Marisken Surgery: Treatment, Procedure & Experiences

What are marisks and how do they develop?

Marisks are soft, harmless skin folds at the outer edge of the anus. They usually develop as a residual condition after swelling, such as from enlarged hemorrhoids, an anal thrombosis, diarrhea irritations, or small inflammations of the anal skin. When the tissue swells and then subsides again, an excess skin flap often remains that does not fully regress.

Typical triggers in brief:

• Hemorrhoidal swelling → overstretched skin
• Anal thrombosis → residual excess skin
• Irritation from straining/diarrhea → inflammatory edema
• Anal eczema or small fissures → temporary thickening of the skin

Complaints arise less from the marisk itself and more from impaired hygiene, moisture, or friction.

CANNEFF® SUP can provide supportive effects here, as CBD and hyaluronic acid soothe the irritated mucosa and facilitate care – it does not remove marisks but often alleviates accompanying irritations.

How do marisks differ from hemorrhoids and other proctological conditions?

Marisks are external, soft skin folds, while hemorrhoids are internal vascular cushions in the anal canal. Thus, both structures affect different tissues: marisks the outer skin, hemorrhoids the internal erectile tissue.

Marisken themselves do not bleed and rarely cause pain. Complaints are more likely caused by Hygiene problems and local irritations.

In case of inflammatory accompanying symptoms – e.g. after diarrhea or with an anal eczema – the use of a soothing preparation such as CANNEFF® SUP may be useful to soothe the mucosa and facilitate care.

When is a surgery for anal warts medically advisable?

Surgical removal is advisable when the marisks cause functional problems or repeatedly become inflamed. The procedure becomes medically relevant especially when conservative measures do not sufficiently relieve the symptoms.

Typical reasons that indicate surgery:

• Hygiene problems: When stool residues get stuck in the skin folds, causing itching, moisture, or inflammation.
• Recurring irritations: Frequent swelling, anal eczema, or small inflammatory phases that impair quality of life.
• Larger marisks: When the skin folds are so pronounced that they cause mechanical discomfort or aesthetic concerns.
• After anal thrombosis: When permanently disturbing excess skin remains after the symptoms subside.

Since many complaints arise from irritation of the anal skin, local care can delay or sometimes make surgery unnecessary. In such cases, the anti-inflammatory and soothing combination of CBD and hyaluronic acid in CANNEFF® SUP can calm the skin – it does not replace surgery but can significantly reduce symptoms before surgery. Surgery is not necessary if the marisks are only visually disturbing but cause no functional problems.

What indications and decision criteria support surgical removal?

Surgical removal of marisks is considered when they cause clinically relevant complaints and conservative measures are insufficient. The decision is based on clear medical criteria that doctors check during the proctological examination.

Essential Indications

Significantly impaired anal hygiene with frequent moisture, odor, or recurring itching.

• Regular inflammatory episodes, such as in connection with anal eczema, irritant dermatitis, or small lesions.
• Skin folds that cause mechanical discomfort, for example when sitting, exercising, or during bowel movements.
• Persistent excess skin after anal thrombosis that does not regress.
• Exclusion of other diseases: It is important that no fissure, abscess, or acute proctitis is present – these must be treated first.

Medical Decision Criteria

During the proctological examination, the doctor pays particular attention to:

Role of conservative therapy

Not every skin tag needs to be operated on. In milder cases, targeted local care can significantly reduce symptoms. Preparations like CANNEFF® SUP, which combine CBD and hyaluronic acid, can soothe inflammation-related irritations and support mucous membrane regeneration – this often serves as a preoperative or accompanying approach but does not replace surgery if functional disorders exist.

What complaints make a hemorrhoid surgery necessary?

Surgery becomes necessary especially when skin tags cause recurring or persistent symptoms that noticeably affect daily life. The decisive factor is not the size, but the functional disorder caused by the skin folds.

Typical symptoms that justify surgery

Hygiene problems: When stool residues become stuck and cleaning is hardly possible.

Chronic oozing or moisture: Often associated with odor or sore skin areas.

Itching and burning: Mainly due to microbial softening of the skin.

Recurring irritations or eczema: When conservative care does not stabilize the symptoms.

Mechanical impairment: For example, unpleasant rubbing when sitting, exercising, or walking.

Painful episodes: Especially if the skin tag repeatedly becomes inflamed or swollen.

When is conservative treatment sufficient?

