What could be the reason for developing a red line between the butt cheeks, anal itching, constipation, and vaginal discomfort?

Question

Hello doctor,

I have developed a red line between my butt cheeks, itching around the anus, constipation, and vaginal discomfort. I have used Hydrocortisone and zinc cream for haemorrhoids. Nothing works. I have also used probiotic creams for my vagina, but it feels like it is getting worse. The anal itching has been there for a year, not all the time, but for daily moments. The line showed up a couple of weeks ago.

I have been under a lot of stress and have done very long bike rides. I am taking care of my hygiene, but nothing seems to help. I have had a bacterial vaginal infection and candida in the past. I am embarrassed to see a doctor about anal problems.

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

Please get back with the following details and clear photos of the lesions or the area for clarification such as age marital status, symptoms, duration, lesions, and distribution. Menstrual history; investigations, if any; treatment history; partner and intercourse history, if any; family history; usage of any contraceptives, drugs, etc. Any history of allergies, place of residence, occupation, or any other relevant details.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

I have reviewed the photo and details (attachments removed to protect the patient's identity). Therefore, I can determine your anxiety and stress related to this. Kindly relax and do not get stressed out about this. It appears like intertrigo, which may get superadded by fungal or bacterial infection.

My advice:

Consult your specialist doctor, talk with them, and take medications with their consent.

Wear loose cotton inners wear.
Do not wear tight, nylon, or friction-inducing clothes.
See that there is adequate ventilation.
Avoid friction or irritation.
Avoid long bike rides etc.
Do not rub the area with tissue too much, as it can cause a breach in the skin.
Check whether any diapers or tissue is inducing damage.
Use water for ablution rather than tissue, or wipe with wet tissue wipes.
Try creams like Vaseline to prevent friction.
Use Clotrimazole antifungal powders like Abzorb, Candid, or skin barrier creams with Dimethicone.
If you are overweight, reduce your weight.
Check for diabetes, if any.
Take a lot of fiber-rich fruits and vegetables balanced diet for constipation and hemorrhoids.
You can take stool softeners like liquid Paraffin, Isabgol (Psyllium husk), or Lactose.
Take antihistamines like Cetrizine when too itchy.

You have already tried steroids, antifungals, analgesics, etc. You can also stop all creams for a few days and see what works. However, it may get exacerbated as stopping steroids might fare up the lesion.

Revert for further queries.

Thank you.