What is a marisca surgery and when is it necessary?
A marisca surgery can be an effective solution in some cases, especially for large or pronounced mariscas that cause significant and recurring discomfort in the anal region and anus. Mariscas usually do not need to be treated unless they cause persistent or recurring symptoms such as itching, burning, and pain in the anal area. Surgery is recommended if the mariscas are very nodular, firm, or large. Pressure and friction from the lump or skin flap on the anus can cause inflammation in adjacent or opposite skin areas. Before surgery on a marisca, other proctological diseases of the anal canal must always be ruled out or treated. Any existing inflammation around the marisca should also be treated before surgery so that it subsides appropriately before the procedure.
It is advisable to discuss the decision for surgery of the marisca with a doctor who can assess your individual situation and medical history accordingly. Marisca are usually harmless skin folds that form around the anal margin. The consistency of marisca is mostly soft, while the size of marisca can vary greatly. The size range of a marisca here spans from the size of a pinhead to that of an olive. Marisca can also appear singly or as a marisca crown that encircles the entire anus. Causes of secondary marisca include chronic anal fissure, healed anal vein thrombosis, or previous proctological surgeries such as surgery for anal fistulas or hemorrhoids.
If skin tags are present, there is a risk of inflammation of the skin tag. This can lead to swelling around the anus, anal itching, anal burning, or even pain in the anal area. When symptoms first appear, treatment is usually as minimally invasive and conservative as possible, using ointments, creams, suppositories, or sitz baths. Surgical removal of skin tags is not initially medically necessary. Only if skin tags repeatedly cause corresponding symptoms can they usually be removed on an outpatient basis under local anesthesia. After removal of the skin tags, complications such as wound healing disorders, scarring, pain, and abnormal sensations around the anus may occur. Although surgical removal of skin tags is generally rarely medically necessary, skin tags can still impair anal hygiene and make thorough cleaning of stool from the anus more difficult. If this significantly affects the quality of life of the affected person, surgery is possible. Other reasons for removing the skin folds could also be aesthetic aspects. The skin tag removal surgery, called marisectomy, refers to the surgical procedure in which the skin flaps at the anal margin, the so-called skin tags, are removed.
Can I remove skin tags myself or with home remedies?
There is no effective way to remove marisken by yourself or with home remedies. Certain home remedies like sitz baths can relieve symptoms such as anal itching, anal burning, or general irritation in the anal area, but they cannot completely remove the marisken. Attempts to treat marisken with apple cider vinegar will also not be successful. Apple cider vinegar, known for its many culinary uses, does not have sufficient effect on the pronounced tissue of the marisken. For treating marisken, the use of certain creams, ointments, or suppositories, or in severe cases, even a marisken operation for removal, is advisable. Read more here about the treatment of marisken with suppositories.
What should you know about the process of a marisken operation?
A marisken operation is a small, usually outpatient procedure performed under local anesthesia. First, the affected area is locally numbed to make the procedure painless. Then the surgeon removes the marisken either with a scalpel, special scissors, an electrocautery device (cauterization), or using a laser, simultaneously sealing the blood vessels. Depending on the surgical technique, the wound may either be stitched or left open. Due to scarring, the wound in the anal area should ideally not be stressed by sports for 14 days.
The operation usually lasts only a few minutes depending on the extent of the marisca or the marisca crown. The wound is usually only loosely covered with a wound compress, but wound aftercare and wound care play an important role. The anal region contains countless germs of all kinds, so complications such as infections or anal abscesses can result from an open wound.
After the operation, the patient can usually go home the same day. The healing phase lasts several weeks, during which careful hygiene of the anal area is especially important to avoid or best prevent infections such as anal abscesses. Painkillers, suppositories, or anti-inflammatory ointments can support the healing process. As with any surgical procedure, there are risks such as infections or wound healing disorders, but these complications are quite rare during or after a marisca operation.
The operation can also be accompanied by some side effects, which are usually only temporary. Sometimes a hematoma forms after the surgery, which usually resolves within a few days. Small wounds at the anus usually cause no or only minor pain. With larger skin damage, the pain can be stronger and last longer. The body needs time to repair the defects. The removed tissue is always examined histologically under a microscope by pathologists. This allows them to determine the type and nature of the cells and to exclude other (more serious) proctological diseases.
Does pain occur after the marisca operation?
After the marisca operation, usually only minor postoperative pain occurs because the surgical procedure is performed outside the anal canal. The removal of the marisca is mostly done under local anesthesia, leaving an open wound at the anus. After a marisca operation, mild to moderate pain in the treated area is quite common, especially in the first few days after the procedure. This pain is caused by wound healing and irritation of the sensitive tissue in the anal area. Patients often report a burning or pulling sensation, especially when sitting, during bowel movements, or with movement.