Mild symptoms can often be controlled by gentle anal hygiene, stool regulation, and soothing care. Preparations like CANNEFF® SUP with CBD and hyaluronic acid can calm the irritated mucous membrane and alleviate inflammatory phases – this can delay surgery but not replace it if functional problems persist.

What treatment options are available for marisks?

Skin tags can be treated conservatively or surgically. Since they are benign, the primary focus is initially on relieving symptoms. Removal is only necessary if functional problems exist.

Conservative treatment options

These measures aim to reduce irritation and improve anal hygiene:

Stool regulation: Fiber-rich diet, adequate fluid intake, possibly mild stool softeners.

Gentle anal hygiene: Lukewarm water, pH-neutral products, avoiding excessive rubbing.

Sitz baths: Short-term use with lukewarm water to soothe the skin.

Local care: In inflammatory or irritated phases, a soothing combination like CANNEFF® SUP with CBD and hyaluronic acid can calm the mucous membrane and alleviate moisture, burning, or mild eczema.

Treatment of comorbidities: e.g. therapy of anal eczema, anal fissures, or diarrhea, as these can enlarge the skin tags.

These approaches are particularly suitable when the skin tags are visually disturbing but do not cause pronounced symptoms.

Operative treatment

If conservative measures are insufficient or the skin tags cause functional problems, removal may be considered. Possible methods include:

What conservative measures can alleviate complaints?

Conservative measures aim to reduce irritation, facilitate hygiene, and avoid inflammatory phases. They are always the first step before considering surgery.

Stool regulation

• A soft, formed stool reduces pulling and friction on the skin folds.
• High-fiber diet (e.g., vegetables, oats, flaxseed)
• 1.5–2 liters of fluid daily
• Mild stool softeners if needed (e.g., Macrogol)

Gentle anal hygiene

Aggressive or frequent wiping can enlarge and irritate skin tags.

Recommended:

• Cleansing with lukewarm water
• Avoidance of perfumed wet wipes
• Gentle patting dry instead of rubbing

Short Sitz baths

Lukewarm water (5–10 minutes) can temporarily relieve swelling and burning, especially after bowel movements.

Care of the irritated mucous membrane

For itching, moisture, or inflammation-like symptoms, a soothing, moisturizing care is advisable.

Treatment of accompanying disorders

Other proctological problems often exacerbate the symptoms:

• Anal eczema
• mild proctitis
• Diarrhea irritations
• small fissures

Targeted therapy of these triggers prevents skin tags from swelling repeatedly.

What surgical methods are available for the removal of hemorrhoids?

Several surgical methods are available for the removal of skin tags. They mainly differ in the technique of tissue removal, but not in the fundamental goal: to precisely remove the bothersome skin fold and enable as uncomplicated healing as possible.

What influences the choice of method?

The decision depends on:

• Size and location of the marisca
• Skin condition (e.g., in anal eczema or sensitive skin)
• Experience of the proctologist with certain devices
• Pre-existing conditions that could affect wound healing

Role of conservative accompanying measures

Regardless of the chosen surgical technique, the skin often remains sensitive for weeks. During this phase, soothing, moisture-binding care can be useful to prevent microlesions and inflammation. CANNEFF® SUP can help soothe the mucous membrane due to the combination of CBD and hyaluronic acid. It does not replace surgery but can support aftercare.

How does a pilonidal cyst surgery proceed specifically?

A marisca operation is a minor outpatient procedure and usually takes only a few minutes. The goal is to cleanly remove the bothersome skin fold and protect the surrounding tissue.

Preparation

• Brief examination to confirm that there is no fissure, acute inflammation, or proctitis.
• Local anesthesia directly at the anal margin; rarely, a short sedation is chosen.

Removal of the marisca

• Depending on the method (scalpel, electrocoagulation, laser), the excess skin is precisely removed.
• The removal itself usually takes less than 10 minutes.

Hemostasis & Wound Care

• Small vessels are closed.
• The wound usually remains open to allow better healing.
• A light dressing or compress is applied.

Immediately after the procedure

• Short observation in the treatment room.
• Patients can usually go home immediately afterward.

What patients feel during the procedure?

Due to local anesthesia, the procedure is almost painless; usually, only pressure or pulling on the skin is felt.

Why aftercare is important

The area is sensitive, and small irritations occur easily. Therefore, many proctologists recommend gentle mucous membrane care after surgery, e.g., with regenerative active ingredients like CBD and hyaluronic acid, as combined in CANNEFF® SUP.

