Itchy in front of anus

If you feel itching in front of your anus, you must not ignore it. This may be caused by some bacterial infection. Therefore, you must judge the cause of your illness based on your symptoms. Most patients still need to receive treatment from traditional Chinese medicine to improve. It is necessary to combine internal and external methods for treatment, which will be more effective.

1. Treatment principles

Actively look for and eliminate possible causative factors, apply topical antipruritic agents, and block local subcutaneous sensory nerves if necessary.

2. TCM Syndrome Differentiation and Treatment

(1) Internal treatment method: Use Chinese medicine according to TCM syndrome differentiation: ① If wind-heat attacks the lungs and moves to the large intestine and anus, the treatment should be to clear away heat, purge fire, and promote bowel movements. The prescription used is Liangge San. ② For those with wind evil accompanied by dampness or damp-heat in the liver and gallbladder, which blocks the anus, the treatment should be to dispel wind, clear heat and remove dampness. The prescription can be Xiaofengsan or Longdanxiegan Decoction. ③ Danggui Yinzi is used for those who suffer from blood deficiency, wind-induced dryness, and skin malnutrition. ④ For those with blood stasis causing wind and those with stagnation that cannot be dispersed, the treatment should be to remove blood stasis and wind, and the prescription should be Shufeng Jiedu Decoction. ⑤ If insect poisons invade the anal area, or if dampness or drug poisons block the posterior genitals, the treatment should be to kill insects, detoxify and relieve itching. The prescription is Wumei Pills.

(2) External treatment ① For those with moist skin, sprinkle alum powder on the affected area 3 times a day. ② Those with dry skin can apply Coptis chinensis ointment or Indigo ointment externally 3 times a day.

(3) Chinese medicine external washing and sitting bathing should mainly use drugs that clear heat and detoxify, remove dampness and relieve itching, and sit bathing in warm water.

3. Western medicine treatment

(1) Etiological treatment: Carefully identify the primary causes of pruritus and try to eliminate them. First, anorectal diseases should undergo surgery, followed by gynecological and skin diseases.

(2) Drug treatment: The drug treatment of localized anal pruritus should be based on local external treatment: ① Antihistamines such as diphenhydramine, chlorpheniramine, and astemizole can be used for treatment. ② Hormone therapy is available for women and elderly patients with severe illnesses. ③ For patients receiving antibiotic treatment combined with bacterial infection, antibiotics may be selected as appropriate based on the condition. ④ External drug treatment can have local cooling, anti-inflammatory, drying and antipruritic effects, such as calamine lotion (water-based powder). ⑤ For external drug treatment, antipruritic, antibacterial and hormonal ointments can be used as appropriate.

(3) Physical therapy can use ultraviolet light or infrared light to irradiate the affected area around the anus.

(4) Injection therapy is currently the most commonly used method. It is simple to operate and has definite efficacy. The method is to use drugs to be injected subcutaneously or intradermally to destroy sensory nerves, causing local sensation to decrease and symptoms to disappear. ① Methylene blue injection has a reversible nerve blocking effect, which makes the patient feel no itching within 1 to 2 weeks. ② Hormone injection uses long-acting glucocorticoids injected subcutaneously, which has long-lasting anti-inflammatory, anti-allergic and antipruritic effects.