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The next photo, graciously donated, shows the classical appearance of an external hemorrhoid, in this case, it is a thrombosed external hemorrhoid. Non-thrombosed external hemroids look just the same for the most part, but a more normal color. Such skin tags can also be formed when an external hemorrhoid goes away, as the stretched skin caused by the hemorrhoid is unable to resume normal shape. In this case the anal skin tag was thought to be caused by excessively large stools earlier in life. The thrombosed hemorrhoid actually looks like a black pearl in many respects, but even though it was thrombosed and causing severe pain, the surgeon considered it too small and sent this lovely lady home with the directions to take an anti-inflammatory, and to take a wash cloth soaked in warm water and salt and place it on the hemorrhoid for a period of 5 minutes twice per day.