Patients often present with burning, soreness and itching. These symptoms may be due to perianal dermatitis. It may be related to external tags resulting in difficulty in cleaning after a movement, burning and soreness, spotting of blood on the toilet paper, and itching.
The external hemorrhoids or tags act as a wick for the mucus that is present in the rectum and anal canal to leak, causing irritation and inflammation of the skin around the anus or the anal verge. The dermatitis can be severe and a disruption of the quality of life for the patient. If an external tag is present, resection of the tag often results in a cure of the disorder.
Perianal irritation can sometimes occur even without an external tag being present. In that case, topical medication and behavior modification can be very effective.
Dietary measures, including avoiding caffeine and acidic and spicy foods can be helpful. Use of flushable wet wipes, rather than scrubbing with dry toilet paper avoids the injury to the sensitive skin and helps healing of the dermatitis. Use of a bidet or shower irrigation after a movement is also effective.
Silvadene cream is used often in major wounds, burns and bedsores. It has an effect on the healing of wounds in addition to being bacteriostatic ie., stops bacterial growth. I used it often on the trauma service and found that it is very effective in helping cure perianal dermatitis.
Patients with this form of perianal disorder require a careful external examination and anoscopy to determine the cause of the dermatitis. Only then can the appropriate treatment be prescribed.
As a board-certified surgeon, I am familiar with the treatment of perianal dermatitis hemorrhoid disease and other perianal disorders as well. Please review the other pages on this website that explain internal hemorrhoids and the Ultroid procedure, external hemorrhoids, hypertrophic anal papillae, fissures and the treatment of these lesions.