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Suggest Remedies For Recurring Skin Infection In The Anal Area

Posted on Thu, 12 May 2016

Question: About 3 years ago I had Campylobacter and was given high doses of Cipro and Flagyl for an extended period of time. I was hospitalized and continued to take it for about a month after. A few months later my anal area started to feel like it had poison ivy and it eventually spread to my genital area. My doctor said it was probably Candida and told me to use Lamisil. That has been working although sometimes I have to reapply it and if I miss one day, it starts to recur in the anal area. Also my stools never were the same afterwards although they are now firmer than they were at first. Is there anyway to get to a point where I don't have to use the salve. It's been years and I'm afraid the fungi will become resistant to the salve. What then? My gastroenterologist said that the anal problem would be for a dermatologist and he could not help for that. Seemed like a strange response, although I may take that route next if it makes sense??? email: YYYY@YYYY

Answered by Dr. Dr.Albana Sejdini (2 hours later)

Brief Answer:
Problems not related to skin but to candida infection of bowels...

Detailed Answer:
Hi XXXXX,

I have gone through your medical history carefully and understood your concerns.

1. The use of antibiotics (such as cipro and flagyl) for long period of time is accompanied by the alteration in intestinal flora.

This will end up with GI candida infection presenting with feeling like poison ivy in the anal/groin area and changes in bowel movements.

2. In such cases, we usually recommend as following:
- take probiotics to stabilize the intestinal flora
- take antifungal treatment, but first run culture of stool for candida. Oral fluconazole will be the treatment together with applying combination of clotrimazole cream with zinc oxide ointment

3. The first thing is to determine the candida infection of the bowels by culture and sensitivity testing to determine the anti-fungal drug to use.

Systemic treatment is suggested together with local hygiene and anti-fungal treatment.

With regards to salve, as long as the area is not infected and no discharge, no need to use salve for the moment, until you get proper diagnosis.

All the best!
Dr.Albana

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr.Albana Sejdini (4 hours later)

My family Doctor just says keep using salve as long as it works. My gastroenterologist simply said that all stool has candida and I should go to dermatologist. What specialist would know how to treat this?

Answered by Dr. Dr.Albana Sejdini (2 hours later)

Brief Answer:
Gastroenterologist should treat it

Detailed Answer:
Hi back,

If stool has Candida, then should treat with oral meds. Dermatologist won't treat stool Candida, just skin Candida. Stool comes from inside of your bowels. If you treat stool Candida, consequently your anal candida infection will be also treated adequately.

So, get back to gastroenterologist and discuss what I said with him. He should prescribe fluconazole once a week for 4 consecutive weeks. Should also take clotrimazole cream for anal Candida infection.

If the one you consulted does not agree, then change gastroenterologist and consult with another one.

All the best!
Dr. Albana

Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar