External Hemorrhoids: Causes, Relief, and What Works Best

When you feel a tender lump near your anus, especially after straining or sitting too long, it’s often external hemorrhoids, swollen veins outside the anal canal that become inflamed and painful. Also known as external piles, they’re not dangerous but can make sitting, walking, or even using the bathroom uncomfortable.

Unlike internal hemorrhoids, which stay inside and may bleed without pain, external hemorrhoids sit right under the skin. They can thrombose—meaning a blood clot forms inside—turning into a hard, purple, and very painful bump. This often happens after heavy lifting, chronic constipation, or long periods on the toilet. Pregnancy, obesity, and sitting for hours at a desk also raise your risk. You don’t need to have diarrhea or bleeding to have them. Just persistent pressure or irritation is enough.

Many people try over-the-counter creams, witch hazel pads, or ice packs first. Some work for a day or two. But if the pain doesn’t ease, or if the lump keeps growing, you might need more. Sitting in warm water (a sitz bath) for 10–15 minutes a few times a day helps reduce swelling and relaxes the area. Fiber and water are just as important as any cream—soft stools mean less strain, which stops the cycle. If you’ve tried everything and still feel like you’re sitting on a marble, a doctor can remove the clot in a quick office procedure. It’s not surgery, and recovery is fast.

What you won’t find in most blogs are the hidden triggers. Like how some painkillers (especially NSAIDs) can worsen swelling. Or how prolonged use of steroid creams, meant to reduce inflammation, can actually thin the skin around the anus over time. And while most people think hemorrhoids are just a "grown-up problem," they’re increasingly common in younger adults who sit all day and skip veggies. The key isn’t just treating the lump—it’s understanding what made it happen in the first place.

Below, you’ll find real stories and science-backed advice on what helps, what doesn’t, and how to avoid repeating the same mistakes. From safe topical treatments to lifestyle fixes that actually stick, these posts cut through the noise. No fluff. Just what works when your backside is on fire.