To relieve pain, painkillers such as ibuprofen or paracetamol are usually prescribed. Also, CANNEFF® SUP rectal suppositories with CBD and hyaluronic acid can contribute to faster healing and tissue regeneration in diseases of the anorectal canal. CANNEFF® SUP rectal suppositories are a popular treatment option to support the healing process of the tissue even after colorectal surgeries, such as the operation of a marisca. CANNEFF® SUP suppositories can help you support the recovery process and minimize discomfort after colorectal surgeries. Read more here about the treatment of marisca with suppositories.
Sitz baths with warm water or chamomile can also have a soothing effect on the anal area and promote blood circulation and thus the healing process. It is important to keep the anal area clean and dry to avoid infections that could worsen the pain. In most cases, the symptoms significantly decrease within a few days to weeks, provided no postoperative complications such as wound healing disorders occur.
How long am I unable to work and on sick leave after a marisca operation?
After a marisca operation, the duration of incapacity to work depends on the size of the procedure and individual healing. Usually, the sick leave lasts about 3 to 10 days. For smaller procedures or if no complications occur, it can be shorter, while for extensive operations, such as a marisca crown, or slower wound healing, a longer incapacity to work of up to two weeks or even longer is possible.
It is important that the healing process is regularly monitored by a doctor to ensure that no infections or other complications occur that could prolong the healing process. During the first days after the operation, physical exertion should be avoided, especially heavy lifting or prolonged sitting, to not impair healing.
How long does healing take after a marisca surgery?
Healing after a marisca surgery usually takes about 2 to 4 weeks but can vary depending on the extent of the procedure and individual healing progress. In the first days after surgery, swelling and mild pain usually occur, which gradually subside. During this phase, it is important to keep the anal area clean to avoid infections. Sitz baths and the use of anti-inflammatory ointments can support the healing process.
After about a week, the most severe symptoms usually subside, and after 2 to 3 weeks, the wounds should be mostly healed. In some cases, especially with larger marisca or slower wound healing, it can take up to 6 weeks to achieve full healing. Follow-up examinations with the doctor are necessary to monitor the healing process and ensure no complications occur.
After marisca removal, the wound should remain open and be carefully cleaned several times a day as well as after each bowel movement. You can also insert a wound dressing with an ointment into the gluteal fold to prevent secretion buildup in the wound area around the anus. Due to the open wound healing at the anus, fluid discharge is expected for 1-3 weeks, but it should already decrease after a few days. A diet tailored to the treatment can also optimize stool consistency, thereby preventing pressure in the anal area and pain in the wound area.
How can I promote the healing process after a marisca surgery?
After a marisca surgery, there are several things you can do in your daily life to actively support the healing process, avoid complications, and speed up your recovery. Below you will find an overview of some measures to promote the healing process after a marisca operation.
Wound Care and Anal Hygiene
Wound care plays a central role in this. The anal area should be kept clean and dry by gently washing it with lukewarm water and then carefully patting it dry. To support wound healing, you should clean the anal region with lukewarm water only for two to three weeks. It is advisable to avoid straining during bowel movements, as this puts pressure on the wound in the anal area. Use soft, dry toilet paper after bowel movements and clean the anal region gently. Avoid vigorous wiping, rubbing, or scrubbing, as this can mechanically irritate the skin and wound. Physical exertion and heavy lifting should be avoided in the first days after surgery to not impair healing.
Suppositories and painkillers to promote the healing process
Also, CANNEFF® SUP rectal suppositories with CBD and hyaluronic acid can contribute to faster healing and tissue regeneration in diseases of the anorectal canal. CANNEFF® SUP rectal suppositories are a popular treatment option to support the tissue healing process even after colorectal surgeries, such as the removal or excision of a skin tag. CANNEFF® SUP suppositories can help you support the recovery process after colorectal surgeries and minimize discomfort in the anal region. Read more here about treatment of skin tags with suppositories. Painkillers like ibuprofen, if prescribed by a doctor, can also help relieve pain.
Fiber-rich diet, fluid intake, and sitz baths
A fiber-rich diet and sufficient fluid intake are crucial to avoid constipation, as hard stool can delay the healing process and cause pain. Sitz baths with chamomile or antiseptic additives can help prevent inflammation and promote blood circulation, thereby supporting healing.
Medical monitoring of wound healing
Regular check-ups with the doctor ensure that the wound heals well after skin tag surgery and no complications arise. In case of unusual symptoms such as severe pain, bleeding, or fever, the doctor should be informed immediately. With patience and proper care, the healing process can proceed optimally.
