Anal eczema is one of the most common skin problems seen by procologists. But many people are reluctant to see a doctor with such symptoms because of shame.
What is anal eczema?
The term anal eczema identifies acute or chronic inflammation of the skin around the anus. The term anal eczema identifies acute or chronic inflammation of the skin around the anus. It can be an accompanying symptom of other organic diseases, but also of a skin disease. Physicians distinguish three main types of anal eczema:
- Irritative-toxic anal eczema
- Contact allergic anal eczema
- Atopic anal eczema
In all forms, there is a reddened to weeping skin and excruciating itching that does not allow sufferers to rest, and is particularly bad at night.
Causes
Because of the special anatomic conditions involving skin-on-skin contact, the anus area is particularly prone to rashes. In irritant-toxic anal eczema, the skin is irritated by intestinal secretions that collect in the anal fissure, for example, in enlarged hemorrhoids or anal fistulas that weep. Diarrhea or incontinence can also cause skin irritation. Sometimes small skin folds (marisques) form at the anus, making careful cleaning after defecation difficult. Fecal debris can collect there and become inflamed. Strong rubbing when cleaning with toilet paper after defecation as well as too much anal hygiene can also irritate the skin. In contact allergic eczema, an allergic reaction occurs to ingredients or fragrances of toilet paper, especially 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 a generally hypersensitive skin, which also leads to skin rashes on other parts of the body. If a rash occurs only in the anal area, it is difficult to diagnose. Other causes of anal eczema may include fungal infections, profuse sweating in the anal area, consumption of hot spices and citrus fruits, and overly intensive or insufficient anal hygiene.
Symptoms, signs and symptoms
In the acute state, the skin on both sides of the anal fissure is symmetrically reddened, sometimes covered with a white coating, and weeping. Affected individuals are permanently plagued by excruciating itching, which may be worse at night. The skin is sore from constant scratching and every bowel movement becomes a torture because anal hygiene keeps irritating the already inflamed skin, especially because mechanical cleaning with toilet paper additionally irritates the skin. When the condition becomes chronic, the skin can tear and fissures and ulcers can form.
Diagnosis and course
Careful diagnosis is necessary for successful treatment. A detailed history is followed by a physical examination of the anal area. In atopic anal eczema, diagnosis is very difficult if a rash occurs only in the anal area. If intestinal disease is suspected, a rectoscopy (proctoscopy) and/or a rectoscopy (rectoscopy) is performed. Swabs are taken for examination in the laboratory, and if a contact allergy is suspected, an allergy test provides clarity. If treatment is not effective, a tissue sample may be taken as a precaution and examined in the laboratory to rule out rectal cancer, which can also cause anal eczema. The course of the disease varies. Often anal eczema can be treated in a short time, but it can also take a protracted course. If no treatment is given, the skin can be irreparably damaged.
Complications
When eczema persists in the anal area, further discomfort and complications may occur. One of the most persistent symptoms of anal eczema is phasic itching. Many people constantly give in to the itching, thus delaying the healing of the eczema or making it worse due to the additional skin damage caused by excessive scratching. If anal eczema persists for a long period of 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 area of eczema, is particularly susceptible to all kinds of infections. The risk of the formation of anal carcinoma also increases enormously. Even with medical treatment of anal eczema, complications can occur. Determining the cause of the eczema often proves difficult and leads to incorrect diagnoses. If wrong ointments and medications are prescribed, it may lead to worsening of anal eczema. If anal eczema reacts negatively to an ointment, under no circumstances should the patient shy away from going to the doctor again.
When should you go to the doctor?
If anal eczema is suspected, the family doctor should be consulted immediately. Medical clarification is necessary if the eczema is accompanied by severe pain, itching or other accompanying symptoms that noticeably reduce the general well-being. If the above-mentioned complaints persist for more than a week, a doctor must clarify the cause and treat it if necessary. If bleeding or the formation of further nodules occurs, an immediate visit to the doctor is recommended. An anal eczema should be clarified at the latest when pain or bleeding is noticed during bowel movements. The same applies to an unexplained feeling of pressure at the anus, which increases rapidly. Then it is possibly a serious inflammation, which must be treated by a doctor. Further contacts are the proctologist or a gastroenterologist. Patients who have already suffered from anal eczema or hemorrhoids should talk to a doctor at the first signs of eczema. Children, the elderly and pregnant women should also have corresponding complaints clarified immediately to avoid further complications.
