puritus ani remedy

[bomber628]

After 2 years of suffering from rectal itching, I was diagnosed by a surgeon with puritus ani. I tried every suggestion for diet modification; no alchohol, caffiene, citric acid, spicy food, fried food, tomato based food, dairy, even limited red meat. I treat the area gently, don't over clean, shower after bowel movements, drink lots of water, added fiber with metamucil, and protect the area with desitin baby rash ointment, (zinc oxide cream). The infected area just got worse and spread along the length of the rectal area/crack. Of all the treatments I've tried, the one thing that clears it up is triamcinolone acetonide cream 0.1 %, (a cortico-steroid cream). So I'm thinking I may have psoriasis in the anal area. The problem is, when I stop using the cream, the condition returns. My supply has run out, and I am wondering if a stronger cortico-steroid cream might be better, like clobetasol propionate. Is that stronger and is that something I can use for a possible psoriasis problem? What are the pros and cons of that idea?

[BhumikaMD]

Hi,

The chances that this is psoriasis are less- this seems to be persistent pruritus ani only.

It would be ebst to consult a doctor and get a proper clinical examination.

Steroid medications can cause skin damage and should not be used for more than a few days to weeks at a time.

The OTC medication Lotrimin cream mixed with hydrocortisone 1% cream can be applied daily. A mild alphahydroxyacid cream can help, as can plain vaseline applied each day to the anal area.

Methylpred 4mg (methylprednisolone tapered dose pack) has shown remission of symptoms in some cases.

For persistent anal itching, efforts are directed toward identifying an underlying cause.

Let us know if you need any other information and post us on how you are doing.

Regards.

[bomber628]

Thank you for your suggestions. I had been to 2 doctors, both of whom decided to refer me to a surgeon for a possible anal fissure. They also tried bactrim and cipro along with analpram. The surgeon was the one who diagnosed puritus and recommended the diet modifications I mentioned in my first post, and told me to protect the area with Desitin. I tried this for several weeks, and during that time, the infected area spread all the way to the top of the crack of my butt and almost all the way to the scrotum. It was like a split in the skin and was raw and sore. I don't see how it could be from irritants in my stool, considering everything I took out of my diet, not to mention the care I took to always wash the area after bowel movements when at home, and when I was at work I would soak flushable wipes with water and gently clean then pat dry the infected area. The affected area just kept expanding until I used a cortico-steroid cream, whick healed it right up. Right now I'm waiting to see if the condition returns after stopping the treatment. Daily hydrocortisone,(analpram), just didn't help clear it up. It at best kept it from worsening. What kind of specialist should I see about this? The methylprednisolone pack is a good idea I hadn't thought of, but I don't know if I should go back to my doctor or to a different specialist. Any other underlying causes you can think of that I haven't thought of? Thanks again for your suggestions...