Infected Hemorrhoids: Symptoms, Causes & Treatment

Written by

Jessica Guht

Jessica is a medical writer with an unquenched thirst to discover something new. She believes that medical content should be accessible to everyone and strives to write content that every single person can understand. When Jessica isn’t writing, she can usually be found reading a book with a dog cuddled in her lap. Jessica has a Masters of Engineering degree in Biomedical Engineering.

Medically reviewed by

Amy Dougherty, FNP-BC, AGAC

Amy is a Board Certified Family Health Nurse Practitioner (FNP) with over 15 years of experience working in Hospital Medicine, Urgent Care and Primary Care practices. Amy graduated Thomas Jefferson University with high distinction earning a Bachelor of Science in Nursing in 2008, a Master of Science in Nursing in 2010 and a Post Master's Certificate in Adult Gerontology Acute Care (AGAC) in 2014. She was recognized by the Elite American Nurses Association in 2013 for her dedication, achievements and leadership in the field Nursing. She served as a clinical preceptor for a number of Nurse Practitioner students and enjoys teaching the bright minds of future NPs.

A hemorrhoid is a swollen vein in the lower rectum. In most cases, hemorrhoids will go away on their own or with the use of over-the-counter products, but in rare cases, they may become infected.

While some general cases of infection present with white spots, infected hemorrhoids typically appear bright red. However, white spots can still appear around the anus, although they are likely due to another cause.

Table of Contents

• What Causes Infected Hemorrhoids?
• What Are the Symptoms of Infected Hemorrhoids?
• Are White Spots on Hemorrhoids a Sign of Infection?
• Treatment for Infected Hemorrhoids
• When to See a Doctor?
• Key Takeaways

What Causes Infected Hemorrhoids?

Infections of hemorrhoids most often result when there is a restriction of blood flow to the area. This is because healthy blood flow also brings along white blood cells, which are part of the immune system and fight any potential sources of infection. If blood flow to a hemorrhoid is restricted, the supply of white blood cells is also diminished.

Prolapsed internal hemorrhoids are the type of hemorrhoid most likely to become infected because they can experience blood flow issues, which then cuts off the supply of white blood cells. When blood flow is entirely cut off, it is called a strangulated internal hemorrhoid, and infection can very quickly set in.

Even when a prolapsed internal hemorrhoid is gently pushed back into the wall of the rectum, it is still more likely than other types of hemorrhoids to become infected.

Some conditions that can cause reduced blood flow, increasing the risk of infection, include:

• obesity
• diabetes
• atherosclerosis
• Crohn’s disease
• blood clots

Specific procedures to treat hemorrhoids, such as surgical removal or rubber band litigation, can also increase the risk of infection.

What Are the Symptoms of Infected Hemorrhoids?

If you have infected hemorrhoids, you will still experience all the symptoms of normal hemorrhoids, such as:

• swelling around the anus
• small amounts of blood after passing a bowel movement
• pain, especially when straining during a bowel movement or sitting
• itching around and in the anus
• a lump under the skin around the anus

However, infected hemorrhoids also have some additional symptoms, which can include:

• pain that worsens, even after hemorrhoid treatment
• fever
• redness around the anus, especially near the infection site

Are White Spots on Hemorrhoids a Sign of Infection?

When hemorrhoids are infected, the site becomes very red, not white. However, there are other conditions that can cause white spots around the anus. 

Lichen Sclerosus

One potential cause of white spots around the anus is lichen sclerosus. This is an uncommon skin condition that causes a white rash, typically on the genital skin around the anus and vulva, although it can affect any area of the body.

This condition most often affects women before puberty or when they go through menopause, and the symptoms can last for years. For some people, the rash may result in permanent scarring.

Other symptoms of lichen sclerosus include:

• constipation
• itchiness
• pain when urinating

Besides these symptoms, people with lichen sclerosus otherwise have normal health.

Anal Warts

Another potential cause of white spots around the anus is anal warts, which are caused by the human papillomavirus (HPV), the most commonly transmitted sexually transmitted disease (STD).

Like hemorrhoids, anal warts can affect the area in and around the anus, but they may also develop around the genitals.

Anal warts typically appear as small spots or growths at first, but can soon grow very large, sometimes covering the entire anal area.

Anal warts are typically painless and often appear light brown, flesh-colored, or white.

Additional symptoms may include:

• bleeding
• itching
• feeling a lump in the anal area
• mucus discharge

Perianal Abscess

A perineal abscess is a pus-filled bump located near your anus or rectum. It occurs when one of the anal glands becomes clogged and infected and is often painful. Some other names for a perianal abscess include anorectal abscesses or anal abscesses.

There are some conditions that put you at a higher risk of a perianal abscess, including:

• diabetes
• inflammatory bowel disease (IBD)
• pregnancy
• HIV/AIDS
• diverticulitis
• sexually transmitted infections (STIs)

In addition to the pus-filled bump and pain, some other symptoms of a perianal abscess include constipation or pain when passing bowel movements, rectal bleeding, and pain in the lower part of the abdomen.

