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Allen KamravaMD · MBA · FACS · FASCRS

Why is there hair coming out of my anus?

In adult women, what is the cause of hair being visible protruding from or around the anal opening, and does it represent normal perianal hair growth versus a sign of hirsutism, androgen excess, or a pilonidal sinus?

How people search for this, in their own words

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Evidence review in plain language · compiled 2026-10-20 · checked 2026-10-20 · next 2026-11-20 · automated review, how it works

What the evidence says

Bottom line

Visible hair around the anus usually isn't a sign of disease, but this hasn't actually been tested by research; the only study that looked directly at excess perianal hair growth found it was caused by a rare hormone-producing ovarian tumor in one postmenopausal woman.

Only one study examined this directly: a 57-year-old postmenopausal woman had hirsutism (excess hair growth) affecting her face, perianal area and legs, caused by a hormone-producing ovarian tumor, and her hair growth improved after the tumor was removed [1]. No study has measured how common visible hair near the anus is in otherwise healthy women, so calling it 'normal' reflects common clinical reasoning rather than a confirmed research finding. Other studies describe skin and hair-follicle diseases such as hidradenitis suppurativa occurring in the perianal area, but these do not explain hair protruding from the anal opening itself [2,4,5,6].

How well studied

Little evidence

The only direct evidence is 1 case report or small series.

This question asks why something happens, not whether a treatment works, so there is no benefit-or-harm verdict. What can be shown is how well it has been studied.

answers it directly
1answers it directly
studies found
7studies found
randomised trials
0randomised trials
people studied
93people studied
years covered
2004–2025years covered

What the research shows

  • Normal anatomical hair growth around the anus

    No study counted or measured how common visible hair around the anus is in women without any disease, so research cannot confirm how 'normal' it is, even though it is a common body part to have hair.

    Not studied

  • Hirsutism or androgen excess (e.g. PCOS, tumors)

    One case report found perianal hair growth caused by a testosterone-producing ovarian tumor in a postmenopausal woman, which improved after the tumor was removed. This shows the link is possible but comes from a single rare case, not a group of patients.[1]

    Some evidence

  • Pilonidal sinus or cyst

    None of the studies found examined pilonidal sinus (a small pit or tunnel near the tailbone that can trap hair) as a cause of hair visible at the anus.

    Not studied

  • Hidradenitis suppurativa (a chronic hair-follicle skin disease)

    Several articles describe this disease affecting hair follicles in the perianal skin, but none of them describe or explain hair actually protruding from the anal opening, so this cannot confirm or rule out a link.[1,2,3,4]

    Too little evidence

  • Need for further medical evaluation

    No study tested when perianal hair should prompt a doctor's visit. The one case that found a serious cause (a tumor) only came to light because the woman had other signs of excess hormones, not from the hair alone.[1]

    Not studied

What the studies found

  • In the one case where it was directly investigated, hair growth including perianal hair was explained by a treatable cause (a hormone-producing tumor) and improved once that cause was treated.[1]
  • Related research shows some perianal skin and hair-follicle conditions, like hidradenitis suppurativa, are recognised diseases with known patterns, even though they don't specifically explain hair poking out of the anus.[1,2]

Important limitations

  • Only one case report addresses this question, and it describes hirsutism (excess hair growth) including perianal hair caused by a hormone-secreting ovarian tumor; it does not address hair protruding from the anus as a distinct symptom, so there is almost no direct evidence on that specific presentation.[1]
  • The other six sources are about related but different problems: hidradenitis suppurativa, nutritional deficiencies, or a spine condition, and none of them describe hair protruding from the anal opening.[1,2,3,4,5,6]
  • Nearly all of these studies are single case reports or small case series of one or two people, and most describe unrelated conditions — hidradenitis suppurativa, post-surgical nutritional deficiency, or spinal cord malformation — rather than the cause of hair around the anus itself. The one larger study, a case-control study of hidradenitis suppurativa with 87 people, measured body image, not hyperandrogenism or hair growth, so it cannot speak to why hair appears there. This means almost nothing here can be generalised to most women noticing this.[1,2,3,4,5,6,7]

