Perianal warts and hemorrhoids have different causes, symptoms and appearance, and warts can usually be determined by checking for HPV. 1. different causes: hemorrhoids because the anal structure out of the normal position or localized venous mass formation; warts belong to the viral infection, for infectious diseases, usually have a history of unclean sex. 2. symptoms are different: hemorrhoids are mainly manifested as anal bleeding, swelling out, itching, pain, etc.; warts are mainly manifested as perineum, perianal and other wet parts of the discomfort, itching, etc., the later may appear swelling growth. 3. Anal warts, usually located in the skin around the anus, or within its folds, the size of the needle tip to rice grains, grayish-white, the surface of the papillary or granular. Hemorrhoids are caused by dilation of blood vessels under the skin or mucous membranes around the anus, usually larger in size, ranging from about the size of a soybean to the size of a peanut, located on the anal verge, with normal surface skin, and can be accompanied by pain and constant dripping of blood from the anus during defecation. Perianal warts and hemorrhoids have the possibility of occurring at the same time, therefore, the need to go to the regular hospital in a timely manner for diagnosis and treatment of any disease symptoms, examination, and confirmation of diagnosis is the first step.