A hard and painful lump at the anal opening is mostly caused by hemorrhoids and perianal abscesses, and the treatment varies from one cause to another. If the symptoms are caused by hemorrhoids, the area around the anus should be cleaned and anti-inflamed with potassium permanganate lotion or saline. Then apply hemorrhoid cream to the affected area. Commonly used hemorrhoid creams include Ma Yinglong hemorrhoid cream as well as Analtech hemorrhoid cream. To prevent trauma to the hemorrhoids due to dry stools, patients can also take oral pills such as Sophora pills. If medication does not work, surgical removal can be used for treatment. Another cause is a perianal abscess, which should be treated by surgically cutting open the abscess, draining the pus inside and then performing an anti-inflammatory procedure, followed by ligating and suturing.