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Anal rash, spreading, itchiness. Using acyclovir, cortisone creams, no relief. History of genital herpes. Causes for rash ?

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Orthopaedic Surgeon
Practicing since : 1994
Answered : 10407 Questions
A small rash started near my anus closer to the buttocks area a week ago. It started about the diameter of a pea. Now my entire anal area is BRIGHT red. It's spreading further each day. I've have genital herpes for 20 years and It's not an outbreak. But I did take acyclovir to see if that would help in case it was being manefested differently. It slightly itches and is tender. I always clean and shower after BMs so I know it isn't a hygiene problem. I'm married and use condoms because I like to be protective considering what I have. I've tried cortisone cream for two days; no help and rash still growing.
Posted Sat, 21 Apr 2012 in Skin Rash
Answered by Dr. Praveen Tayal 4 hours later
Thanks for posting your query.
A bright red spreading rash on the anal area with mild itching not relieved with steroid ointment is most likely to be due to a fungal infection.

Second probability is bacterial infection. If it is bacterial, and not treated properly, might lead to serious problems. Hence it is best consult your doctor to diagnose it properly.

The preferred treatment if it is fungal in origin would be an antifungal cream such as Clotrimazole.

Sometimes application of one topical antifungal may not suffice and a combination of two and more antifungals may be needed until the itch disappears.

One has to continue application for 2 weeks after the itch disappears to prevent any recurrence.

I hope this answers your query effectively.

In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.

Wishing you good health.

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