What kind of studies

  • Case series4 · 57%
  • Narrative review2 · 29%
  • Case-control1 · 14%

The key studies

  • Cao et al. 2025

    Case Report: Postmenopausal hyperandrogenism misled by adrenal incidentaloma: a rare case of androgen-secreting ovarian adult granulosa cell tumor and clinical implications

    Hormone-secreting ovarian tumor caused itCase seriesVery low quality

    1 people2025

    Hair growth including perianal hirsutism was caused by an androgen-secreting ovarian granulosa cell tumor; removing the tumor normalized testosterone and improved the hirsutism

    Who was studied
    A 57-year-old postmenopausal woman with hirsutism affecting her face, perianal area and legs, plus other signs of high androgen levels
    Main outcome
    Cause of excess hair growth (hirsutism) including perianal hair in a postmenopausal woman
    Quality
    This is a single patient case report, so the cause found here may not explain most people's symptoms.
    Limitations
    Single case report; findings specific to this one rare tumor type and cannot be generalized.

    Taken word for word from the abstract

    • n a 57-year-old postmenopausal Chinese woman
    • population progressive hyperandrogenic symptoms (facial/perianal/leg hirsutism, vertex/frontal alopecia, deepened voice, clitoral hypertrophy)
    • primaryOutcome Postmenopausal women with severe hyperandrogenism require comprehensive adrenal and pelvic evaluation
    • result confirmed FIGO Stage IA AGCT
    • result Postoperatively, her androgen levels normalized, hirsutism/oily skin/acne improved

    Front Oncol · PMID 41602386 · Read it on PubMed ↗

  • Schneider-Burrus et al. 2018

    Association of Hidradenitis Suppurativa With Body Image

    Worse body image in HS patientsCase-controlLow qualityRelated question

    87 people2018

    People with hidradenitis suppurativa had significantly worse body image scores than healthy controls, even after accounting for BMI; the study did not address why hair grows from the anus.

    Who was studied
    adults with hidradenitis suppurativa compared with healthy people (not specifically people noticing anal hair)
    Compared with
    healthy control individuals matched for age, sex, and body mass index
    Main outcome
    body image score measured by a body-concept questionnaire
    Quality
    It is a small case-control study about psychological body-image impact of a skin disease, not an investigation of what causes hair at the anus, so it carries little weight for this question.
    Limitations
    Cross-sectional questionnaire design, small sample, focuses on body image and mental health rather than the anatomy or cause of perianal hair; does not explain hair protruding from the anus.

    Taken word for word from the abstract

    • population 47 consecutive patients with HS entering a tertiary care center and 45 healthy control individuals matched for age, sex, and body mass index (BMI)
    • comparator 45 healthy control individuals matched for age, sex, and body mass index (BMI)
    • primaryOutcome The Frankfurt Body Concept Scale (FKKS) and the Hospital Anxiety and Depression Scale (HADS) were given to patients and controls.
    • result HS significantly reduced body image (mean FKKS score, 234.2 [5.4] in patients and 276.9 [5.7] in controls; P < .001), even when controlled for BMI.
    • n Of the 46 patients and 41 controls included in the evaluation

    JAMA Dermatol · PMID 29466546 · Read it on PubMed ↗

  • Monshi et al. 2015

    Phrynoderma and acquired acrodermatitis enteropathica in breastfeeding women after bariatric surgery

    Not relevant—describes skin deficiency rashes, not anal hair.Case seriesVery low qualityRelated question

    2 people2015

    Both women developed perianal/genitoanal skin lesions, alopecia and hair depigmentation linked to vitamin A or zinc deficiency, not hair growth or protrusion from the anus

    Who was studied
    Breastfeeding women who had previous bariatric (gastric bypass) surgery
    Main outcome
    Skin and hair signs of nutritional deficiency after bariatric surgery
    Quality
    This is a report of only two patients with skin disease, not a study of hair growing from the anus.
    Limitations
    Only two cases, no mention of perianal hair protrusion as a symptom; findings concern perianal eczema and alopecia (hair loss/depigmentation), not hair emerging from the anus.

