skin irritation around anus

i have had this for years now.   it seems this year is worse than ever!   i have been to a few doctors, but like so many of us, im not a big fan of showing my a** around town.   i have been told (and treated) for fungal, stress, hemmorhoids, etc andnothing extinguishes the fire!  it went from discomfort, to disabling.  i have tried the following solutions;

Rx's;
lidocaine(only source of temporary relief)
prilocaine
clotrimazole
betamethsone
"grear's goo" ($100 spent well.....:(
chlorestymine (one dr thought it might be a bile problem)

OTC's;
balmex
lanacane
nupercainal
neosporin
bactine
amb


seems like when thesummer heat comes, its much much worse.   but this is the worst winter i can remember....there is no discharge.  no "mess".   just really irritated, red skin.   sometimes, there is itching, but only 10% of time.   mostly intense pain. hurts when i walk, sit, etc....i can numb it up real well with lidocaine and go back to work.  but now all my Rx's of lidocaine are up. and i would like to find a solution, not a cover up.   any suggestions?   anyone have similar issues?   thanks!

[Bhupinder Kaur, MD]

Hello,
It can be due to moisture(due to sweating or frequent washing), the abrasion caused by clothing, the pressure of sitting, chemical irritants like laundry soaps, colognes and scented toilet paper, certain food irritants, medicines like some antibiotics and laxatives, infections like STD’s and pinworms, anal abrasions and fissures and skin problems such as psoriasis, seborrhea and eczema.

I suggest you to get a biopsy skin done from a dermatologist.
It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.