anal raw, stinging stripe, recurrent

[anal itch/fissure/concern in ohio]

I am a 25 year old female. About 3 years ago, i noticed a stinging sensation occasioanlly, when i would wipe myself after a bowel movement. After inspection with a mirrir, i saw that the tender spot was a very tender, raw line located along the outer edge of a sort of extra flap of skin i have at about 11 o'clock of my anus, in the direction of my vagina. I can't recall how long i've had that skin flap...i'd never noticed it at all until i began having the pain/stinging in that area. After a few days, the raw spot seemed to be covered with a scab-like skin, and eventually it was completely healed. This same thing recurs to this day in the very same spot. sometimes it will come and heal 4 times in 2 or 3 weeks, and then go away for 6 weeks! Other times it will be gone for 5 and 6 months. Sometimes, it seems stress causes this "outbreak" and other times it seems that if i wipe too hard the irritation will occur.
Recently I saw an acupuncturist who treated me for anus support, and this was the only time the next "outbreak" occured mostly within my anus for a short period of time, and then quickly healed. These outbreaks can appear in an instant, it seems, but they usually take between a day and 4 days to go away. The line of tender, raw skin is about a centimeter at most, and can be almost a speck at other times. sometimes the whole thing is only of a deeper red hue than the surrounding skin, and other times the edges seem to be kind of whitish. The edges are clearly defined.
After doing web research, what matches up most with my symptoms are descriptions of anal fissures and external hemorrhoids...but still, some details are not resonant. Such as, i don't seem to have very extreme pain associated with the lesion; it only hurts when i rub it or poke it, run toilet paper over the area, and it does not hurt to poo. sometimes it itches on its own accord. Often, in the peak of the lesion's presence, i often get a tiny, almost indetectable speck of blood when i dab toilet paper on it.
I once had this lesion tested for herpes, and the test came out negative.  it also does not quite behave or look like herpes. But I do worry that this could be a skin lesion caused by a manifestation of chlamydia. My recently ex-boyfriend has a prostate condition (could be epididymitis, although it's never been able to be diagnosed) and occasional severe pain in his left testicle, which sometimes erupts in a small red area of skin lesion (he has a history of herpes, and this is clear not the same thing). Since certain strains of chlamydia manifest in skin lesions, I worry that somehow i could have caught his mysterious form of chlamydia. I took a Z-Pack (azithromycin) to cure the chlamydia, but it came back a couple months later. Without doing a test/culture, what could you say about this condition? Any clue? Do you think it sounds like an anal fissure and/or a communicable disease?
Thanks so much,
anal itch/fissure/concern in ohio

[Alan Rockoff, MD]

I thunk it sounds like a fissure rather than a communicable disease.  I also think that a doctor will need to see it, because one look from a good vantage is worth a lot more than awkward self-examination plus web research.  Meantime, just keep the area well-lubricated with something like Vaseline, and eat lots of prunes and fiber to keep your bowel movements soft.

Take care.

Dr. Rockoff