Treatment for a perianal abscess requires your healthcare provider to drain the abscess, which often provides immense pain relief.

Pimple

While pimples are most common on the face, they can technically appear anywhere on the body, including around the anus. Pimples on the anus can appear as pustules, papules, or nodules, and some may be pus-filled, making them appear white.

If you have a pimple on your anus, it likely is not painful, but passing a bowel movement may irritate it.

Popping a pimple on the anus is not recommended because it can cause an infection. If you have multiple pimples on your anus, it is recommended to speak to a doctor. Additionally, if you have a fever along with pus coming out of the pimple, it is important to seek medical advice.

Many acne treatments intended for the face or back are also effective for pimples on the anus. However, checking with a doctor before using them on the anus is essential to ensure the product is safe for the sensitive area.

Treatment for Infected Hemorrhoids

If your hemorrhoid becomes infected, it is vital to seek medical treatment; otherwise, there might be complications.

In most cases, an infected hemorrhoid is diagnosed by looking for visual signs of infection, such as redness around the hemorrhoid. Doctors can also detect infection using blood tests, such as a white blood cell count.

Once an infected hemorrhoid is diagnosed, an antibiotic, such as doxycycline, is often prescribed to treat it.

If the hemorrhoid has become peritonitis, which is a more severe infection, antibiotics used include imipenem and cefepime. What antibiotic a doctor chooses to prescribe will depend on your infection severity and if you have any allergies to certain medications.

In severe cases of infected hemorrhoids, surgery may be needed to remove the infected tissue around the hemorrhoid or within the abdomen. This procedure is called debridement.

In addition to these medical interventions for infected hemorrhoids, there are also at-home remedies that can help relieve your symptoms, such as:

• oral pain relievers (e.g., ibuprofen or acetaminophen)
• ice packs or cold compresses
• pads containing a numbing agent
• consuming more high-fiber foods

When to See a Doctor?

If you suspect that a hemorrhoid has become infected, it is important to see a doctor. This is because infected hemorrhoids can lead to peritonitis, a severe and potentially life-threatening complication where the abdominal wall and internal organs become infected.

With DrHouse, you can meet with an online doctor in just 15 minutes to discuss your symptoms and receive an antibiotic prescription to treat your infection.

If your doctor would like to perform a physical exam to check for infected hemorrhoids, you can schedule an in-person same-day appointment through the DrHouse app so that you can still experience the benefits of quick medical care.

Key Takeaways

A hemorrhoid is a swollen vein located in the lower rectum. Depending on if the hemorrhoid is internal or external, it may bleed or be painful, but in most cases, it will go away on its own. However, hemorrhoids may sometimes become infected, which requires antibiotic treatment.

Infected hemorrhoids most often occur when there is a reduction in blood flow, which also reduces the number of white blood cells, and this is most common in prolapsed internal hemorrhoids. Infected hemorrhoids typically appear red, not white, and potential causes of white spots around the anus include lichen sclerosus, anal warts, perianal abscess, or a pimple.

An online doctor can help discuss your symptoms and make a diagnosis. If you have an infected hemorrhoid, an antibiotic can be prescribed to help you feel better.

Sources:

• Anal Warts | ASCRS . (2022). https://fascrs.org/patients/diseases-and-conditions/a-z/anal-warts 
• Fan, Z., & Zhang, Y. (2017). Treatment of Prolapsing Hemorrhoids in HIV-Infected Patients with Tissue-Selecting Technique. Gastroenterology Research And Practice, 2017, 1-5. doi: https://www.doi.org/10.1155/2017/1970985 
• Albuquerque, A. (2016). Rubber band ligation of hemorrhoids: A guide for complications. World Journal Of Gastrointestinal Surgery, 8(9), 614. doi: https://www.doi.org/10.4240/wjgs.v8.i9.614 
• Fergus, K., Lee, A., Baradaran, N., Cohen, A., Stohr, B., & Erickson, B. et al. (2020). Pathophysiology, Clinical Manifestations, and Treatment of Lichen Sclerosus: A Systematic Review. Urology, 135, 11-19. doi: https://www.doi.org/10.1016/j.urology.2019.09.034 
• Krapf, J., Mitchell, L., Holton, M., & Goldstein, A. (2020). <p>Vulvar Lichen Sclerosus: Current Perspectives</p>. International Journal Of Women’s Health, Volume 12, 11-20. doi: https://www.doi.org/10.2147/ijwh.s191200 
• Amato, A., Bottini, C., De Nardi, P., Giamundo, P., Lauretta, A., Realis Luc, A., & Piloni, V. (2020). Evaluation and management of perianal abscess and anal fistula: SICCR position statement. Techniques In Coloproctology, 24(2), 127-143. doi: https://www.doi.org/10.1007/s10151-019-02144-1