anal rashes

My 7 yr. old presented 2 days ago with anal itching and bleeding when wiping.  I've been treating it with hydrocorisone cream and vaseline and it doesn't seem to be working.  The rash is about the size of a quarter and is bright red and he has a couple of small pimples around his upper buttocks.  What can I do and should I be concerned?

[Dr Santos]

Hi,

How is your son? Are there other symptoms present? Pruritus ani is the irritation of the skin at the anus, causing the desire to scratch. Try to make him stop scratching to avoid further infection and bleeding. The intensity of anal itching increases from moisture, pressure, and rubbing caused by clothing and sitting. The irritation can also be caused by anal perspiration, frequent liquid stools, diarrhea, or residual stool deposits. Other conditions that can cause anal itching include pinworms, yeast,  hemorrhoids, tears of the anal skin, and skin tags. Have him evaluated further for proper management and to rule out other causes mentioned. Pinworm is common cause at this age wherein there is intense itching at night due to the migration of the adult female worm. It is important to clean and dry the anus thoroughly and avoid leaving soap in the anal area.  After bowel movements, moist pads should be used for cleaning the anus instead of toilet paper.

Take care and keep us posted.