Post-Surgery Itching Around Anus: Is It Normal After Fistula Surgery?

Itching around the anal area after anal fistula surgery?

Hello, doctor.
It has been about three days since my anal fistula surgery, and it has been almost a month since the procedure.
During my follow-up appointment last week, the surgeon said I was recovering normally and that I should return for another check-up in a month.
However, in the past few days, I have been experiencing persistent itching around the anal area, along with a slight warm sensation.
The itching is quite uncomfortable and becomes more noticeable when I move around.
The doctor prescribed a topical steroid for the wound last week.
Is this a normal phenomenon?

Xiao Xiao, 40~49 year old female. Ask Date: 2021/01/12

Dr. Ke Fangxu reply Surgery

One month after surgery, the wound has mostly healed.
It is common for the wound to experience slight itching at this time.
Indeed, corticosteroid ointment can help alleviate the symptoms, and regular follow-up appointments are sufficient.

Reply Date: 2021/01/12

More Info

Post-surgery itching around the anus, especially after a procedure like fistula surgery, can be a common experience for many patients. Itching can arise from several factors, including the healing process, irritation from the surgical site, or even the application of topical medications like steroids.
In the context of your situation, it’s important to consider a few key points:
1. Healing Process: After any surgical procedure, the body goes through a healing phase where tissues regenerate and repair. This process can sometimes lead to sensations of itching as nerve endings are reactivated and the skin begins to heal. The sensation of warmth you are experiencing could also be a normal part of the healing process, as increased blood flow to the area can cause a feeling of warmth.

2. Irritation: The area around the anus is sensitive, and post-operative care can sometimes lead to irritation. This can be due to friction from clothing, moisture, or even the application of topical medications. If the steroid cream prescribed by your doctor is being applied frequently, it may also contribute to irritation if not used as directed.

3. Infection: While itching can be normal, it’s crucial to monitor for signs of infection. If the itching is accompanied by increased redness, swelling, discharge, or a fever, these could be indicators of an infection that requires medical attention. The fact that you mentioned a "slight warm" feeling could also be a sign to keep an eye on, as it may indicate inflammation.

4. Steroid Cream Usage: Steroid creams can help reduce inflammation and itching, but they can also cause skin thinning or irritation if used excessively. It’s important to follow your doctor’s instructions regarding the frequency and amount of cream to apply. If you feel that the cream is not helping or is exacerbating the itching, you should reach out to your healthcare provider for further advice.

5. Follow-Up Care: Since your doctor has advised a follow-up appointment in a month, it’s essential to keep that appointment. However, if the itching becomes unbearable or if you notice any concerning symptoms, do not hesitate to contact your healthcare provider sooner. They may want to assess the surgical site to ensure that everything is healing properly and to rule out any complications.

In summary, while some itching and warmth around the surgical site can be normal during the healing process, it is essential to monitor your symptoms closely. If the discomfort persists or worsens, or if you notice any signs of infection, it is crucial to seek medical advice promptly. Your healthcare provider can offer tailored recommendations and possibly adjust your treatment plan to alleviate your symptoms effectively.

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