Causes of anal eczema
The causes of anal eczema are manifold. Often the affected patients have hemorrhoids, which make anal hygiene difficult after going to the toilet. Any bowel movements remaining on the anus lead to irritation of the surrounding skin and thus cause an irritant toxic anal eczema.
An additional irritation of the skin is caused by wetting of the haemorrhoids. Similarly, marisks (harmless skin fold at the transition from the anal mucosa to the “normal” skin) or an anal prolapse (prolapse of the anal canal from the anus) lead to an irritant toxic anal eczema. Other causes are inadequate or excessive anal hygiene, excessive sweating or clothing that is too tight.
Contact allergic anal eczema occurs, for example, as a reaction to preservatives or fragrances in moist toilet paper. But medical products such as haemorrhoid ointments or suppositories can also trigger contact allergic anal eczema in some people. An atopic anal eczema occurs in patients with neurodermatitis, a typical symptom is itching of the anus which occurs only in phases. Other causes of anal eczema are a fungal infection of the anus or chronic psoriasis, which can also manifest itself in the anus. A chronic anal eczema usually has several of the above causes.
Is anal eczema contagious?
Whether anal eczema is contagious cannot be said in general terms. The decisive factor is the cause of the skin irritation. If the eczema is caused by skin diseases such as neurodermatitis or psoriasis, it is not contagious and therefore no special precautionary measures have to be taken.
Even in the case of allergic reactions or mechanical irritation, no danger of infection can be assumed. If it is a cancerous disease, no infection is possible. However, the situation is different in the case of eczema, which is caused by pathogens such as bacteria, fungi or viruses. In this case, strict hygiene with sufficient disinfection of hands and contact surfaces should be ensured in order to avoid infecting the surrounding area.
The treatment of anal eczema
Simple methods, which can be used without a visit to the doctor, can easily be performed at home. It is recommended to clean the anal area with lukewarm water after going to the toilet and to pat it carefully dry. In this way, stool remains are removed and softening of the skin on the anus is prevented.
Patients with anal eczema should refrain from using moist toilet paper, as it can irritate the skin in the anal region. It is also important not to use any special washing lotions or greasy tissues for the anal area. These contain fragrances and preservatives that are harmful to the sensitive skin of the anus.
If these simple methods do not contribute to an improvement of the anal eczema, a doctor should be consulted in order to start a medicinal treatment. In addition to good anal hygiene as described above, warm sitz baths with oak bark or other tanning agents help to alleviate the symptoms of anal eczema. The treatment is supported by a sufficient amount of drinking and a healthy diet rich in fibre, as a soft bowel movement does not additionally irritate the anal eczema.
Avoiding hot spices also helps to protect the inflammatory skin around the anus. In addition to this self-treatment, anal eczema should be treated by a doctor. Treatment of anal eczema also relieves itching.
If the anal eczema is caused by an allergic reaction, taking antihistamines can help against itching. Otherwise, it is advisable to wait until the therapy, consisting of good anal hygiene, sitz baths and ointments, is effective. For the treatment of anal eczema, good anal hygiene and disinfecting sitz baths as well as drug therapy with ointments, which a doctor can prescribe, are suitable.
The treatment of anal eczema can be carried out by the family doctor, a proctologist, a gastroenterologist, a general internist or a dermatologist (dermatologist). In the short term, the use of a cortisone ointment is recommended, which is replaced by a soft zinc paste after some time. Cortisone counteracts an exuberant reaction of the immune system and thus reduces inflammation.
The zinc paste has an anti-inflammatory and drying effect, thus treating the inflammation and preventing the skin from softening again. If the anal eczema is colonized by bacteria, disinfecting ointments or ointments with antibiotics are used. If the pain is severe, an analgesic ointment containing local anaesthetics can be prescribed, which numbs the skin in the anal region.
However, this type of ointment should not be used for anal eczema, which has an allergic cause. If haemorrhoids are the cause of the anal eczema, they must be treated without fail, as a therapeutic success with ointments is then unlikely, if at all, to be achieved. If you suffer from anal eczema, various ointments and creams can help.
If it is only mechanically irritated, dry skin, moisturizing creams can help and alleviate the symptoms. In this case it is a good idea to seek advice in a pharmacy. If the eczema is the manifestation of a skin disease like neurodermatitis or psoriasis, creams with medicinal ingredients may be necessary.
These should be prescribed by the dermatologist and used strictly according to his instructions. If it is an infection with bacterial pathogens, ointments containing an antibiotic could be necessary, which are then applied directly to the eczema. In the case of a fungal infection, there are also antimycotic ointments that can act directly against the fungi.
For some anal eczema, the use of cortisone may be necessary. This can be done locally with an ointment or systemically with tablets. It is not possible to say in general when cortisone is necessary; what is important here is the cause and the severity of the eczema.
For example, in the case of psoriasis or neurodermatitis, a cortisone ointment works well against the inflammation and can lead to rapid healing. Only the treating physician can judge whether a cortisone treatment is necessary, under no circumstances should a therapy be started on one’s own, as the cortisone could possibly aggravate the disease! Many patients suffering from eczema like to use the freely available zinc ointment.
The ointment provides the skin with moisture and has an anti-inflammatory and disinfecting effect. It can thus have a soothing effect on the symptoms, especially in the case of mild inflammation, and bring about faster healing. It is important that zinc ointments are only applied to the skin, so as soon as the skin is torn, zinc ointments should not be used.
In case of doubt, the advice of a doctor or pharmacist should be sought. Homeopaths recommend the use of potassium sulfuricum or thuja occidentalis for anal eczema.
