Ask a Dermatology Question, Get an Answer ASAP!
These answers are for informational purposes and do not replace a physician head-to-head visit. A patient-physician relationship is not established.
Thank you for asking your question.
Your problem is not rare and is called Pruritus Ani.
This is sometime this problem is initially provoked by a yeast infection, so I would recommend a two week application of Lotrimin cream. This, however, usually does not solve the problem.
Sometimes the yeast infection is triggered by an antibiotic.
Many patients such as yourself have self treated this and this can complicate things for us, since they have overtreated a sensitive area.
Other conditions which might have been there initially would include seborrheic dermatitis ( if you have dandruff and a rash which breaks out along your nose and brow), psoriasis ( a variant called inverse psoriasis), and hemorrhoids. The good news is that most cases do respond to rather simple measures. However, strict adherence is important.
1) Diet may be important. Avoid: nuts, chocolate, cheese, and spicy foods. Coffee, while it need not be eliminated, should be decreased in consumption to one cup a day, as long as it is not hazelnut.
2) Realize this is not a problem with uncleanliness. Bathe or shower only once a day. Do not scrub the anal area.
3) AVOID SCRATCHING!! Scratching leads to a vicious cycle. Scratching leads to more itching which causes more scratching.
4) Harsh toilet paper contributes to the chronicity of this condition. Cotton or tucks must be use for wiping. Mineral oil or Balneol lotion ca be added to cotton. Avoid tinted toilet paper at all costs. Avoid Baby wipes, but Tucks are OK. This is one case where I would stick to the name brand.
Those are general suggestions: As far as specific ways to treat this. After the two weeks of treatment with Lotrimin cream you should use Burow's solution wet packs. I usually recommend DomeBoro brand, but other ones found in Ireland should suffice. Add one packet of Domeboro to 1 quart of cool water. Apply wet clothes, preferably cotton such as in a men's handkerchief, to the area twice a day while lying in bed for twenty minutes, or more often if needed for severe itching. Ice cubes can be added to the solution for an even greater anti-itching effect. A week steroid such as Hydrocortisone ointment 1% should be applied twice a day. I like ointments for this rather than creams since the compound is simpler and contains less ingredients. Take Benedryl 25 mg. at night. If the itching is sevre you can increase this to 50 mg. as long as you are not working, driving , using heavy machinery the next day.
If you follow the above instructions diligently your problem should resolve or at least ease. If it does not, I would definitely recommend consulting with your physician.
I would be happy to answer further questions.