Q. My anus is red with unpleasant odor and I have a history of pilonidal sinus and abscess. Please help.

Answered by
Dr. Pathave Hari Shivaram
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on May 29, 2020

Hello doctor,

I have had an issue with my anus area for a while now. The area is always red, and there is always an unpleasant smell (fish). I do not notice any drainage. I have a history of Pilonidal sinus and abscess. I was tested for a few STD's but not all. I think it may have something to do with the pilonidal sinus, as the two issues were consecutive. I will attach an image that will hopefully help.



Welcome to

If possible provide me photographs of affected areas that will help me for a better understanding of your skin problem and proper treatment plan. Photographs required for more accurate diagnosis purpose because treatment given without proper diagnosis can be less helpful.

Thank you doctor,

I will attach an image.



Welcome back to

I have seen the picture. (attachment removed to protect patient identity).

Yes, it looks repeated perianal infection with secondary eczematization (infective eczema-like presentation). You can go for pus culture and sensitivity. If possible per anal examination or per rectal colonoscopy.

You can start tablet Cefixime 200 mg BD after food for seven days, Metronidazole 400 mg TDS for seven days, Flutibact (Fluticasone propionate) cream at night for seven days, Mupirocin 2% ointment at morning and afternoon for seven days, Levocetirizine 5 mg OD at night for 10 days. I do not have an idea about the availability of medicines over there but you can try or purchase online.

Review after seven days.

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