How Do I Treat an Itchy Incision?

Pruritus Ani (Pruritus Ani) refers to a skin disease without any primary skin damage around the anus, but only with itching symptoms. This disease is more common in 20 to 40 young adults. There are more males than females, which is more common in those who do not love activists.

Basic Information

English name: Pruritus Ani
Visiting department: Gastroenterology, Dermatology
Multiple groups: 20 to 40 year old men
Common locations: anus

Common causes: Excessive consumption of spicy food and condiments, allergic reactions, excessive mental excitement or depression, fungal and viral infections around the anal skin, etc.
Common symptoms: Paroxysmal itching of perianal skin with tingling or burning

Causes of anal pruritus

Food factor

Spicy foods and condiments, such as chili, liqueur, mustard, pepper, spices, coffee, etc., excessive consumption can cause anal canal and anal skin irritation and induce itching.

2. Allergic reactions

Certain proteins (fish, shrimp, crab, etc.), drugs, pollen, lacquer, etc. can cause allergies to some parts of the body, causing the body to produce too much histamine, which acts on peripheral nerves and produces an itch.

3. Mental factors

Excessive mental excitement, depression, neurasthenia, addiction, etc.

4. Perianal skin fungal and viral infections

Common infections such as Epidermophyton.

Anal pruritus classification

Classification by cause:

Primary anal pruritus

The cause is unknown, there is no primary damage, and the main symptoms are itching and stubbornness. 45% -70% of cases are primary anal itching.

2. Secondary anal pruritus

Secondary to primary diseases and various skin diseases, accompanied by obvious specific skin damage, itching is a symptom of the primary lesions, such as anal fistula, perianal eczema, genital warts, neurodermatitis, tapeworm, etc.

Clinical manifestations of anal pruritus

Itching

Initially it is limited to perianal skin pruritus, which is paroxysmal, often exacerbated at night, quiet, emotional changes, spicy food, hot and humid, and severe itching is unbearable.

Pain

Itching is mild to severe, sometimes tingling or burning. Scratching makes the skin ulcerate, exudate, become idiotic, and will not heal for a long time.

Anal pruritus examination

A full physical examination should be performed and targeted laboratory tests such as blood, urine, stool routine, liver and kidney function, urine glucose, blood glucose, glucose tolerance test, and group biopsy weaves and smears.

Anal pruritus diagnosis

According to a typical history of anal itching, combined with clinical symptoms and signs, it is not difficult to diagnose the disease, but it is more difficult to determine the cause.

Anal pruritus treatment

Treatment principle

Actively find and remove possible pathogenic factors, apply topical antipruritic agents, and block local subcutaneous sensory nerves if necessary.

2. TCM Syndrome Differentiation

(1) Internal treatment method According to the dialectical classification of traditional Chinese medicine, Chinese medicine is used for treatment: wind and heat hit the lungs and move to the large intestine and anus ; wind evil dampness or liver and gallbladder dampness and heat, obstructing the anus should be Shufeng Qingre dampness, only Xiaofeng powder or Longdan Xiegan decoction. Those with blood deficiency, weathering and dryness, and skin insufficiency should use Angelica sinensis. Those who have blood stasis and wind, and the knots are not scattered . Insect poisoning invades the perianal area, or wet poisoning or drug poisoning hinders the vulva .

(2) External treatment method Those with moist skin can dry the affected area with alum powder, 3 times a day. Those with dry skin can use Huanglian cream or Qingdai cream externally, 3 times a day.

(3) Washing bath outside Chinese medicine The warm-water sitz bath is mainly used for clearing heat and detoxifying, dehumidifying and itching.

3. Western medicine treatment

(1) Etiology treatment Carefully look for various causes that may cause itching and try to eliminate them. First, anorectal diseases should be operated first, followed by gynecological and skin diseases.

(2) Drug treatment For the treatment of local anal pruritus, topical treatment should be mainly used: Antihistamine treatment Diphenhydramine, chlorpheniramine, and zismin can be selected. hormone therapy For women and elderly patients with severe illness, hormone therapy is available. Antibiotic treatment For patients with bacterial infection, antibiotics can be selected according to the condition. external washing treatment of drugs may have local cooling, anti-inflammatory, dry, antipruritic drugs, such as calamine lotion (water powder). Drug external treatment can be used as appropriate antipruritic, antibacterial, hormone ointment.

(3) Physical Therapy The perianal area can be irradiated with ultraviolet and infrared rays.

(4) Injection therapy is a commonly used method at present, which has the characteristics of simple operation and accurate curative effect. The method is to use drugs to inject subcutaneously or intradermally, destroy the sensory nerves, make local sensation decrease, and symptoms disappear. Methylene blue injection has a reversible nerve block effect, so that patients do not feel itching in 1 to 2 weeks. Hormone injection The long-acting glucocorticoid is injected under the skin, which has long-lasting anti-inflammatory, anti-allergic and antipruritic effects.

(5) Surgical treatment Itchy skin resection is applicable to a small range of primary anal itching. pruritus skin resection and suture is suitable for primary anal itching in a small area and bilateral symmetry. Perianal subcutaneous nerve ending dissection is suitable for those who have refractory anal itching without obvious skin lesions and fail to undergo conservative treatment.

Anal pruritus prognosis

1. Injection therapy has better treatment effect on anal pruritus, but those with severe pruritus tend to relapse and need to be injected again.

2. Surgical therapy is rarely used clinically due to the inaccurate effect. Although the symptoms of pruritus disappear quickly after the operation, after the incision heals, long-term adherence to the anal hygienic care and open patency must be maintained.

Anal pruritus prevention

1. Avoid anxiety, anxiety, and excessive tension.

2. Conditioning diet, eat more fiber-rich foods such as green vegetables and fruits, fast food or less foods and condiments that are irritating or can induce allergies, such as spicy foods, strong tea and coffee, and spirits.

3. Pay attention to hygiene, wash the anus with warm water after use, and keep the skin fresh and clean.

4. Avoid inappropriate self-treatment, such as scalding with hot water, topical high concentration of corticosteroids or anti-irritant drugs, self-treatment of some crude home physiotherapy equipment, etc. These methods have more disadvantages and can only be used. There is a temporary suppression of itching, which leads to a prolonged increase in lesions, and patients should be advised to stop using it.

5. Cotton underwear is better for underwear. The clothes should be loose fit, not too tight or too hard, so as not to rub the anal skin.

6. Do not scratch, if you have the habit of scratching at night, you should cut your nails or wear film gloves before going to bed.

7. Adjust your bowel habits and go to the toilet regularly every day. ^[1-4]