Wounds Near the Anus: Causes and Treatment Options

Wound near the anus?

Hello Doctor, I have a wound in my groin area located towards the direction of my testicles from the anus, very close to the anal opening (but not in the anal folds).
It has not healed for about two weeks, and I suspect it might be an anal fistula.
I visited the colorectal department at the hospital, and the doctor said it didn't look like a fistula but rather like an abrasion.
He prescribed "Le Yu Zhi" ointment for me to apply, and after about a week, the wound healed.
However, about half a month later, the same area has developed a wound again (it feels like the same one).
It indeed looks like a broken skin, but I am worried it could be another lesion.
Could it be due to my frequent and forceful wiping after using the toilet? Additionally, I tend to sweat in my groin area, making it difficult to keep it dry, which might also contribute to the wound's difficulty in healing.
Currently, it does not affect my daily life, but wiping after using the toilet causes pain at the wound site, and seeing blood is distressing.
Should I try applying a different ointment? Thank you very much for your response!

Mr. Chen, 20~29 year old female. Ask Date: 2022/12/20

Dr. Zhang Shuhao reply Surgery

The occurrence of anal fistula can present with symptoms such as redness, swelling, heat, and pain, resembling an open wound.
It is recommended to rinse the area with clean water after using the restroom to reduce friction and irritation.
Wear loose and breathable clothing, and avoid detergents and lotions that contain fragrances.
If sweating occurs, change underwear frequently.
Once the wound has healed more significantly, you may switch to using an antihistamine ointment, but it should not be used for an extended period.

Reply Date: 2022/12/20

More Info

Understanding wounds near the anus, particularly in the groin area, can be quite complex due to the sensitive nature of the skin and the potential for various underlying conditions. Based on your description, it seems that you have experienced recurrent wounds in the same area, which can be concerning. Here’s a comprehensive overview of possible causes, treatment options, and care recommendations.

Possible Causes
1. Skin Irritation or Abrasion: Frequent wiping, especially with rough toilet paper or excessive force, can lead to skin irritation and abrasions. This is particularly true in areas that are prone to moisture, such as the groin, which can exacerbate the problem.

2. Infection: The area around the anus is warm and moist, making it susceptible to infections. Bacterial infections can occur, leading to painful sores that may bleed.

3. Fungal Infections: Given the moist environment, fungal infections like candidiasis can develop, causing irritation and sores.

4. Anal Fissures: These are small tears in the lining of the anus, often caused by passing hard stools or excessive wiping. They can be painful and may bleed.

5. Fistulas or Abscesses: While your doctor suggested that it does not appear to be a fistula, it’s important to monitor for any signs that might indicate a more serious condition, such as persistent pain, swelling, or discharge.

6. Dermatological Conditions: Conditions such as eczema or psoriasis can also affect the groin area, leading to skin breakdown and wounds.

Treatment Options
1. Gentle Cleaning: Use mild, unscented soap and water to clean the area. Avoid harsh soaps or wipes that can further irritate the skin.

2. Moisture Control: Keeping the area dry is crucial. You might consider using absorbent powders designed for moisture control in sensitive areas.
3. Topical Treatments: Over-the-counter creams such as hydrocortisone can help reduce inflammation and itching. If a fungal infection is suspected, antifungal creams may be beneficial. Always consult with a healthcare provider before starting any new medication.

4. Avoiding Irritation: If wiping is causing irritation, consider using a bidet or moistened wipes that are gentle on the skin.
5. Dietary Adjustments: Ensure you are consuming enough fiber to prevent constipation, which can lead to straining and further irritation of the area.

6. Consultation with a Specialist: If the wound does not heal or recurs frequently, it may be beneficial to see a dermatologist or a colorectal specialist for further evaluation. They can provide more targeted treatments and rule out any serious conditions.

When to Seek Immediate Care
- If you notice increased redness, swelling, or warmth around the wound.

- If there is a significant increase in pain or if the wound begins to drain pus.

- If you experience fever or systemic symptoms that may indicate an infection.

Conclusion
It’s understandable to be concerned about wounds in such a sensitive area. Maintaining good hygiene, controlling moisture, and using appropriate topical treatments can help promote healing. However, if the problem persists or worsens, seeking further medical advice is essential to rule out any underlying conditions. Your comfort and health are paramount, so don’t hesitate to reach out to a healthcare provider for personalized care.

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