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Family Physician
Family Physician, Doctor
Category: Medical
Satisfied Customers: 2592
Experience:  Emergency Medicine and Family Practice for over 26 years
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I have had severe anal itching months. A colonoscomy 2 weeks

Customer Question

I have had severe anal itching for 3 months. A colonoscomy 2 weeks ago showed no signs of hemorroids. I have tried witch hazel, preparation H, and tenactin with no good results. I have been to a walk-in clinic that told me to take sitz baths. Again no relief. Itching has seemed to be most severe at night. Any suggestions
Submitted: 1 year ago.
Category: Medical
Expert:  khagihara replied 1 year ago.

It could be allergic dermatitis. You should take over-the-counter oral antihistamine such as Zyrtec and topical 1% hydrocortisone cream (two or three times a day). But you should not use opical 1% hydrocortisone cream for more than two weeks because of possible side effects, such as thinning of the skin.

Customer: replied 1 year ago.
I have been taking benadryl and have tried hydrocortisone to no avail
Customer: replied 1 year ago.
how would I detect pin worm or is that not a possibility
Expert:  khagihara replied 1 year ago.

Okay. It is not allergic dermatitis. Any skin change? How old are you? How tall are you? How much do you weigh? Any medical problems? Any surgeries? Any other medications? Do people around you have similar problem? Any family medical history?

Customer: replied 1 year ago.
65 years old 5'8" 172lbs no other medical problems that I am aware of. First time for this problem
Expert:  khagihara replied 1 year ago.

No skin change?

Customer: replied 1 year ago.
no skin change except in anal area irritation
Expert:  khagihara replied 1 year ago.

Enterobius vermicularis (pinworm) is possible because of nocturnal anal pruritus although it is more common in children as compared with adults. Erythrasma, an infection withCorynebacterium minutissimum, is more common in older adults. But it presents as a slowly enlarging area of pink or brown dry skin.

Customer: replied 1 year ago.
How would that get diagnosed and what should I do.
Customer: replied 1 year ago.
what do you suggest I do at this point. I have not gotten any new answers for the direction I need to go in.
Expert:  khagihara replied 1 year ago.

Enterobius vermicularis (pinworm) can be diagnosed via a pinworm paddle test. This is a clear plastic paddle coated with an adhesive surface on one side that is pressed against several areas of the perianal region. The paddle is then placed onto a glass slide and eggs can be visualized under a microscope. The diagnostic yield is greatest if the test is performed at night or first thing in the morning, prior to bathing. The diagnosis of erythrasma is based upon physical appearance and the presence of coral-red fluorescence with a Wood's lamp.

Expert:  khagihara replied 1 year ago.

You should see a dermatologist to have the tests. S/he may do a skin biopsy if necessary.

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