Brief Answer: Could be a fungal infection. Detailed Answer: Hi XXXX! Good evening. I am Dr Shareef answering your query. If I were your doctor, I would have advised you for a routine blood sugar test ( both fasting and post prandial) to exclude any chances of a Diabetes at this age, which your doctor might already have done, but there is no mention of this in your history. Also a thyroid function test might be helpful. treat these conditions if found positive. Also I would get your routine stool test done for ova and cysts, as worm infestation is also known to cause anal pruritus not responding to local treatment till these are eradicated by anti worm medications. Next I would go for anti fungal along with a local steroid ointment, presuming that it is a fungal infection, which sould be decided only on personal clinical examination and by examination under microscope of the scrapping from the area affected. Because of its long duration, I would not hesitate to give you a systemic anti fungal like fluconazole once a week for four weeks. This will relieve you of the presumed fungal infection. For some symptomatic relief, you can go for a cetrizine, if you are allergic to actifed. Last but not the least, I would also advise you on your personal hygiene which I am sure you must be taking care about. Just to re emphasize, you must keep the area dry after bath and any kind of lotion like a hair remover or any such cosmetic lotions over there to which your skin might be allergic to.If you are overweight, take efforts to reduce your weight. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Thanks for choosing health care magic for clearing doubts on your health problems. Wishing you an early recovery. Dr Shareef.

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