Anal itching and treatment

Treatment varies widely, depending on the actual cause of the itching.

In almost all cases, hygiene of the area is reassessed and special attention is paid to cleaning and gentle wiping after defecations. Inadequate hygiene, or excessive hygiene and the type of cleaning products used (such as soap), play a role in the onset or aggravation of the problem.

MAIN PROBLEM: The disease is self-perpetuating and the condition is aggravated by scratching and rubbing. The intense itching causes the patient to scratch the affected area. Scratching and rubbing on the superficial layers of the skin makes the itching more intense, causing the patient to scratch more. As the periorbital skin begins to break down, the protective layers of the skin begin to ooze interstitial fluid. The area then becomes moist and susceptible to fungal infection. Open sores are created from scratching, which become vulnerable to bacterial infection. Therefore, treatment is always individualized and depends on the degree of skin lesions.

Hydrocortisone medications are often prescribed and applied topically, especially in the first phase of treatment, to treat skin lesions such as contact dermatitis. However, their long-term use is not recommended.

Using a protective cream or emollient ointment, can also help prevent skin irritation from direct contact with feces. In case there is a development of fungal infection, antifungal drugs should be added to the treatment regimen.

In case there is a bacterial component to the skin irritation, antimicrobial drugs should also be prescribed. Formulations containing a combination of an antifungal, antibacterial, and corticosteroid may be helpful because they can treat the symptoms of itching as well as many of the causes of skin irritation.

The warm and moist environment is ideal for the growth of fungi and bacteria. If the perianal area is irritated by a constant feeling of dampness, the area should be dried with a blow dryer after showering and a cotton pad should be placed between the buttocks to maintain dryness.

A contraindication is to use absorbent powders that do not contain corn starch, which is food for bacteria and fungi. In the case of hyperhidrosis in the perianal area, an antiperspirant formula containing aluminum hexahydrate or aluminum chloride may be useful.

It is worth noting that an unwise diet, the use of antibiotics or an infection can alter the pH, a measure of the acidity or alkalinity of a solution, of the intestinal tract. An increase in pH (alkalinity) allows the normal protective mechanism of the intestinal tract to be lost, increasing the proliferation of fungi and bacteria. A simple stool acidity test may be useful in diagnosing the problem, but it is not specific and should not be settled for.

To correct this problem, the patient’s diet is modified to avoid foods with high alkalinity and the type of foods that come from fermentation, such as citrus juices, beer, wine and carbonated drinks. At the same time, friendly bacteria in the form of Lactobacillusacidophilus, taken orally 4 times a day for 7-10 days, are reintroduced into the intestinal tract.

Finally, the patient should be tested for food allergies and sensitivities. A common cause of anal itching may be lactose intolerance, i.e. the inability to digest significant amounts of lactose, which is the predominant sugar in milk and cheese. Antihistamines can help counteract the reaction of certain allergens. However, foods to which intolerance is present should be avoided. Foods whose use is observed to cause worsening of itching should also be avoided. These are usually chocolate, citrus fruits, coffee, dairy products, nuts, spicy foods, tomatoes, etc.

Usually, the cause of anal itching is difficult to identify and treat. In many cases the above treatments have poor results and anal itching is considered persistent. In these forms of resistant anal itching, our many years of experience allow us to use special techniques, such as periorbital infiltration, with very good results. 90% of patients are relieved from the chronic torturous problem of anal itching.