This is Dr. David
the itchiness in the area could be due to a fungal infection.
if he has moisture problems around the anus or gluteal area, this can be a good setup for a fungal infection of the skin
fungus like to grow in areas of darkness, warmth and moisture.
using powder on the area can help dry the skin
there are some over the counter antifungal creams he can try like clotrimazole.
He has tried some over the counter fungal creams which he said relieved it slightly but it didn't go away. Would he need prescribed cream?
Also, does a fungal infection cause discharge and swelling?
antifungal creams have to be used for 3-6 weeks often.
and they have to be used for 1 week even after the symptoms have resolved.
so he might not be using the antifungal cream long enough.
if he has moisture in the area from excessive sweating, he needs to use a powder to help dry the skin there.
if he has anal discharge, he should make sure his stools are not liquidy
more fiber in his diet can help that.
also if his anal sphincter has weakness, he should be doing kegel exercises as well to help strengthen his anal sphincter to help prevent leakage as well.
OK thank you. Is swelling normal? I have been worrying about anal cancer
Although he says the swelling is worse on some days to others
anal cancer usually bleeds and there is a mass which can be felt which bleeds
anal cancer would not get better with steroid creams
his swelling around the area sounds more likely to be hemorrhoid swelling or anal sphincter tissue swelling from inflammation or fungal infection.
have him do the kegel exercises
and use the baby powder.
and antifungal cream again.
and work on adding more fiber to his diet
to prevent leakage
and I bet his symptoms will get better.
The cracked skin on the exterior healed up with steroid cream however he hasn't been given anything to use on the swelling internally.
have him ask his doctor for a 25mg hydrocortisone suppository medication
this can be used once a day internally dissolving to help reduce swelling and inflammation.
That's great, thank you. Perhaps the cracked skin externally were a result of the scratching
if the area is very itchy.
let me know if you have other questions.
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Yes, thank you. Thanks for your help, will let you know if it clears up! Fingers crossed!