This supports the skin during open wound healing but does not replace surgical treatment.

What preparations, diagnostics, and types of anesthesia are common?

Before a skin tag surgery, a brief but targeted proctological evaluation is performed. The goal is to ensure that the symptoms actually originate from a skin tag and that no acute disease is present in the background.

Diagnostics before the procedure

The examination usually includes:

• Inspection of the anal margin to assess size, location, and skin condition.
• Palpation (digital rectal examination) to differentiate from hemorrhoids or fissures.
• Proctoscopy if an internal hemorrhoidal disease is suspected.

Important: Acute inflammations, anal eczema, or painful fissures must be treated before the surgery.

Preparation

The preparation is minimal:

• No bowel preparation necessary.
• Only light meals on the day of the surgery.
• Avoid deodorants, ointments, or wet wipes in the surgical area.
• In case of recurring irritations, preoperative mucosal soothing may be useful (e.g., CANNEFF® SUP to stabilize the anal mucosa).

Types of anesthesia

Skin tag removal is usually performed under local anesthesia:

For individual skin tags, local anesthesia is completely sufficient and well tolerated.

How does the procedure take place step by step?

The procedure is standardized and usually brief. In a compact form, a skin tag surgery usually looks like this:

Positioning and disinfection

You lie on your left side or in the lithotomy position. The anal area is disinfected and covered sterilely.

Local anesthesia

The skin tag and surrounding tissue are infiltrated with a local anesthetic. After a few minutes, the area is pain-free, leaving only a feeling of pressure.

Tensioning and grasping the skin tag

The skin fold is gently lifted with a clamp or tweezers to clearly separate it from the surrounding tissue.

Excision (removal of the skin tag)

The skin tag is removed at its base using a scalpel, electrosurgery, or laser.

Care is taken not to cut too deeply to avoid injuring the sphincter muscle.

Hemostasis

Small vessels are closed with electricity, laser, or compression. Depending on the technique, no sutures are used so that the wound can heal secondarily (open).

Insertion of a compress

A small compress or wound strip is inserted to absorb secretions and any subsequent bleeding.

Short post-observation

After a few minutes of rest, most patients can leave the practice again.

Which method is more sensible: laser, scalpel, or electrocoagulation?

There is no universally "best" method – the choice depends on the findings, skin condition, and the experience of the treating proctologist. All three procedures can reliably remove skin tags but differ in handling and wound reaction.

Comparison of methods

What influences the decision?

• Size and location of the Mariske
• Skin sensitivity and existing anal eczema
• Tendency to bleed
• Recurrence of irritations
• Competence and preference of the surgeon

In practice, the scalpel remains the most commonly chosen method because it is reliable and well controllable. Laser is often used when especially low bleeding is desired.

Aftercare is more important than the method

Regardless of the chosen method, the skin in the anal area is sensitive during the first weeks. Gentle mucous membrane care can help relieve burning, oozing, or microinflammations. Preparations like CANNEFF® SUP with CBD and hyaluronic acid soothe the tissue and can make open wound healing more comfortable – however, they do not influence the choice of surgical method.

What risks, complications, and side effects can occur?

The Marisken surgery is considered a minor, safe procedure, yet certain complications can occur – as with any operation in the sensitive anal area. Most are temporary and easily treatable.

• Common, mostly harmless side effects
• Pain or burning in the first few days
• Swelling of the surrounding tissue
• Minor bleeding immediately after the procedure
• Oozing due to open wound healing
• Sensitivity during bowel movements
  

These reactions are typical for secondary wound healing and usually subside within a few days to weeks.

Possible complications

Although rare, the following risks should be known:

How to reduce discomfort

Good aftercare is essential: soft stool, gentle hygiene, and regular rinsing with water. To soothe irritated mucous membranes during the healing phase, many patients also use a soothing care product.

CANNEFF® SUP can help here – thanks to the combination of CBD and hyaluronic acid – to alleviate burning, oozing, and skin irritation. This supports the wound environment but does not replace medical supervision in case of noticeable symptoms.

How does the aftercare and healing proceed after a hemorrhoid surgery?

Aftercare is crucial for complication-free healing, as the wound remains open and is especially sensitive in the following days. The healing time usually ranges between 2 and 6 weeks, depending on size, skin condition, and comorbidities.