    Taken word for word from the abstract

    • population two young women with dermatological signs of combined post-gestational nutritional deficiencies following Roux-en-Y gastric bypass surgery
    • primaryOutcome cutaneous signs of malnutrition occurring in this specific clinical setting
    • result Patient 1 exhibited follicular papules on the extremities, perianal eczema, perlèche, alopecia, and depigmentation of hair.
    • result Patient 2 showed erythematous plaques in genitoanal and acral areas, perlèche, diffuse alopecia, and depigmentation of hair.
    • n two young women

    J Dtsch Dermatol Ges · PMID 26513075 · Read it on PubMed ↗

  • Witmanowski et al. 2013

    Acne inversa goes an extra mile than hidradenitis suppurativa

    Not about hair from anus itselfCase seriesVery low qualityRelated question

    1 people2013

    The patient was successfully treated surgically for the disease around the anus and buttocks

    Who was studied
    a 46-year-old woman with a severe hidradenitis suppurativa-type skin condition around the anus and buttocks
    What they received
    surgical excision of the diseased skin with wound closure using local flaps and skin grafts
    Main outcome
    successful surgical treatment of the skin disease
    Quality
    This is a single case report of a surgical treatment for a chronic skin disease, so it offers no reliable information about why hair grows near the anus and cannot be generalised.
    Limitations
    Single case report describing acne inversa (hidradenitis suppurativa), a chronic inflammatory disease of hair follicles and sweat glands, not an explanation of hair protruding from the anal canal itself.

    Taken word for word from the abstract

    • population a case of a 46-year-old patient who was successfully treated surgically for AI around the anus and buttocks
    • intervention excision of the changes and closure of the wound with local flaps and split-thickness skin grafts, taken with dermatome from the rear surface of the thighs
    • primaryOutcome successfully treated surgically for AI around the anus and buttocks
    • result successfully treated surgically for AI around the anus and buttocks by excision of the changes and closure of the wound with local flaps and split-thickness skin grafts
    • n a 46-year-old patient

    Postepy Dermatol Alergol · PMID 24278084 · Read it on PubMed ↗

  • Pedraz et al. 2008

    [Practical management of hidradenitis suppurativa]

    Possibly linked to a skin gland disease, not explained directlyNarrative reviewLow qualityRelated question

    size not given2008

    States hidradenitis suppurativa is a chronic inflammatory disease affecting skin areas rich in apocrine glands, including the perianal region, and is thought to be caused by a primary defect of the hair follicle; no mention of hair actually protruding from the anal opening itself

    Who was studied
    Not specific to anal hair; describes women with hidradenitis suppurativa, a skin condition often starting at puberty
    Main outcome
    Explanation of disease mechanism and management of hidradenitis suppurativa
    Quality
    This is a general review of a skin disease, not a study designed to explain anal hair specifically, so it provides only indirect, background information rather than a direct answer.
    Limitations
    No original data, no direct discussion of hair visibly protruding from the anus; abstract covers hidradenitis suppurativa broadly rather than this specific symptom.

    Taken word for word from the abstract

    • population It usually appears in women during puberty.
    • primaryOutcome Management of the disease includes general measures (antiseptic soaps, warm baths, etc), pharmacological therapy (topical, intralesional, and systemic), surgery (direct closure, second-intention healing, grafts, flaps, etc), and other measures (carbon dioxide laser, radiation therapy, etc).
    • result Hidradenitis suppurativa is a chronic inflammatory disease that usually affects areas of the skin with a high density of apocrine glands (axillae, groin, perianal and perineal regions, submammary area, etc).
    • result The etiology of the disease is unknown, although it is thought to be a primary defect of the hair follicle.