Treatment and therapy
The treatment of anal eczema is primarily aimed at relieving the symptoms so that the overly irritated skin calms down. If there are no more severe symptoms yet, it can also be treated well with home remedies, such as 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 gently relieve the unbearable itching. To let the discomfort subside, the anus must be kept dry and clean. After defecation, it is best to clean it with lukewarm water or oil and dry it carefully and thoroughly after cleaning. If the anal eczema is very weeping, it helps to place a soft cloth between the buttocks to absorb the moisture and allow the inflammation to subside. A wound cream for babies or Vaseline helps very well. If the discomfort is more severe, suppositories and ointments can provide relief and promote the healing process. The doctor can prescribe anti-inflammatory ointments against the itching and inflammation. Depending on the cause, anal eczema is then further treated with zinc ointment or other fatty ointment and, if necessary, a change in diet. If hemorrhoids are responsible for the eczema, they are sclerosed. Surgery is usually required only for large hemorrhoids and large skin tears.
Outlook and prognosis
In most cases, anal eczema causes a very intense and, above all, unpleasant itching that occurs directly at the anus. This itching enormously reduces the patient’s quality of life and restricts everyday life. Not infrequently, anal eczema also causes psychological discomfort or depression. Those affected are not infrequently ashamed of the complaint and thus suffer from inferiority complexes or reduced self-esteem. Going to the toilet can also become a torment for the patient, as defecation is usually associated with pain. Rubbing through toilet paper can also cause irritation in the process. Without treatment, anal eczema can also cause ulcers or fissures to form. In most cases, the discomfort can be well limited with the help of creams and ointments, so that there is a positive course of the disease. In the case of a disease of the intestine, surgical intervention may be necessary. However, the further course of the disease strongly depends on the underlying disease, so that a general prediction is not possible in most cases. The affected person has various means of self-help at his disposal to limit these complaints. As a rule, life expectancy is not reduced by anal eczema.
Prevention
Anal eczema can be prevented particularly well by gentle and skin-friendly anal hygiene. Drinking enough and eating a diet rich in fiber will keep stools soft. It is best to use white toilet paper made of cellulose. Recycled paper, dyed and wet toilet paper can irritate the skin. It is better for sufferers to limit the consumption of hot spices and citrus fruits, and to wear cotton underwear because synthetic fibers promote sweating.
Aftercare
Aftercare is an important factor in preventing the condition from recurring in cases of anal eczema. Good intimate hygiene is part of this in this context. However, it is important that the patient does not exaggerate this. This is because anal eczema often develops when the area is cleaned too much and the natural skin environment is affected. For this reason, harsh surfactants should be avoided in cleansing products, as should moist toilet paper, which can trigger irritation in sensitive skin. Cleaning with gentle products is sufficient, and often only lukewarm water is needed to clean the anal region. The area should also not be irritated by using toilet paper that is too hard, as eczema can also easily flare up again due to mechanical stress. Damp skin regions are a gathering place for pathogens and other None, which find favorable conditions to live and multiply in this milieu. Therefore, it is recommended to always pat the anal region dry well after going to the toilet or washing. The right underwear can also support the aftercare. Cotton is often more suitable than synthetic fiber, in which the affected person sweats. Aftercare for anal eczema also includes promptly visiting the family doctor or treating proctologist if symptoms are suspected of flaring up again, in order to prevent the eczema from spreading.
What you can do 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 alleviated by simple measures and home remedies. First of all, increased intimate hygiene is recommended. For anal eczema, anti-inflammatory care products are just as effective as ointments and lotions from the pharmacy. In order to speed up recovery, strenuous sports should also be avoided temporarily. Gentle relaxation exercises and yoga are more sensible. A proven home remedy is 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. Equally effective are suppositories and ointments made from Hammamelis tree. Hot compresses with yarrow or steam baths with chamomile are also suitable and should be applied daily if possible. 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, sufficient fluids should be drunk, preferably mineral water or light herbal teas made from chamomile, lemon balm or deadnettle. If anal eczema persists despite everything, it is necessary to go to the doctor with the symptoms.
