Suggest Treatment For Perianal Itching
I have been having severe itching around the delicate parts of my anal area since long time. I am getting some relief when I use candid B ointment but the itching comes back if I don't apply it for a few days. What could be the reason for this and treatment?
Oral fluconazole tablets, once weekly and antifungal dusting powder
Detailed Answer:
Hello. Thank you for writing to us.
I have gone through your query and I have noted down your concern.
Perianal itching is most likely due to intertrigo which arises as a result of candidal overgrowth, a yeast. Body folds trap moisture and heat and this favors the growth of this fungus. Underlying medical conditions like diabetes favor recurrent candidal intertrigo and needs to be ruled out by a fasting blood sugar test.
If I was the treating doctor I would start you on an Oral antifungal e.g Fluconazole tablet 150 mg Once every week for 4 weeks.
In adddition to that you may also take a tablet of cetrizine 10 mg once daily in evening for symptomatic relief from itching.
Instead of using an antifungal cream i.e candid- b cream which is also fine, the better option would be to use an antifungal dusting powder e.g abzorb dusting powder, in that region twice or thrice daily. An absorbant powder would keep the folds dry as well as being antifungal would be unfavorable for fungal growth.
Local causes of perianal itching like piles should first be ruled out.
Thank you. The dusting powder and cetrizine tablet should be taken for how long? As the itching goes away when I use candid B and comes back only after a few days after I stop, I may not be able to know when exactly this is cured if it is to be applied until this go away completely. Please advise.
I suggest 4 weeks of both oral and topical treatment
Detailed Answer:
Hi.
You must use both oral and topical forms of treatment for at least 4 weeks. Incomplete treatment is the most common cause for relapse.
Regards