    Actas Dermosifiliogr · PMID 18346431 · Read it on PubMed ↗

  • Edlich et al. 2005

    Difficult wounds: an update

    Does not explain anal hair.Narrative reviewVery low qualityRelated question

    size not given2005

    The review discusses hidradenitis suppurativa (a skin/gland disease) as occurring in the perianal region among other apocrine-gland-bearing sites, but it does not describe or explain hair growing out of or protruding from the anus

    Who was studied
    Adults with various chronic 'difficult' wounds and skin conditions (not specifically women with perianal hair)
    Main outcome
    Advances in treatment of several skin conditions, including Gardner's syndrome, pseudofolliculitis barbae, nasal septal perforation, factitious wounds, and hidradenitis suppurativa
    Quality
    This is a general narrative review of treatments for unrelated conditions and does not study or explain perianal hair growth, so it offers no direct evidence for this question.
    Limitations
    The abstract is a collective review focused on surgical treatment advances for several distinct diseases; it does not investigate or explain the cause of hair protruding from the anus.

    Taken word for word from the abstract

    • population Hidradenitis suppurativa is an inflammatory disease of the skin and subcutaneous tissue that occurs in apocrine-gland-bearing areas distributed in the axilla, mammary nipple areola, mons pubis, groin, scrotum, perineum, perianal region, and umbilicus.
    • primaryOutcome The purpose of this collective review is to describe revolutionary advances in the treatment of Gardner's syndrome (GS), pseudofolliculitis barbae, nasal septal perforation, factitious wounds, and hidradenitis suppurativa (HS).
    • result perianal region, and umbilicus

    J Long Term Eff Med Implants · PMID 16022640 · Read it on PubMed ↗

  • Guilloton et al. 2004

    [Split-cord malformation (diastematolmyelia) presenting in two adults: case report and a review of the literature]

    Not about anal hair; back hair tuft from spine defectCase seriesVery low qualityRelated question

    2 people2004

    One patient had a hair tuft over the lower back (lumbar region), not the anus, found alongside a disc herniation and tethered spinal cord on MRI; the other patient had a birthmark (angioma) over the lower back instead of hair

    Who was studied
    Two adult women, ages 40 and 54, with a spinal cord developmental anomaly (split cord malformation)
    Main outcome
    Clinical and imaging findings in adults diagnosed with split cord malformation
    Quality
    This is a report of only two patients and does not discuss anal or perianal hair at all, so it cannot answer the question asked.
    Limitations
    Only two cases; the hair described is over the lower back (lumbar spine), not at the anus; no information on perianal hair is given.

    Taken word for word from the abstract

    • population We report the case of two women whose type II SCM was discovered at the age of 40 and 54 years.
    • primaryOutcome Split cord malformation (SCM) is an uncommon developmental anomaly characterized a cleft spinal cord.
    • result Physical examination revealed a radicular syndrome with abolition of the left Achille reflex and a lombar hair tuft.
    • result Physical examination showed a lombar cutaneous angioma.
    • n We report the case of two women