Immediate phase (days 1–7)

• Pain & swelling are normal and decrease daily.
• Short sitz baths with lukewarm water soothe the region.
• After each bowel movement, the area should be rinsed with water instead of rubbed.

Middle phase (2nd–4th week)

The wound begins to close; oozing and slight traces of blood may still occur.

• Soft stool remains important to avoid pulling on the tissue.
• Light sports activities are possible again, provided they do not cause friction.

Late phase (from week 4)

• The tissue stabilizes, but residual sensitivity may persist.
• Final resilience usually develops after 6–8 weeks.

How care supports healing

Gentle, irritation-free aftercare protects the wound edges and prevents inflammation. Moisturizing and soothing mucosal care has proven effective here.

The combination of CBD and hyaluronic acid in CANNEFF® SUP can:

• reduce burning and irritation,
• soothe small irritated mucosal areas,
• support natural regeneration.

It does not replace surgical care but can make the process significantly more comfortable.

How can nutrition and stool regulation support the healing process?

Gentle stool regulation is one of the most important factors for complication-free healing. Any friction or straining stresses the fresh wound – soft, formed stool protects the tissue and prevents pain as well as secondary bleeding.

Why nutrition is so important

After a Marisken surgery, the anal skin is sensitive. An optimally regulated stool:

• avoids pulling and pressure on the wound edges,
• reduces the risk of fissures or rebleeding,
• facilitates hygiene and minimizes irritation.

Recommended dietary principles

A fiber-rich diet provides volume and a smooth stool consistency.

Favorable foods:

• Oat flakes, flaxseed, psyllium husks
• Vegetables, fruits (especially pears, apples, berries)
• Whole grain products
• Plenty of water (at least 1.5–2 l/day)

Less suitable:

• Spicy foods
• Alcohol
• White flour products
• Large amounts of cheese or meat (constipating)

Supportive measures for stool regulation

When should complications after the surgery be medically clarified?

After a marisca surgery, mild pain, oozing, and minimal traces of blood are normal. However, certain symptoms indicate that a medical check-up is necessary to detect infections or wound healing disorders early.

Warning signs that require timely clarification

• Severe or increasing pain that does not subside despite painkillers
• Significantly increased redness, warmth, or rapidly increasing swelling
• Purulent discharge, foul odor, or yellow-greenish secretions from the wound
• Persistent or heavy bleeding
• Fever or general feeling of illness
• Difficulty with bowel movements leading to repeated straining
• Suspected fissure formation (sharp pain during bowel movement)

Why early action is important

Infections and pronounced inflammations can prolong healing and lead to problematic scarring. A proctological check-up allows for quick countermeasures such as rinsing, local treatment, or adjustment of pain therapy.

Supportive care – useful, but not a substitute for medical supervision

Gentle mucous membrane care remains helpful, especially when the wound area is irritated. Preparations like CANNEFF® SUP can:

• Reduce irritations,
• Keep wound edges moist,
• Soothe microinflammations.

However, they do not prevent medical complications – an examination is absolutely necessary if the symptoms mentioned above occur.

How can skin tags be avoided in the future?

Marisks usually develop as a result of swelling or irritation. The goal of prevention is therefore to protect the anal skin and avoid situations that lead to overstretching or inflammation.

Soft, regulated stool

The most important factor, as straining overstretches the sensitive anal skin.

Recommended:

• fiber-rich diet
• adequate fluid intake
• if necessary, mild stool softeners in case of constipation tendency

Gentle anal hygiene

• Excessive or harsh rubbing promotes irritation.
• Cleansing with lukewarm water
• unscented, pH-neutral products
• gentle patting dry instead of wiping

Treat irritations early

Diarrhea, anal eczema, or small fissures increase the risk of swelling – if untreated, new skin tags can develop from this.

Avoiding constant pressure

Prolonged sitting, intense straining during sports, or a chronically tense pelvic floor muscle can increase swelling.

Care of the mucous membrane prone to irritation

If the anal skin is frequently sensitive, inflamed, or prone to oozing, soothing care can help prevent cycles of irritation.

The combination of CBD and hyaluronic acid, as contained in CANNEFF® SUP, is suitable here to:

• to reduce micro-irritations,
• to keep the skin moist and elastic,
• to stabilize inflammation-prone phases.

This does not replace medical treatment for acute conditions, but can contribute in the long term to improving the conditions so that new skin tags do not develop in the first place.