General information
Eczema of the buttocks is an inflammatory skin reaction (dermatitis) of the anal or perianal region (i.e. the skin around the anus). This reddening of the skin, which is called anal eczema in the technical language, is not an independent disease but an expression of other pathological processes. These processes can be of microbial or dermatological nature. Anal eczema occurs very frequently, but is associated with a great sense of shame and is still a taboo subject, which is why it is often treated late.
Forms of anal eczema
There are three forms of anal eczema: Each of these forms has a different process to the cause and requires different forms of treatment.
- The cumulative toxic anal eczema,
- The contact allergic anal eczema
- The atopic anal eczema.
About 30% of all eczema on the buttocks belong to this variant, which is called “wolf” in its acute form. The main symptoms of cumulative toxic anal eczema are severe itching caused by wetting of the anus and a softening inflammation of the skin (dermatitis).
The large areas of this anal eczema are sharply delineated from healthy skin; in the chronic form, additional punctiform or extensive tears of the skin (rhagades) occur. The cumulative toxic anal eczema is mainly caused by haemorrhoidal diseases; but also parasitic infectious diseases, incorrect (both excessive and insufficient) anal hygiene, heavy sweating (hyperhidrosis) or strong mechanical stress (running a wolf) can trigger the eczema. Contact allergic eczema is responsible for another 40% of eczema on the buttocks.
This is caused by various allergens. These include substances such as dibucaine, quinine and menthol, which are very often found in skin care products, intimate sprays and toilet paper. In 20 – 30% of cases of eczema of the buttocks, it is due to an atopic cause.
Atopia is understood to be an increased readiness of the immune system to react to environmental substances, i.e. in simple terms an allergy. Ultimately, atopic anal eczema is thus an expression of neurodermatitis. Neudermatitis manifests itself preferably as eczema of the buttocks, which is mainly due to the frequent contact of the anal skin with allergens from the stool. The causes of atopic eczema are still not completely understood, but probably a combination of genetic factors, environmental influences and immunological changes.
