Itching around the anus can be very uncomfortable, often interfering with daily activities, and making it difficult to get a good night’s sleep.

The basic aim of treatment is to keep the anal area clean, dry, and to avoid injury to the skin from excessive wiping or abrasion. Items in the diet that produce gas, indigestion or loose bowel should be avoided. Foods associated with irritation of the bowels, producing mucus or aggravating drainage, include tomatoes (including ketchup), citrus fruits and juices, coffee and tea (including “decaf” in excess of two cups a day), beer and alcoholic beverages, colas, nuts and popcorn, milk, chocolate, spices (especially peppers). Some people have anal itching only after certain foods (coffee, tea, cola, beer, chocolate, and tomatoes) beginning 24 to 48 hours after eating them and clearing up in a few days provided the more isn’t eaten.

The diagnosis intertrigo refers to an inflammation of the body folds. This is usually located in the inner thighs, armpits, and underside of the breasts or belly. It is red and raw looking. It may itch, ooze or be a little sore.

It is most often due to chafing together of the warm, moist skin, especially in those who are overweight or diabetic. Infection with bacteria or yeast will then develop in the broken skin. A dermatologist should evaluate the condition since there are also several skin diseases that can cause an intertrigo to develop (inverse psoriasis, Haily-Haily, pemphigus, bullous pemphigoid, glucagonoma and others).

Yeast or bacterial infection can be treated with topical or oral medications. Oozing may be controlled with moist compresses with Burows solution 1:20 followed by air drying, preferably using a hair dryer with a “cool” setting. Prescription topical steroid creams such as hydrocortisone can be used, but only for a few weeks. Stronger topical steroid creams will be more rapidly effective, but if used for more than a few days may cause serious skin damage.

Keeping the area dry and exposed to the air can prevent recurrences. If obese, weight loss is helpful. A wad of soft absorbent cotton, or a band of cotton fabric will help absorb sweat. Antiperspirants will help if excess sweating is part of the problem but should only be tried when it has completely healed. It also helps to wash daily with an antibacterial soap and dust with Zeasorb AF Powder.

Relapses are common with this condition, and revisits periodically to the dermatologist may be needed to adjust treatments in many cases.

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