Whether or not external hemorrhoids need to be surgically removed requires a combination of the type of external treatment and the symptoms of external hemorrhoids, which are divided into connective tissue external hemorrhoids, varicose external hemorrhoids, inflammatory external hemorrhoids and thrombotic external hemorrhoids. The connective tissue external hemorrhoid is the superfluous skin around the anal verge, if there is no symptom, no special treatment is needed, usually pay attention to the cleanliness and disinfection of the anal area can be. The inflammatory external hemorrhoids are caused by the edema of the connective tissue external hemorrhoids, which looks like blisters and does not need to be removed surgically. Varicose external hemorrhoids look like sponges and get bigger when squatting and shrink after standing or defecating, and they do not require surgical treatment unless they are complicated by internal hemorrhoids, which become mixed hemorrhoids and require surgical removal. The thrombosed external hemorrhoid is caused by circulation disorder, and the pain is very severe in the early stage. If the medication or conservative treatment does not work or if there are signs of aggravation, surgical removal is required.