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Anthony Osula
Anthony Osula, Doctor
Category: Dermatology
Satisfied Customers: 1763
Experience:  MB ChB DRCOG
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I developed redness, rash, itchiness, burning and soreness

Customer Question

Hello Pearl I developed redness, rash, itchiness, burning and soreness in my perennial (rectal area). I tried hydrocortisone, sudocream and daktakort none of which helped.
JA: How long have you had the symptoms? What seems to make the symptoms worse or better?
Customer: Since almost 2 weeks, symptoms got worse over this time. Symptoms are worse in the evening and night time, no specific triggers. Very sore after using toilet paper, shower
JA: Is there anything else the Doctor should know before I connect you? Rest assured that they'll be able to help you.
Customer: I have rectal fissure treating with disltzem. It’s 3rd time I have it and I never had problems with this cream. Also, I only use it internally. My skin is prone to dermatitis and eczema
Submitted: 19 days ago.
Category: Dermatology
Expert:  Anthony Osula replied 19 days ago.

Thanks for using just answer

Has the perenial area  been examined recently?

Customer: replied 19 days ago.
by GP on Monday they seem to think it’s fungal and prescribed Daktakort but my symptoms are not relieved at all since I used it and in fact been getting worse.
Expert:  Anthony Osula replied 19 days ago.

Sound like some lichen type of rash, obviously I'm not able to examine

What is your specific question?

Customer: replied 19 days ago.
The question what treatment I could try please. Given that hydrocortisone, daktakort haven’t helped. I can send photos, but I don’t know if it’s appropriate being that it’s in perennial area
Expert:  Anthony Osula replied 19 days ago.

Pictures would definitlely help if you can send a good quality one though, if you cant let me know and I still have some suggestions on what you can try

Customer: replied 19 days ago.
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Customer: replied 19 days ago.
I hope it’s ok, thank you
Expert:  Anthony Osula replied 19 days ago.

ok, you have lots of hyperpigmentation changes, have you been scratching the area?

Customer: replied 19 days ago.
No I haven’t I tried really hard not to. But I wash, use toilet paper and my skin is generally very sensitive. I also sit most day for my work. I also used wet toilet wipes but not any longer
Expert:  Anthony Osula replied 19 days ago.

I see this condition all the time, and it can be treated easily

You have severe dermatitis in this region.

I cant tell if fungal just by looking at it, your GP should have done a skin swab to make sure

I'll recommend trying the strongest steroid cream available called Dermovate, used once daily for not more than 4 weeks.

This should solve the problem. Creams like daktacort or hydrocortisone are too weak for this area.

If your GP thinks fungal, then he/she should have prescribed Trimovate instead of Daktacort which is far stronger

Expert:  Anthony Osula replied 19 days ago.

toilet wipes is a definite no

Customer: replied 19 days ago.
Thank you very much!
Expert:  Anthony Osula replied 19 days ago.

No worries, dermovate would have to be prescribed by your Dr as its very strong

Customer: replied 19 days ago.
Sorry one more question I have at home elocon and advantan. Can I use either one of them whilst I am waiting for GP spot to get prescription for the creams you advised?
Expert:  Anthony Osula replied 19 days ago.

Elocon is second to Dermovate in terms of strength so yes you can use that

I'll recommend Elocon over Advantan

Customer: replied 19 days ago.
Thank you for your help
Customer: replied 19 days ago.
Really appreciate it.
Expert:  Anthony Osula replied 19 days ago.

You are welcome