Hi XXXXXXX,
Thanks for writing to us.
Persistent itch around the anus is known as pruritus ani.
There could be multiple causes
Skin- eczema, psoriasis, intertrigo, fungal infection, warts etc
Surgical- fissures, piles, mucus discharge ,fistulas, skin tags
Local causes- excessive anal sweating, irritation due to soaps, creams, residual stool deposit due to improper cleaning etc
Pin worm infection


So firstly to treat the condition the underlying cause has to be delineated. For the same I would advise you to visit a dermatologist nearby so that the concerned area can be examined.

However as a general treatment protocol, follow these suggestions
1) just use water to clean the area. Do not use soap
2) wipe the area dry, there should not be any wetness after bathing or due to sweat
3) wear loose cotton underclothes to keep the area well ventilated
4) take tablet cetirizine to alleviate the itch. Itching has to be controlled as itching and scratching the area further aggravates the problem.
5) if having constipation take stool softeners or take high roughage diet
6) instead of applying cloben g , mix flutibact cream and candid cream in equal proportion and apply in the affected area. Cloben g contains a very potent steroid that should not be used for prolonged period and also contains gentamycin that can sensitise the area causing further itching.

These are just general measures, the cause and the specific treatment is required to treat it properly

Hope that helps. Should there be any doubt, feel free to write back. I shall be available for follow up

---

Hi XXXXXXX,
The redness and burning sensation could have been initially due to anal fissure. But prolonged application of cloben g could have aggravated it as the antibiotic component( neomycin or gentamycin) of this cream has an irritant potential and hence I had advised you to apply a milder steroid and antibiotic combination which would not only help on healing of tear but would prevent any infection developing at the torn site. I also advised clotrimazole cream as the area is usually wet and prone to get fungal infection which could also have led to redness or burning.
Anal fissure is nothing but a split or tear in mucosa of anus that occurs either due to constipation or hard stool or sometimes due to diarrhoea. During defectation the torn area gets irritated by stool.
As far as treatment is concerned I would still advise you to follow the treatment I suggested in my previous post along with the treatment suggested by your GP so that the redness and burning sensation subsides . Sucral ano cream contains lignocaine- a numbing or local anaesthetic, metronidazole -an antibiotic
Sitz bath is basically to help relieve the pain . But none of this treatment is aimed to control redness and burning and that can be controlled by application of steroid antibiotic cream. Clobetasole is too strong too be applied in anal area and hence I suggested a cream containing fluticasone. Also make it a point to take salads, fibres to increase roughage content of your diet as that will soften stool and prevent development of fissures.

Hope that helps. Should there be any other query, I will be available for follow up.
Regards

---