    Rev Neurol (Paris) · PMID 15602364 · Read it on PubMed ↗

All 7 studiesEvery study that answered the question, with its design, size and result.
How we searchedThe exact query, the date it ran, and what came back — so you can run it yourself.
Searched
PubMed · ClinicalTrials.gov · Crossref on 2026-10-20
The exact search — paste this into PubMed to repeat it
(hair[tiab] OR hirsutism[tiab] OR "Hirsutism"[Mesh]) AND ("Anus"[tiab] OR anal[tiab] OR perianal[tiab] OR perineal[tiab] OR "Anal Canal"[Mesh] OR "Anus"[tiab]) AND (female[tiab] OR women[tiab])
PubMed expanded that to: ("hair"[Title/Abstract] OR "Hirsutism"[Title/Abstract] OR "Hirsutism"[MeSH Terms]) AND ("Anus"[Title/Abstract] OR "anal"[Title/Abstract] OR "perianal"[Title/Abstract] OR "perineal"[Title/Abstract] OR "Anal Canal"[MeSH Terms] OR "Anus"[Title/Abstract]) AND ("female"[Title/Abstract] OR "women"[Title/Abstract])
What came back
75 records found · 72 read · 7 answered the question
Included
  • Human, animal or laboratory studies reporting an outcome relevant to the question
Excluded
  • Records about a different condition or intervention
  • Studies mainly about Pilonidal sinus hair tuft (hair embedded in a sinus cavity, a different mechanism)
  • Studies mainly about Rectal prolapse (skin/tissue protruding from the anus)
  • Studies mainly about Anal skin tags
  • Studies mainly about External hemorrhoids
  • Records reporting no outcome
  • Retracted publications, which are listed but excluded from every count
Limits
  • Details were read from abstracts, not full papers, so anything reported only in a paper's methods section is not captured here.
  • Fields were read from abstracts, not full text, so detail reported only in a paper's methods section is not captured.
  • Evidence strength is adapted from the GRADE framework. It is not a GRADE assessment and was not produced by a GRADE panel.

Automated evidence review — PubMed, ClinicalTrials.gov, Crossref. Search strategy, grading rules and the checks that must pass before anything publishes were written by Allen Kamrava, MD, MBA, FACS, FASCRS, colon & rectal surgery, Beverly Hills. The pages themselves are compiled by software running that method and are not read one by one before publication — saying otherwise would be the one claim here that could not be checked.

How we grade evidence →

  1. 75records came back from the search
  2. 72were read
  3. 7actually answered the question
Risks and safetyReported side effects and who should be careful.
  • The only identified serious underlying cause in this evidence was a hormone-producing tumor, found through blood tests and imaging after the woman had other signs of excess hormone (not from hair alone). Missing such a cause, if present, could delay treatment.
Why people askWhat brings people to this question.
  • People notice hair near the anus during washing or wiping and worry it means something is abnormal.
  • Embarrassment and lack of clear information make people search online rather than ask a doctor first.
  • Concern about hormone problems, like PCOS, after seeing unusual hair growth elsewhere on the body.
  • Confusion with other symptoms near the anus, such as skin tags, lumps, discharge, or bleeding, which feel related but are actually different issues.
Common questionsShort answers, drawn from the same studies.
Why is there hair coming out of my anus, female?
In the one case report that studied this directly, it was caused by a rare ovarian tumor raising testosterone in a 57-year-old woman, and it improved once the tumor was removed. For most people, though, this hasn't been studied, so research can't say how often it's simply normal versus a sign of something else.
Why is there skin coming out of my anus?
Loose skin near the anus is a different issue from hair, often extra folds of skin. None of the studies in this review looked at skin folds, only hair, so they can't explain this symptom; a doctor can look and tell you what type of skin change it is.
What is the lump coming out of my anus?
A lump near the anus can have several causes, such as a swollen vein or a small cyst, but no study in this review tested lumps, only hair. Because lumps sometimes need treatment, it's best to have one examined by a doctor rather than guess from a description.
What is the thing coming out of my anus?
This review only covers hair seen at or near the anus, not other possibilities like tissue, haemorrhoids, or prolapse. If what you're seeing isn't clearly hair, a doctor can examine it and tell you what it is.
Why is blood coming out of my anus?
Bleeding from the anus is a different symptom from hair and isn't addressed by any study in this review. Blood from the anus should always be checked by a doctor, since causes range from minor to serious.

This is information, not advice

This page summarises published research. It cannot tell you what is happening in your own body, and evidence changes. If something is bleeding, painful, or new, it is worth being looked at — that is a different question from the one on this page, and a better one to bring to a consultation.

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Automated evidence review — PubMed, ClinicalTrials.gov, Crossref. Search strategy, grading rules and the checks that must pass before anything publishes were written by Allen Kamrava, MD, MBA, FACS, FASCRS, colon & rectal surgery, Beverly Hills. The pages themselves are compiled by software running that method and are not read one by one before publication — saying otherwise would be the one claim here that could not be checked.

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