Brief Answer:
Proper cleaning, keeping the area dry and Medicines.

Detailed Answer:
Hi.
Thanks for your query and a clear photograph.

This clearly shows a picture of dermatitis with peri-anal excoriation.

The commonest causes are:
-Infection of the skin around the anus by the spread of bacteria from the soiling by fecal bacteria.
-Dermatitis caused by the retained skin secretions and the sweat causing itching and thus allowing entry of the infection by bacteria and / or fungal infection.

I would advise you the following:
Have Sitz bath- in a tub with warm water and cleaning the area with soaked cotton , particularly after passing motion so that all the soiling is cleaned thoroughly. Apply Liquid Betadine Solution after this. Have a bath, dry up the area.
-Avoid using soap in this area as the soap contains chemicals which can cause more harm, can enhance dermatitis. A
-Apply Liquid Povidone Iodine (Betadine) locally after cleaning with plain water at bedtime, allowing it to dry up. You can use hair dryer if you have.
-Use loose underwear and pant.
-Keep the area aerated whenever possible, at least when you are at home.
-Avoid hot and humid places.
-Take a 5-day course of an antibiotic and metronidazole to have a better control over infection.
-Therapeutic dosage of Vitamin A and D.
-Maintain with multivitamins one capsule a day for at least one and half month.

If you continue the treatment as advised above, and if there is no hot and humid atmosphere, and if you maintain dryness, this problem will get cleared up.

This is not the area to have fungal infection commonly and the photograph you have posted looks more of a local dermatitis, anti-fungal lotion is not required at the moment and is avoided as it maintains the wetness of the area and does not allow the skin to come back to normal condition.The area needs to be kept as dry as possible for getting the skin to the normal condition (integrity).

I have tried to simplify the diagnosis, treatment and management, this helps all my patients and if you maintain the condition this may not recur.

Please feel to ask for more if you need to or if you feel there is a gap of communication.

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