Managing Perianal Skin Tears: Tips for Healing and Prevention

Perianal skin fissure?

Last week, I inquired about a wound located on the left posterior near the groin, which was caused by allergic dermatitis due to medication irritation.
The more I applied the ointment, the more it irritated the skin, and it did not improve until I stopped using the medication for about 3-4 days.
However, I have been experiencing itching around the anal area, and in the past few days, I scratched it.
During today's follow-up appointment, I discovered that I had scratched two wounds at the 12 o'clock position near the anal area, but I have no idea when this occurred.
I recall feeling discomfort while riding my bike a few days ago when my weight shifted forward.
Initially, rinsing did not cause pain, but after using the restroom today, rinsing caused stinging.
The doctor advised me again not to apply any medication, as it could lead to allergic irritation similar to last week.
Last week's wound did not come into contact with feces after rinsing with water, but this time, even after rinsing and patting dry, there is still some residual feces present.
I am concerned about the possibility of infection in the wound.
Last week, the healing was rapid, and I wonder if it was due to stopping the irritating medication.
Since this time it was caused by scratching, I am worried that the residual feces could affect the healing process.
I am not used to not being able to apply medication due to the allergy.

xu wen gang men po pi, 40~49 year old female. Ask Date: 2022/10/18

Dr. Ke Fangxu reply Surgery

Visual observation of skin issues is crucial; it is difficult to make a judgment based solely on written descriptions.
If symptoms persist for more than a week without improvement, please seek medical attention promptly to prevent the condition from worsening.

Reply Date: 2022/10/18

More Info

Managing perianal skin tears can be quite challenging, especially when they are caused by allergic reactions or irritation from medications. Here are some tips for healing and prevention that can help you navigate this situation effectively.

Understanding the Condition
Perianal skin tears often occur due to friction, moisture, or skin irritation. In your case, it seems that the initial irritation was caused by a medication that led to an allergic reaction, which then resulted in skin tears from scratching. The presence of residual fecal matter can further complicate the healing process, as it increases the risk of infection.

Immediate Care
1. Gentle Cleaning: After each bowel movement, it is crucial to clean the area gently but thoroughly. Use lukewarm water and a mild, fragrance-free soap if necessary. Avoid scrubbing the area; instead, let the water run over it and pat it dry with a soft towel. If you experience pain when cleaning, consider using a peri-bottle to squirt water gently.

2. Drying the Area: After cleaning, ensure the area is completely dry. You can use a soft cloth or a hairdryer on a cool setting to help with this. Moisture can exacerbate irritation and slow down the healing process.

3. Avoiding Irritants: Since you are experiencing allergic reactions, it’s essential to avoid any topical medications or creams that might cause further irritation. Stick to gentle, non-irritating products. If you need to apply something, consider using a barrier cream that is specifically designed for sensitive skin, such as those containing zinc oxide, which can help protect the area without causing irritation.

4. Managing Itchiness: Itching can lead to scratching, which worsens skin tears. To manage itchiness, consider wearing loose-fitting cotton underwear to reduce friction. You might also find relief with cool compresses applied to the area, which can help soothe irritation.

Monitoring for Infection
Given that you have residual fecal matter in the area, it’s important to monitor for signs of infection. Look for increased redness, swelling, warmth, or discharge from the wounds. If you notice any of these symptoms, it’s crucial to consult your healthcare provider promptly.

Preventive Measures
1. Hygiene Practices: Maintain good hygiene by cleaning the area regularly and ensuring it stays dry. Consider using flushable wipes that are alcohol-free and unscented for additional cleanliness after bowel movements.

2. Dietary Considerations: A diet high in fiber can help prevent constipation and straining during bowel movements, which can lead to further irritation. Stay hydrated to keep your stool soft.

3. Avoiding Scratching: Since you mentioned that scratching has led to new tears, it’s vital to find ways to minimize this behavior. Keeping your nails trimmed and wearing gloves at night can help prevent accidental scratching while you sleep.

4. Consulting a Specialist: If your symptoms persist or worsen, it may be beneficial to consult a dermatologist or a gastroenterologist. They can provide tailored advice and treatment options, including potential allergy testing to identify irritants.

Conclusion
Managing perianal skin tears requires a combination of gentle care, hygiene, and preventive measures. By following these tips, you can promote healing and reduce the risk of further irritation or infection. Always listen to your body, and don’t hesitate to seek medical advice if you have concerns about your healing process or if you notice any signs of infection. Your comfort and health are paramount, and addressing these issues promptly can lead to better outcomes.

Similar Q&A

Understanding Perineal Tears: Causes, Treatments, and Care Tips

Hello, doctor. After having intercourse with my boyfriend, I consistently develop small fissures or skin tears in the perineum (the skin area below the vaginal opening and above the anus). These do not affect my daily life, but they cause a stinging sensation when touched (such a...

Dr. Huang Zifei reply Obstetrics and Gynecology
Dear Anonymous, 1. It is advisable to use skincare products to care for the perineal skin. Additionally, it is recommended to rinse the perineum with warm water during washing and to massage it to increase elasticity. Of course, one should also consider the size of the partner&#...

Postpartum Pain and Healing: Understanding Perineal Tears and Care

Hello, Doctor! I am currently over 7 months postpartum with my second child. In the past, after being intimate with my husband, I would experience some tearing at the perineum, which resulted in slight bleeding and sharp pain when urinating, but it usually healed within a week. R...

Dr. Lü Lizheng reply Obstetrics and Gynecology
The response suggests that there may be inflammation and laceration. It is recommended to consult an obstetrician-gynecologist for further examination, and based on the severity, additional treatment may be necessary. Sincerely, Dr. Li-Cheng Lu, Taoyuan General Hospital.

Dealing with Painful Skin Tears on the Penis: What to Do?

I'm sorry to hear that you're experiencing this issue. It sounds like you may have a minor injury to your foreskin. Here are some steps you can take to help with the healing process: 1. Keep the area clean: Gently wash the area with mild soap and water. Avoid using...

Dr. Du Shixi reply Urology
Hello: It is advisable to seek medical attention for wound care, as this area is difficult to keep clean, and repeated scabbing may lead to scarring. It is best to have a physician evaluate it. Wishing you good health.

Dealing with Labial Skin Tears: Healing and Infection Concerns

If you accidentally injured your vulva while showering and it is bleeding slightly, here are some steps you can take: 1. Clean the Area: Gently clean the area with mild soap and water to prevent infection. Avoid using harsh soaps or scrubbing the area. 2. Apply a Clean Dr...

Dr. Cao Guotao reply Obstetrics and Gynecology
Hello, if the wound is not large, it will heal on its own. If you are concerned, it is advisable to consult an obstetrician-gynecologist. Wishing you good health.