If the anal area is very itchy or burns, you may have anal eczema (or perianal eczema). This is an inflammatory skin reaction. The cause is almost always harmless. Even if the anal region is a taboo for many people, you should consult a doctor if necessary. He or she can not only remedy the situation, but also rule out a more serious illness, such as cancer.
Below you will find further information and selected doctors for the treatment of anal eczema.
Anal eczema is an inflammatory and sometimes very painful reaction of the skin around the anus. It is not a disease in itself, but rather a side effect of other diseases, but often also of incorrect or inadequate anal hygiene. Severe itching is the most common symptom.
For treatment, it is important to find the cause of anal eczema. Only then can it be treated effectively.
Many sufferers initially mistakenly suspect a haemorrhoidal condition, which can be characterized by the same symptoms.
Anal eczema is an inflammatory skin reaction on the anus © Henrie | AdobeStock
The most important and most common externally visible sign of anal eczema is a large area of redness, which is usually blurred. In addition, there are often spots in the anal region, which can range from dark to light red and even appear whitish. Weeping and open areas are also typical. Blisters are also common.
The skin discoloration and open areas are usually very painful. This is also due to the fact that the anal region is very well supplied with nerve endings and is therefore extremely sensitive to pain.
These clinical signs mentioned above do not necessarily occur in every patient. They can also occur individually or in combination.
Many patients wish to see the condition of their anal region for themselves before seeking medical treatment. This can be done using a mirror or a cell phone camera. However, this does not replace a medical examination, which is highly recommended.
The typical symptoms of anal eczema are
which occur particularly at the beginning of the disease and often increase in intensity.
Many patients aggravate the symptoms by scratching and rubbing, which is often done due to the intense itching. This often makes the situation worse. For many sufferers, however, it is very difficult not to give in to the need to scratch. Anesthetic ointments that relieve the itching can help here.
The causes of anal eczema vary. The anatomical characteristics of the anal region alone, which is a so-called moist environment, mean that the skin is exposed to very strong irritation. This is made more difficult by the fact that the anal region is almost invariably covered with textiles, which creates a particular burden.
If anal hygiene is too intensive or neglected, additional damage to the superficial skin barrier can occur and cause anal eczema.
In simple terms, there are three main forms of anal eczema:
Irritant-toxic anal eczema is caused by
The consequences of inadequate or excessive anal hygiene are particularly prominent. However, rubbing and scratching in conjunction with increased sweat production and chronic diarrhea in chronic intestinal diseases with increased fluid secretion are also to be mentioned.
To make matters worse, the skin folds in the perianal region are difficult to clean. All hygienic measures or the application of ointments must be repeated after each visit to the toilet. This is not practical in the case of diarrhea and makes treatment more difficult.
Mechanical irritation of the anal region is particularly common in cyclists (cyclists are particularly affected). This can be explained by the increased pressure exerted by the bicycle saddle and the sweat production during sporting activities. However, a pronounced sedentary strain, which can be observed in truck drivers, for example, also frequently leads to anal eczema. Less stressed occupational groups, e.g. salespeople, doctors or teachers, are affected much less frequently.
Atopic anal eczema is characterized by a congenital tendency to skin rashes. The skin exhibits an increased immune response to all materials that come into contact with it.
It is therefore an underlying immunological disease, the best known of which is neurodermatitis, which occurs particularly in the area of the hands and arms.
Here, the hypersensitivity reactions of the skin are easily visible to everyone, as the hands and arms are usually uncovered. Neurodermatitis in the anal region is less well known because this area of the body is only visible to others in exceptional situations.
Contact allergic anal eczema is caused by allergic reactions to all materials that come into contact with the skin surface (most commonly textiles or diapers).
Other triggers, also known as contact allergens, can be certain ingredients, especially fragrances from soap and detergents. However, contact allergies to detergents when wearing tight briefs, panty liners or toilet paper are also not uncommon.
The use of moist toilet paper in particular can trigger a contact allergy. The use of certain ointments, e.g. against hemorrhoids, is also often the cause of an allergic skin reaction.
Finally, chemical ingredients in cosmetic products can also be the cause of allergic anal eczema. Ingredients in certain foods (hot spices, citrus fruits, etc.), which come into contact with the anal region during bowel movements and can lead to an allergy or hypersensitivity reaction in the surrounding skin, should not be forgotten.
Many itchy and weeping skin conditions are contagious. However, most anal eczema (similar to neurodermatitis or psoriasis) cannot be transmitted to other people.
The majority of anal eczema is caused by external influences or a corresponding predisposition. Only in the very rare cases where an infection is caused by viruses, bacteria or fungi is a risk of infection possible in principle.
Anal eczema is only dangerous in the rarest of cases. Nevertheless, as with all skin changes, there is a risk that a malignant cancer may be the underlying cause. It is therefore highly recommended to have a medical examination carried out.
If necessary, an examination of the rectal region or an endoscopy of the gastrointestinal tract can also be arranged in this context. The latter is recommended as a preventive measure from the age of 50, which is why treatment for anal eczema may be the reason to schedule a colonoscopy.
If the symptoms are mild, anal eczema can initially be treated with home remedies. Here are the most important tips:
If these measures do not bring relief or healing within a few days, medical help should be sought. It can then be decided whether the use of an ointment containing cortisoneis necessary. This usually helps anal eczema very quickly and effectively.
General practitioners (family doctors) are the first port of call for anal eczema. They will then decide whether general medical treatment is sufficient or whether a referral to a specialist (proctologist) should be arranged.
However,surgery is rarely necessary, e.g. in the case of chronic anal fistulas or hemorrhoids, if they are diagnosed as the cause of anal eczema.
The ingredients of ointments and care products can themselves have an irritant effect. This also applies to your diet. Avoid hot spices or acidic foods during the illness. This also applies if they cannot be identified as the actual trigger.
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