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What Causes Itching Sensation Around Anal Area After Using Vasodilator Cream?

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Posted on Wed, 26 Nov 2014
Question: I have had a chronic perianal excoriation/redness/itching for about 6 years after treatment of an anal fistula with a vasodilator cream. I used this vasodilator cream for about 8 weeks and it did take care of the fistula and I have had no further problems in that regard. About a week later however, I developed itching and of course tried over the counter cortisone, lotrisone, etc. It controls symptoms temporarily but returns and is spreading. My gynecologist gave me Valsone and I used this for about 6 weeks and it went away only to return again. It looks just red and sore.
doctor
Answered by Dr. Dr. Kakkar (1 hour later)
Brief Answer:
Intertrigo; Antifungals(Oral + Topical)

Detailed Answer:
Hello. Thanks for writing to us at healthcaremagic

I am Dr. Kakkar. I have gone through your query.

Judging from the history and the treatments tried, which seems to benefit the condition only temporarily; I would keep a possibility of Intertrigo, which is inflammation of the body folds (red and sore folds).
Closely opposing body folds can trap moisture and therefore make the area prone to Inflammation from rubbing against each other.
Candidal infection may superimpose (Candidal Intertrigo) thus exacerbating the inflammation (redness and soreness) and itching.
Clinically intertrigo Or candidal intertrigo presents as red, moist, scaly patches of skin on closely opposed body folds.

If I was the treating doctor I would have started you on oral antifungals e.g Oral Fluconazole, in addition to the topical (antifungals+steroids) creams that you have been using already.
Oral antifungals are faster acting and much better in controlling candidal superinfection. Oral antifungals are prescription drugs.

Once the condition improves significantly (usually within 2-4 weeks), what I do in my patients of Intertrigo is, I then ask them to use an antifungal dusting powder e.g clotrimazole dusting powder in the folds, twice daily, for maintenance of improvement.
An antifungal dusting powder not only keep the area dry but also inhibits the growth of fungus/yeast thus preventing recurrence/exacerbation of Intertrigo.

It would be better if you present yourself for examination to a dermatologist. Your dermatologist would tell you more about this condition and prescribe accordingly.

Hope this helps
Take care
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Dr. Kakkar (2 hours later)
What dose of flu console and frequency for oral tablets
doctor
Answered by Dr. Dr. Kakkar (41 minutes later)
Brief Answer:
Oral antifungals

Detailed Answer:
Hi.

Fluconazole is given orally as a weekly dose, for 4-6 weeks. Some dermatologists may also give it as twice weekly dose (e.g Wednesdays/Saturdays Or Mondays/Thursdays) for 4-6 weeks.

Oral fluconazole is available in 150 mg and 200 mg strengths. The dose is calculated according to body weight. You can discuss more with your treating doctor about the exact dose that would be suitable for you.

Regards
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. Dr. Kakkar

Dermatologist

Practicing since :2002

Answered : 9612 Questions

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What Causes Itching Sensation Around Anal Area After Using Vasodilator Cream?

Brief Answer: Intertrigo; Antifungals(Oral + Topical) Detailed Answer: Hello. Thanks for writing to us at healthcaremagic I am Dr. Kakkar. I have gone through your query. Judging from the history and the treatments tried, which seems to benefit the condition only temporarily; I would keep a possibility of Intertrigo, which is inflammation of the body folds (red and sore folds). Closely opposing body folds can trap moisture and therefore make the area prone to Inflammation from rubbing against each other. Candidal infection may superimpose (Candidal Intertrigo) thus exacerbating the inflammation (redness and soreness) and itching. Clinically intertrigo Or candidal intertrigo presents as red, moist, scaly patches of skin on closely opposed body folds. If I was the treating doctor I would have started you on oral antifungals e.g Oral Fluconazole, in addition to the topical (antifungals+steroids) creams that you have been using already. Oral antifungals are faster acting and much better in controlling candidal superinfection. Oral antifungals are prescription drugs. Once the condition improves significantly (usually within 2-4 weeks), what I do in my patients of Intertrigo is, I then ask them to use an antifungal dusting powder e.g clotrimazole dusting powder in the folds, twice daily, for maintenance of improvement. An antifungal dusting powder not only keep the area dry but also inhibits the growth of fungus/yeast thus preventing recurrence/exacerbation of Intertrigo. It would be better if you present yourself for examination to a dermatologist. Your dermatologist would tell you more about this condition and prescribe accordingly. Hope this helps Take care