What is Perianal Dermatitis

Perianal dermatitis is inflammation of the skin around the anus. This condition causes patches of red, irritated skin that may be itchy or painful. It can be passed from one person to another (contagious), depending on what caused it.

What are the causes?

This condition may be caused by:

• Contact with an irritant, such as stool, urine, mucus, soap, or sweat.
• Bacteria, especially certain types of strep (streptococcal) bacteria.
• Hemorrhoids.
• Fungus.
• Skin conditions, such as psoriasis.
• Medical conditions, such as diabetes and Crohn disease.
• Certain foods.
• An opening between the rectum and the skin around the anus (fistula).

What increases the risk?

This condition is more likely to develop in:

• People who are unable to control when they go to the bathroom (have incontinence).
• People who have trouble walking or moving around (mobility problems).
• People with thin or fragile skin.
• People taking oral antibiotic medicines or steroids.

What are the signs or symptoms?

Itchy, red patches of skin are the main symptom of this condition. The skin in this area may also be swollen and have:

• Cracks or tears (fissures).
• Small, raised bumps (papules).
• Small, pus-filled blisters (pustules).

Other symptoms include:

• Pain when passing stools.
• Blood in the stool.
• Itching around the anus.
• Tenderness around the anus.
• Holding back stools to avoid pain (constipation).

How is this diagnosed?

This condition is diagnosed with a medical history and physical exam. The diagnosis is confirmed by testing a sample of the skin for bacteria or fungus.

How is this treated?

Treatment for this condition depends on the cause. Mild cases may go away without treatment when contact with the irritant is stopped. Treatment for more severe cases of perianal dermatitis may include medicines, such as:

• A waterproof barrier cream.
• Topical or oral corticosteroids to ease skin inflammation.
• Antihistamines to relieve itching.
• Antibiotics to treat a bacterial infection.
• Antifungal cream to treat a fungal infection. Severe fungal infections may also be treated with topical steroids and medicine to control itching.

Follow these instructions at home:

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Apply prescribed or suggested creams only as told by your health care provider.
• If you were prescribed an antibiotic, take it as told by your health care provider. Do not stop taking the antibiotic even if your condition improves.
• Do not scratch the affected area.
• Wash your hands carefully with soap and warm water after each time that you use the bathroom. If soap and water are not available, use hand sanitizer. Make sure other people in your household wash their hands frequently as well.
• Keep all follow-up visits as told by your health care provider. This is important.

How is this prevented?

• Avoid contact with any substances that cause perianal inflammation.
• Keep the perianal area clean and dry.

Contact a health care provider if:

• Your symptoms do not improve with treatment.
• Your symptoms get worse.
• Your symptoms go away and then return.
• You are not able to control your bowel movements or you are leaking stool (have fecal incontinence).
• You have a fever.

Get help right away if:

• You frequently pass blood in your stools.
• You lose weight and you do not know why.
• You have fluid, blood, or pus coming from the rash site.

Summary

• Perianal dermatitis is inflammation of the skin around the anus. This condition causes patches of red, irritated skin that may be itchy or painful.
• Itchy, red patches of skin are the main symptom of this condition.
• Treatment for this condition depends on the cause. Mild cases may go away without treatment when contact with the irritant is stopped. Treatment for more severe cases of perianal dermatitis may include medicines.
• Wash your hands carefully with soap and warm water after each time that you use the bathroom. If soap and water are not available, use hand sanitizer.
• Keep the perianal area clean and dry to prevent this condition.