What does a hemorrhoid look like?

External hemorrhoids appear as soft, skin-colored or slightly bluish lumps near the anus. Thrombosed hemorrhoids are hard, purple lumps. Prolapsed internal hemorrhoids appear as pink or reddish, soft tissue protruding from the anus.

How do I know if I have a hemorrhoid or something else?

Hemorrhoids typically appear as soft swellings that may bleed during bowel movements. If you see a hard, irregular mass, have unexplained weight loss, or symptoms do not match typical hemorrhoids, see a doctor to rule out other conditions.

What does a thrombosed hemorrhoid look like?

A thrombosed hemorrhoid appears as a hard, firm lump with a bluish or purple color due to the blood clot inside. The skin over it is often tense and shiny. It causes sudden, severe pain and significant swelling.

Can you see internal hemorrhoids?

Internal hemorrhoids are not visible unless they prolapse (protrude outside). Grade 1-2 internal hemorrhoids stay inside and cannot be seen. Grade 3-4 hemorrhoids may be visible as pink, soft tissue protruding from the anus during or after bowel movements.

What Do Hemorrhoids Look Like? Visual Guide & Identification

What Do Hemorrhoids Look Like?

Knowing what hemorrhoids look like can help you identify your condition and determine the right treatment approach. This guide describes the visual characteristics of different hemorrhoid types.

External Hemorrhoids: Visible Signs

External hemorrhoids form under the skin around the anus, making them visible upon inspection.

Normal External Hemorrhoid Appearance

Typical characteristics:

Soft, skin-colored lumps near the anus
May appear slightly swollen
Can range from pea-sized to grape-sized
Skin texture similar to surrounding area
May have slight bluish tinge if blood pooling occurs

Thrombosed External Hemorrhoid

Distinctive appearance:

Hard, firm lump
Bluish or purple coloration
Significant swelling
Tense, shiny skin surface
Clearly defined borders

This is what a thrombosed hemorrhoid looks like - a blood clot has formed inside.

Skin Tags (Healed Hemorrhoids)

After external hemorrhoids heal, they may leave:

Small, soft skin flaps
Same color as surrounding skin
Painless
Permanent unless surgically removed

Internal Hemorrhoids: What You Might See

Internal hemorrhoids are inside the rectum and typically are not visible unless they prolapse.

Grade 1-2: Usually Not Visible

Located inside the rectum
May cause bleeding but no visible mass
Grade 2 may briefly appear during bowel movements

Grade 3: Visible During/After Bowel Movements

Appearance when prolapsed:

Pinkish or reddish tissue
Soft, spongy texture
Protrudes during straining
Can be pushed back inside

Grade 4: Permanently Visible

Characteristic appearance:

Constantly prolapsed tissue
May appear purplish if circulation compromised
Cannot be pushed back inside
Larger, more prominent mass

How to Tell Hemorrhoid Types Apart

External vs. Internal (Prolapsed)

Feature	External	Internal (Prolapsed)
Location	Under skin around anus	Protrudes from inside
Color	Skin-colored to bluish	Pink to reddish
Texture	Firm, skin-like	Soft, moist, mucous-covered
Pain	Often painful	Usually painless
Reducible	N/A	Can often be pushed back

Normal Hemorrhoid vs. Thrombosed

Feature	Normal	Thrombosed
Color	Skin-colored	Blue/purple
Firmness	Soft	Hard
Pain	Mild to moderate	Severe
Onset	Gradual	Sudden

What is Normal vs. Concerning

Normal Hemorrhoid Signs

Mild swelling
Soft texture
Skin-colored or slightly pink
Gradual onset
Improves with treatment

Concerning Signs - See a Doctor

Dark purple or black color - may indicate strangulation
Extremely hard, painful lump - likely thrombosed
Bleeding that does not stop - needs evaluation
Foul smell or discharge - possible infection
Tissue that looks abnormal - rule out other conditions

Hemorrhoids vs. Other Conditions

Hemorrhoids vs. Anal Fissures

Hemorrhoids:

Visible swelling
Bleeding often painless
Lump present

Anal fissures:

No visible lump (tear is internal)
Sharp pain with bowel movements
May see small amount of blood

Hemorrhoids vs. Skin Tags

Hemorrhoids:

May be swollen or tender
Can change size
Actively symptomatic

Skin tags:

Soft, painless
Stable size
No symptoms

Hemorrhoids vs. More Serious Conditions

When to get checked:

Any new lump that does not match hemorrhoid description
Rapidly growing mass
Hard, irregular texture
Unexplained weight loss
Persistent bleeding

Self-Examination Tips

How to Check Safely

1. Use a mirror - handheld mirror allows visibility 2. Good lighting - ensure you can see clearly 3. Clean hands - wash before and after 4. Gentle inspection - don't probe or squeeze 5. Note what you see - describe to your doctor

What to Look For

Location of any lumps
Color and size
Firmness when gently touched
Any bleeding
Changes over time

If your symptoms match typical hemorrhoid patterns, a topical cream can provide relief while you monitor your condition.

When to See a Doctor

Always consult a doctor if:

You're unsure what you're seeing
Symptoms don't match typical hemorrhoids
Treatment isn't helping
You see concerning signs listed above
You're over 45 with new bleeding

A proper diagnosis from a healthcare provider is essential. What you think is a hemorrhoid could be something else that requires different treatment.

The Bottom Line

External hemorrhoids appear as soft, skin-colored lumps near the anus. Thrombosed hemorrhoids are hard and bluish. Prolapsed internal hemorrhoids are pink/red, soft tissue that protrudes.

If you're unsure what you're dealing with, take our hemorrhoid assessment quiz for guidance, and see a doctor for confirmation.

For a deeper dive into types, see our guide on internal vs external hemorrhoids. If you've identified your type, browse our best hemorrhoid cream recommendations for relief.

Remember: Visual identification is helpful, but a medical professional should confirm your diagnosis, especially if symptoms are severe or don't improve with treatment.