What complications can occur during or after a skin tag surgery?
Although a skin tag surgery is generally considered a short and uncomplicated procedure, certain complications can occur as with any proctological surgery. In the following section, you can get an overview of possible complications during or after the surgery to remove a skin tag.
Bleeding of the surgical wound in the anal area
Immediately after the procedure to remove the skin tag or during the healing process, bleeding or secondary bleeding in the surgical area may occur. These are usually mild and subside on their own, but in some cases, wound healing disorders can occur, requiring further medical follow-up treatment.
Wound infection and anal abscess
Wound infection is a common complication after surgical procedures. Symptoms such as severe redness, swelling, pus formation, or fever may indicate it. Timely treatment with antibiotics can effectively control infections in most cases. Redness, swelling around the anus, and pus formation can indicate an anal abscess. If this anal abscess remains untreated or bursts uncontrollably, an anal fistula can develop as a result. Find more information here about the conservative and surgical treatment of an anal abscess.
Pain in the anal area
Pain in the anal area is common after surgery, especially during or while having a bowel movement. If the pain is unusually severe or persistent, this could indicate a complication. Please discuss any such pain or symptoms promptly with your treating doctor.
Wound healing disorders
In some patients, wound healing after marisken surgery can be delayed. This can lead to a prolonged healing period. Factors such as underlying conditions like diabetes or impaired or poor blood circulation in the anal region can increase the risk of wound healing disorders after marisken surgery.
Scar tissue at the anus
In rare cases, excessive scar tissue can form, hardening the tissue and causing discomfort at the anus. In extreme cases, this can lead to narrowing of the anal canal (anal stenosis), which makes bowel movements difficult. With hard stools or constipation, there is an increased risk of anal fissures in cases of anal stenosis.
Recurrence of a marisken
Although the marisken are completely removed during surgery, there is a risk that new skin tags may form in the anal area. When a marisken returns after surgery, this is medically referred to as a recurrence, meaning a recurring marisken.
Problems with fecal incontinence after surgery
In very rare cases, the procedure to remove the sentinel fold can impair sphincter function, which may lead to temporary or permanent fecal incontinence. Especially surgery on a marisken crown can increase the risk of fecal incontinence, as the procedure can affect sensitive structures in the anal area.
Fine nerves run around the anus that are responsible for controlling stool continence. If these nerves are damaged during surgery, it can lead to reduced sensitivity and control over stool continence. There is also a risk that the internal or external sphincter muscle may be damaged, which can impair the ability to finely control stool and intestinal gases. Scar tissue formation following surgery can also reduce the elasticity and mobility of the sphincter muscle. Furthermore, postoperative complications such as infections or wound healing disorders can disrupt the healing process and cause long-term fecal incontinence. Therefore, such surgery is usually only performed when there is a clear medical necessity. A skin tag ring generally refers to several skin tags or folds that appear in a ring around the anus. These skin folds often arise from stretching of the anus or tissue in the anal area, for example in chronic hemorrhoids, anal vein thrombosis, or also recurrent anal vein thrombosis or during pregnancy.
Unlike hemorrhoids, skin tags are not filled with blood vessels and therefore do not tend to bleed. In most cases, they do not require medical treatment unless they cause the mentioned discomfort or there is a desire for removal for aesthetic reasons. Surgical removal should be carefully considered. Surgery for a proctological condition usually carries some risks of complications. Regular follow-up examinations with a doctor help to detect complications early and treat them accordingly. Most of these risks are rare, and the surgery of a skin tag usually proceeds without major problems.
How is health insurance coverage regulated for the operation of a skin tag?
The costs for the operation of skin tags are usually covered by health insurance, provided the treatment is deemed medically necessary due to symptoms and not purely for aesthetic reasons. The costs for the treatment of the skin tag surgery can vary depending on the cause, type, and surgical technique used. Coverage is especially granted if the skin tag causes significant discomfort due to its size, which severely affects the patient's health and quality of life. Typical symptoms of skin tags such as pain, anal itching, and anal burning, which cannot be sufficiently relieved or eliminated by conservative treatments like ointments, creams, suppositories, or sitz baths, often justify surgical removal or excision of the skin tag. Since the operation is medically justified in such cases, statutory and private health insurance usually cover the costs of the procedure as well as the associated pre- and post-treatment. An indication for surgery as a covered service only exists for skin tags with the mentioned anal complaints. Purely cosmetic or aesthetic aspects of the skin tag and the associated desire for removal often have to be paid for independently. Patients should therefore consult their health insurance in advance to ensure that all costs are covered or to find out if and to what extent any deductible may apply.
