Need help analyzing/knowing what to do about anal pain
20 M, Utah. This is something that's been on my mind for a while. I've been avoiding a doctor visit, as everyone seems to do, and doing everything I possibly can to self-treat (sitz baths, lots of water, fiber, exercise, etc.), and I finally took a picture and wanted to share it to see if anybody knows anything about what I'm supposed to be looking for, as I'm not even sure if it's a roid. It's painful when passing stool and throughout the day it's soar, slighlty painful, and even itchy. I'm primarily asking about whether or not it looks like a roid to you in the photo, and if you think I should go get it checked out or if you think self-medication is enough (I've had extremely expensive medical attention in the past, and so I really want to avoid it if I can).
If it helps, for context, I've been very constipated in the past (like years ago), not so much anymore. I'm also bi/pan and have been getting experimental semi-recently starting a year ago with anal play (probably TMI I know) and think thats about when I started noticing anal pain as I think that was what started flaring up the hemorrhoids. Nothing with real people though. First anal pain started about half a year ago, went away, came back three months later, and here I am, 2 months later without it going away.
What do you think?