If it's rough, it might be a kind of wart. Don't be embarrassed - it's very common. It's a tough area to see, obviously, so it's hard to know what you are dealing with. A hemorrhoid is usually soft - it's really a varicose vein and they are also common. Sometimes they go away on their own, sometimes they can be treated with silver nitrate applied by the doctor - if not your regular one, then a specialist in a quick procedure. If it bleeds, it's probably a hemorrhoid. If that happens, do not use the Prep H or any other product. They can cause pain and also itching. But this doesn't sound like a hemorrhoid to me if it's a pimple-like thing with a rough surface. Don't panic, don't be embarrassed, just have it looked at by someone. They will also feel inside your rectum (feels like a pelvic exam and takes 2 seconds) to see if there are any more inside. If it's a wart, it's caused by a virus and it can spread and cause more. So waiting forever is probably not a great idea. It could also be some sort of mole, although the pain is unusual, and if it's irregular in shape, it should be looked at and possibly removed. Until you know, you can't treat it yourself. Again, don't be embarrassed - we all have stuff "down there" and can't see it!