Anal eczema

A Anal eczema is one of the most common skin problems in procologists' offices. But many people shy away from seeing a doctor with such complaints out of shame.

What is anal eczema?

The term anal eczema is used to describe acute or chronic inflammation of the skin around the anus. It can be a side effect of other organic diseases, but also a skin disease. Doctors distinguish between three types of anal eczema:

• irritative-toxic anal eczema

• Contact allergic anal eczema

• atopic anal eczema

In all forms, reddened or oozing skin and excruciating itching occur, which do not allow those affected to rest and which is particularly bad at night.

causes

Due to the special anatomical conditions with skin-on-skin contact, the anus area is particularly prone to rashes. In irritative-toxic anal eczema, the skin is irritated by intestinal secretions that collect in the anal cleft, for example in enlarged hemorrhoids or anal fistulas that ooze.

Diarrhea or incontinence can also cause skin irritation. Sometimes small skin wrinkles (skin tags) form on the anus, which make it difficult to clean properly after a bowel movement. Feces can collect there and ignite. Vigorous rubbing when cleaning with toilet paper after a bowel movement and too much anal hygiene can also irritate the skin.

In contact allergic eczema, an allergic reaction occurs to the ingredients or fragrances of toilet paper, especially to moist toilet paper, soaps, panty liners or ointments. Hemorrhoid ointments are also a common trigger for this form of eczema.

Atopic anal eczema is based on neurodermatitis with generally hypersensitive skin, which also leads to rashes on other parts of the body. If a rash only appears in the anal area, it is difficult to diagnose. Other causes of anal eczema can be fungal infections, profuse sweating in the anal area, the consumption of hot spices and citrus fruits, and excessive or inadequate anal hygiene.

Symptoms, Signs & Ailments

In the acute state, the skin on both sides of the anal cleft is symmetrically reddened, sometimes covered with a white coating, and wet. Those affected are constantly plagued by excruciating itching, which can be worse at night.

The skin is sore from the constant scratching and every bowel movement becomes torture, because anal hygiene irritates the already inflamed skin again and again, especially because mechanical cleaning with toilet paper also irritates the skin. If the condition becomes chronic, the skin can crack, cracking and ulcerating.

Diagnosis & course

Careful diagnostics are required for successful treatment. After a detailed anamnesis, a physical examination of the anal area is carried out. Atopic anal eczema is very difficult to diagnose if a rash only appears in the anal area.

If an intestinal disease is suspected, a rectoscopy (rectoscopy) and / or a rectoscopy is performed. Smears are taken for examination in the laboratory, and if a contact allergy is suspected, an allergy test provides clarity. If treatment does not work, a tissue sample can be taken as a precaution and examined in the laboratory to rule out rectal cancer, which can also cause anal eczema.

The course is different. Anal eczema can often be treated in a short time, but it can also take a long time. If not treated, the skin can be irreparably damaged.

Complications

If eczema in the anal area persists, further complaints and complications can arise. One of the most persistent symptoms of anal eczema is intermittent itching. Many people are constantly giving in to the itchiness, delaying the eczema to heal or making it worse with the additional skin injuries that result from excessive scratching. If anal eczema persists for a long time, there is a risk that it will develop into chronic eczema and thus become a permanent problem.

Another problem that can occur in the course of anal eczema is a fungal or bacterial infection. The weakened and irritated skin in the eczema area is particularly prone to all types of infections. The risk of developing anal cancer increases enormously.

Medical treatment of anal eczema can also lead to complications. Determining the cause of eczema is often difficult and leads to incorrect diagnoses. Prescribing the wrong ointments and medication can worsen anal eczema. If anal eczema reacts negatively to an ointment, you should definitely not avoid going back to the doctor.

When should you go to the doctor?

If you suspect anal eczema, your doctor should be consulted immediately. A medical evaluation is necessary if the eczema is accompanied by severe pain, itching or other accompanying symptoms that noticeably reduce the general condition. If the symptoms mentioned persist for more than a week, a doctor must clarify the cause and treat it if necessary. If there is bleeding or the formation of further lumps, an immediate doctor's visit is recommended.

Anal eczema should be clarified at the latest when pain or bleeding is noticed during bowel movements. The same applies to an inexplicable feeling of pressure on the anus, which increases rapidly. Then the inflammation may be severe and a doctor should treat it. Other contacts are the proctologist or a gastroenterologist. Patients who have ever had anal eczema or hemorrhoids should speak to a doctor at the first signs of eczema. Children, the elderly and pregnant women should also have any complaints clarified immediately in order to avoid further complications.

