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?