Anal eczema

Anal eczema (or perianal dermatitis) occurs due to inflammation of the sensitive skin at the end of the anal canal and the surrounding area. It has various underlying causes or external factors and falls into one of three categories:

• Irritant toxic anal eczema
• Atopic anal eczema
• Allergic anal eczema

Severe itching and a burning sensation around the anus are the most common symptoms. The burning may appear right away or develop later as the skin becomes more damaged. The skin is often inflamed and may have a reddish-white patchy appearance. Tiny, weeping spots or open, tender areas of skin may also develop. In certain cases, the skin may become thicker and form deep lines and wrinkles, a condition referred to as lichenification. The symptoms of anal eczema can occur in different combinations depending on the cause, severity and duration, and may alter over time.

It is important to treat the cause. In the case of diarrhoea, for instance, regulating bowel movements by consuming the right amount of fibre and staying hydrated can be beneficial. The symptoms of anal eczema can be relieved with ointments and suppositories containing anti-inflammatory, pain-relieving and anti-itching agents such as lidocaine, camphor and menthol.

Lukewarm water (personal hygiene shower, sitz bath) or medical wipes developed specifically for anal cleansing are recommended for cleaning the anal area. Then gently dry the skin with a soft towel or cotton pad.

If itching and burning persist, you should seek the advice of a specialist (proctologist) is recommended.

Anal eczema can be triggered by various factors, which have one thing in common: The skin barrier around the anus is weakened, either due to underlying conditions or external influences. This makes it easier for irritating, allergenic substances and infectious pathogens to penetrate the skin and aggravate the inflammation. The skin around the anus is highly prone to this kind of inflammation due to the special microclimate in the buttocks. Hair and sweat glands create a warm, damp environment that heightens the risk.

• Irritant toxic anal eczema: Caused by persistent irritation, for example from stool, anal fluid or wound fluid
• Atopic anal eczema: In people with atopic conditions such as eczema, where skin inflammations occur repeatedly
• Allergic anal eczema: Allergic reactions to contact allergens, such as those found in skincare products or wet toilet wipes.
• In some cases, multiple factors interact and exacerbate each other, making it difficult to pinpoint a single cause for perianal eczema.