Hemorrhoids are often discussed as a single condition, but not all hemorrhoids are the same. Internal and external hemorrhoids differ in location, symptoms, discomfort level, and sometimes healing time. If you’re currently dealing with symptoms, you may be wondering whether the hemorrhoid healing stages vary depending on the type you have.
Understanding these differences can help you manage symptoms effectively, track recovery progress, and know what to expect during healing.
Understanding the Difference Between Internal and External Hemorrhoids
Before comparing healing stages, it’s important to understand the anatomical difference.
Internal Hemorrhoids
Internal hemorrhoids develop inside the rectum. They are usually not visible and often painless because there are fewer pain-sensitive nerves inside the rectum. However, they may cause bleeding during bowel movements.
They are graded based on severity:
Grade I: No prolapse
Grade II: Prolapse during bowel movement but retract naturally
Grade III: Prolapse and require manual repositioning
Grade IV: Remain prolapsed
External Hemorrhoids
External hemorrhoids form under the skin around the anus. Because this area contains many nerve endings, they can be painful, especially when irritated.
External hemorrhoids may also become thrombosed, meaning a blood clot forms inside the swollen vein, causing severe pain.
While both types go through similar hemorrhoid healing stages, symptom intensity and duration can differ.
Stage 1: Inflammation Phase
Internal Hemorrhoids
During the first stage, internal hemorrhoids may cause:
Bright red bleeding during bowel movements
Mild discomfort
A feeling of incomplete evacuation
Pain is usually minimal unless prolapse occurs.
External Hemorrhoids
External hemorrhoids often cause:
Noticeable swelling near the anus
Sharp pain while sitting
Itching and irritation
Tenderness to touch
If thrombosis develops, pain can be severe and constant.
In this early stage of hemorrhoid healing stages, inflammation is at its peak for both types, but external hemorrhoids are typically more painful.
This stage usually lasts 2 to 4 days.
Stage 2: Stabilization and Reduced Swelling
As inflammation begins to decrease, symptoms gradually improve.
Internal Hemorrhoids
Bleeding reduces
Prolapse occurs less frequently
Mild discomfort continues but improves
External Hemorrhoids
Swelling decreases
Pain becomes less intense
Itching reduces
Tenderness improves
For thrombosed external hemorrhoids, the clot may remain painful for up to a week before gradually shrinking.
The stabilization stage of the hemorrhoid healing stages typically occurs within the first week.
Stage 3: Tissue Repair and Shrinking
This is the active repair phase.
Internal Hemorrhoids
Bleeding stops
Swollen veins shrink
Prolapse resolves in lower-grade cases
Rectal comfort improves
External Hemorrhoids
Lump size decreases
Pain becomes mild
Clot dissolves (if thrombosed)
Sitting becomes comfortable again
Internal hemorrhoids may heal faster because they are less exposed to friction and irritation compared to external ones.
This stage usually lasts from week one to week two.
Stage 4: Resolution or Residual Effects
By the final stage of the hemorrhoid healing stages, most symptoms disappear.
Internal Hemorrhoids
No bleeding
No prolapse
Normal bowel function
External Hemorrhoids
Pain resolves
Swelling disappears
Possible leftover skin tag remains
Skin tags are more common after external hemorrhoids. They are harmless but may cause minor hygiene concerns.
Full recovery can take:
Internal hemorrhoids: 1–2 weeks
External hemorrhoids: 2–3 weeks
Thrombosed hemorrhoids: Up to 3 weeks
Do Internal Hemorrhoids Heal Faster?
In many cases, yes. Internal hemorrhoids often heal more quickly because:
They are less exposed to irritation
They cause less pain
They are less likely to develop blood clots
However, higher-grade internal hemorrhoids (Grade III or IV) may require medical procedures and longer recovery.
Do External Hemorrhoids Take Longer to Heal?
External hemorrhoids may take longer because:
They are exposed to friction from clothing
Sitting places pressure on them
They are more prone to thrombosis
Pain can persist longer in external cases, even if swelling reduces.
Still, the overall pattern of hemorrhoid healing stages remains consistent across both types.
Healing After Medical Procedures
If conservative treatment fails, procedures may be used.
Internal Hemorrhoid Treatments
Rubber band ligation
Sclerotherapy
Infrared coagulation
Healing typically takes 1–2 weeks after minor procedures.
External Hemorrhoid Treatments
Thrombectomy (clot removal)
Surgical excision
Recovery may take 3–6 weeks depending on severity.
Post-procedure recovery still follows the same inflammation, stabilization, repair, and resolution phases seen in natural healing.
Signs of Normal Healing
Whether internal or external, normal healing includes:
Gradual pain reduction
Decreasing swelling
Less bleeding
Improved bowel comfort
Tracking these improvements helps confirm smooth progression through the hemorrhoid healing stages.
Warning Signs That Require Medical Attention
Regardless of type, seek medical care if you experience:
Heavy or persistent bleeding
Severe pain that worsens
Fever
Pus discharge
Swelling that increases instead of decreases
Symptoms lasting longer than four weeks
Not all rectal bleeding is due to hemorrhoids. Proper evaluation is important.
Lifestyle Habits That Support Both Types
Recovery depends heavily on daily habits.
Key recommendations:
Consume 25–35 grams of fiber daily
Stay hydrated
Avoid straining
Do not delay bowel movements
Exercise regularly
Avoid prolonged sitting
These habits support smoother hemorrhoid healing stages and prevent recurrence.
Emotional and Practical Differences
External hemorrhoids are often more distressing due to visible swelling and discomfort while sitting. Internal hemorrhoids can cause anxiety due to bleeding.
Understanding the type you have reduces fear and helps set realistic recovery expectations.
Can You Have Both Types at Once?
Yes, some individuals experience mixed hemorrhoids, meaning both internal and external components are present.
In such cases, symptoms may overlap, and recovery may take slightly longer, but the fundamental hemorrhoid healing stages remain the same.
Preventing Recurrence After Healing
After recovery:
Maintain consistent fiber intake
Stay physically active
Maintain healthy body weight
Practice proper bathroom habits
Prevention reduces pressure on rectal veins and protects long-term health.
Frequently Asked Questions (FAQs)
Do internal and external hemorrhoids heal differently?
They follow the same basic hemorrhoid healing stages, but external hemorrhoids are often more painful and may take slightly longer.Which type is more painful?
External hemorrhoids are generally more painful due to nerve endings in the anal skin.Do internal hemorrhoids bleed more?
Yes, bleeding is more common with internal hemorrhoids.Can thrombosed hemorrhoids heal on their own?
Yes, but they may take two to three weeks as the clot gradually dissolves.Are skin tags normal after external hemorrhoids?
Yes, they are common and usually harmless.When should I see a doctor?
If symptoms persist beyond four weeks or worsen instead of improving.Can both types occur together?
Yes, mixed hemorrhoids can involve both internal and external components.Does surgery guarantee permanent relief?
Surgery removes existing hemorrhoids but does not prevent new ones without lifestyle changes.
Final Thoughts
While internal and external hemorrhoids differ in location and discomfort level, they generally move through similar hemorrhoid healing stages. External hemorrhoids may cause more pain and take slightly longer to heal, but most cases improve within a few weeks with proper care.
Understanding these differences allows you to monitor symptoms confidently and take appropriate action if needed.
