Doctors give the scoop on a treatment that’s becoming more mainstream.

By Jessica Migala
December 26, 2019
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If you’ve ever taken a mirror to look down there, you may notice that the skin around your anus is, well, dark. Some people opt to get a cosmetic procedure that lightens this pigmentation, which is called anal bleaching, Fouad Georges Kaado Moawad, MD, who offers this treatment in his Virginia Beach medspa, tells Health. “The goal is to achieve an even skin tone similar to the rest of the body,” he says.

What started as a treatment sought out by adult entertainers has gone mainstream. Zuri A. Murrell, MD, is a colorectal and general surgeon in Beverly Hills who performs anal rejuvenation procedures. He has treated 400 to 500 patients seeking anal bleaching. During procedures to treat hemorrhoids and anal skin tags, “patients would jokingly ask ‘can you make it look nice?’” he tells Health.

“Most of the patients coming to me for anal rejuvenation procedures are recently divorced middle-aged women who just started dating again,” says Dr. Murrell.

Here’s the thing, it’s totally normal for the skin around your anus to look darker. “This can be due to genetics, everyday friction, sweat, diet, irritation, hormonal changes, among other reasons,” says Dr. Kaado. And don’t forget that your poop is, well, brown, and stool pigments can change the coloring of this area overtime, adds Dr. Murrell.

How does it work?

Despite what the name implies, there’s no Clorox being rubbed on your anus, says Dr. Kaado. Actual bleach can cause skin burns, so that’s out. More commonly, the lightening or brightening agent is hydroquinone or kojic acid, though some places may also use other topicals, like azelaic acid or niacinamide, he says.

Dr. Murrell’s lightening ingredient of choice is hydroquinone (HQ) because he’s found that it’s the most effective, painless, and safe. HQ helps brighten the area because it inhibits the enzyme that produces melanin, the natural pigment in skin. You can find HQ in skin creams over-the-counter. HQ might be available in 2% strength OTC, but Dr. Murrell uses a higher strength in-office. He says that 8 to 10% is safe—any higher can cause burning.

In Dr. Murrell’s office, he applies the HQ cream to the perianal skin and has the patient leave it on for 10 hours. They return for a follow-up visit one week later, where he looks at the skin to make sure that there’s no irritation or reaction. Patients then go home with the HQ cream and apply it themselves twice daily. They’ll return for another visit a month later to see if the tone is right.

Some places may also offer other types of treatments, like cryosurgery (liquid nitrogen is used to rid pigmentation), chemical peels (these exfoliate dark areas), or lasers (to break down melanin in the skin, which the body then gets rid of), says Dr. Kaado.

The cost of anal bleaching varies depending on the number of follow-up visits you need, but expect about $350 to $450, says Dr. Kaado. If you’re opting for laser treatments, those each run $300 to $400, he adds.

Do results last forever? 

They don’t. “Anal bleaching is a semi-permanent treatment,” says Dr. Kaado. While bleaching reverses the process temporarily, melanin in the skin eventually will build up, and the skin around the anus will darken again.

Results aren’t immediate either, so it’s best to guard your expectations. Dr. Kaado says that if you’re using topical products, you can expect full results in three to four months, and the brightening effect can last for six months. Chemical peels or laser treatments require a few sessions, though you’ll see lightening after the first, and cryosurgery results stick around for a few months, as well, he says.

Can you do it at home? 

Good news DIYers: you can anal bleach at home. If you’re interested in going this route, Dr. Murrell recommends buying a hydroquinone cream and applying daily. Because the concentration is much lower—usually 2%--it’ll take about six to eight months to reach the level of lightening you want.

Though, beware of buying bleaching products from overseas. “These are not well regulated, you don’t know what chemical ingredients [they contain], and if they are approved to be used in the U.S.,” says Dr. Kaado.

Is anal bleaching dangerous?

Under a skilled provider who knows how to look for and treat any reactions, anal bleaching is safe. However, intimate areas are delicate. Before treatment, the area should be clean and shaved with no cuts, and products need to be applied evenly, Dr. Kaado cautions. More severe side effects include scarring, burning, or permanent discoloration. If you have hemorrhoids, address those before a treatment.

You should also avoid sex for two to five days after anal bleaching and stay out of the bath or hot tub for 72 hours. Dr. Kaado notes that heat and friction can cause hyperpigmentation after anal bleaching, so you should rethink habits like hot yoga, running, and wearing thongs.