Doctors & therapists in your area

Treatment & Therapy

Treatment for anal eczema is primarily aimed at relieving symptoms so that over-irritated skin soothes. If the symptoms are still not severe, it can also be treated well with home remedies, for example with Sitz baths made from oak bark extract or green and black tea. Tannins in teas can dry out eczema and have an antiseptic effect. Medicinal herbs such as chamomile, lavender and ivy have an anti-inflammatory effect and soothe the unbearable itching in a gentle way.

In order to subside the discomfort, the anus must be kept dry and clean. After a bowel movement, it is best to clean it with lukewarm water or oil and dry it carefully and carefully after cleaning. In the case of heavily oozing anal eczema, it helps to place a soft cloth between the buttocks so that the moisture is absorbed and the inflammation can subside. A wound cream for babies or petroleum jelly helps very well.

In the case of more severe symptoms, suppositories and ointments can provide relief and promote the healing process. The doctor can prescribe anti-inflammatory ointments to relieve the itching and inflammation. Depending on the cause, the anal eczema is then treated with zinc ointment or another fatty ointment and, if necessary, a change in diet. If hemorrhoids are responsible for the eczema, they become deserted. As a rule, surgery is only required for large hemorrhoids and large tears in the skin.

Outlook & forecast

In most cases, anal eczema causes a very strong and, above all, unpleasant itchiness that occurs directly on the anus. This itching reduces the patient's quality of life enormously and restricts everyday life.

It is not uncommon for anal eczema to cause psychological complaints or depression. Those affected are often ashamed of the complaint and suffer from inferiority complexes or a reduced self-esteem. Going to the toilet can also be torture for the patient, as bowel movements are usually painful. Rubbing through toilet paper can also cause irritation. Without treatment, anal eczema can also develop ulcers or cracks.

In most cases, the symptoms can be limited with the help of creams and ointments, so that the disease progresses positively. Surgical intervention may be necessary if the intestine is diseased. However, the further course of the disease depends heavily on the underlying disease, so that a general prediction is not possible in most cases. There are various means of self-help available to those affected to limit these complaints. Life expectancy is usually not reduced by anal eczema.

prevention

Anal eczema can be prevented particularly well through gentle and skin-friendly anal hygiene. Drinking enough and eating a high-fiber diet will keep your stool soft. It is best to use white cellulose toilet paper.

Recycled paper, colored and damp toilet paper can irritate the skin. Those affected should limit the consumption of hot spices and citrus fruits and wear cotton underwear, because synthetic fibers promote sweating.

Aftercare

Follow-up care for anal eczema is an important factor in ensuring that the disease does not recur. Good intimate hygiene is part of this. However, it is important that the patient does not overdo this. Because anal eczema often occurs when the area is cleaned too much and the natural skin environment is affected.

For this reason, harsh surfactants should be avoided in cleaning products as well as damp toilet paper, which can cause irritation in sensitive skin. It is sufficient to cleanse with gentle products, often only lukewarm water is necessary to cleanse the anal region. The area should also not be irritated by toilet paper that is too hard, since eczema can easily flare up again due to mechanical stress.

Moist skin regions are a gathering point for pathogens and other none that find favorable conditions for life and reproduction in this milieu. It is therefore advisable to pat the anal region well dry after using the toilet or washing.

The right underwear can also support aftercare. Cotton is often better than synthetic fibers, in which the person concerned sweats. Follow-up care for anal eczema also includes seeing your family doctor or treating proctologist promptly if you suspect that the symptoms will flare up again in order to prevent the eczema from spreading.

You can do that yourself

In the case of anal eczema, those affected do not necessarily need to see a doctor. In most cases, the painful growths can be relieved with simple measures and home remedies. First of all, increased intimate hygiene is recommended. Anti-inflammatory care products are available for anal eczema, as are ointments and lotions from the pharmacy.

In order to speed up recovery, strenuous sports should also be temporarily avoided. Gentle relaxation exercises and yoga make more sense. A tried and tested home remedy are sweet clover flowers. Prepared in the form of a lotion, the plant can be applied directly to the anus and should quickly relieve the symptoms. Suppositories and ointments made from Hammamelis tree are just as effective. Hot compresses with yarrow or steam baths with chamomile, which should be used daily if possible, are also suitable.

The diet should also be changed. High-fiber foods such as whole grains, fruits, and fresh vegetables are recommended. Sweets and other foods that could cause constipation should be avoided. In addition, you should drink enough, preferably mineral water or light herbal teas made from chamomile, lemon balm or dead nettle. If the anal eczema persists despite everything, the symptoms must be taken to the doctor.