Hemorrhoid Care Products
Find relief with appropriate care products:
