Dear doctor, I am in need of an consultant. The whole perineum area itches and bleeds . It started off as an anal fissure but has now spread. After each bowel movement , the wipe causes the perineum to itch and bleed. The scratching feels good but I know it s only making it worse. It s beginning to spread upward towards the scrotum. When it heals, it heals very dry crust-like. But it won t go away because it itches when I wipe so it breaks and bleed. I am not insured so getting to a doctor isn t easy. Is there a treatment cream you could recommend I purchase to treat this infection? Please help it s been almost a year and I don t know how to treat it proper.