Itchy bottom? Moist Toilet Tissues Can Cause A Rash

Itchy butts are part of my everyday. It shouldn’t be part of yours.

Itching on your bottom is usually a minor annoyance, but it can be debilitating. A patient of mine was unable to work because his derrière itching was so intense. A common cause of itching bottom, called pruritus ani, is allergic contact dermatitis.

Places where your skin transitions from outside to inside, such as lips or anus, are susceptible to dermatitis because your skin’s barrier is limited in these locations. Without a thick layer of keratin, irritants on the outside easily get into your skin. Moist toilet tissues, such as baby wipes or towelettes, might seem to get you cleaner than old-fashioned toilet paper, but chemicals in the wipes cause a rash in some people.

Preservatives such as methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) or kathon CG are often used in packaged toilet wipes and are a common cause of allergic contact dermatitis. Many patients who have itching on their behinds fear that they are unclean, use more cleaning wipes, worsening their dermatitis. It becomes a vicious cycle. Avoiding all commercial wipes or towelettes usually resolves the rash and itching. If not, then see your dermatologist before you find yourself on extended medical leave.

Have you ever had an itch so bad that you thought you’d go mad?

Photo: RLHyde

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10 Tips to Get The Most From Your Dermatology Visit

Having a high quality doctor’s visit takes effort on my part and on yours. Here are 10 tips to get the most out of your next dermatology visit with me or any other dermatologist.

1. Write down all the questions you have and things you want to discuss with me. Be sure to list any spots you’d like me to check or any moles that have changed. Have a loved one lightly mark spots on your skin they are concerned about.

2. Know your family history: Has anyone in your family had skin cancer? What type? Patients often have no idea if their parents have had melanoma. It matters. If possible, ask before seeing me.

3. Know your history well: Have you had skin cancer? What type? If you have had melanoma, then bring the detailed information about your cancer. Your prognosis depends on how serious the melanoma was, that is its stage, 1-4. You need to know how it was treated, if it had spread, and how deep it was. The answers to these questions determines the risk of your melanoma returning.

4. If you have a rash, there are a few things I’ll need to know: Have you changed any of your medications? Soaps? Moisturizers? Cosmetics? Do you have a history of eczema? Asthma? Hayfever? Does anyone in your family have a skin disease? Take a picture of your rash at its worst with your phone; the rash might be improved by the time you see me.

5. If you are seeing me for acne, come prepared. Keep a journal of when your acne is worse. Is it around your period? When you are stressed? In summer or winter? What products or cosmetics are you using? What treatments have you tried? Have you had dryness or burning with previous treatments?

6. If you are seeing me for hair loss, then collect your hairs that fall out and count how many you lose in one day. It’s normal to lose 100-150 hairs per day. Make a list of other symptoms or health problems that you think might be related to your hair loss.

7. Always be honest with me. I’ll never judge you even if you are an avid tanner or a picker. I’m here to help, and I can only help if I know the whole story.

8. Have you read something online that you’d like to discuss with me? Print it and bring it. Sometimes patients will tell me they saw something about their disease on the web; without knowing the source, I cannot say if the information is valid or helpful.

9. Am I leaving too soon? Stop me. My time with you is yours. If you see me heading for the door, then tell me that you still have things you’d like to cover. If we are out of time, then ask me if you can set up a follow-up appointment to continue the visit.

10. Don’t leave empty handed — I’m not talking about the freebie hand lotion or drug samples. For every doctor’s visit, you should leave with printed or written instructions about what we discussed and what you should do next. Patients who receive hand-outs from their doctor are more likely to have positive outcomes.

Have you had an excellent or not-so-excellent dermatology visit you’d like to share? Do you have any tips for us?

Photo: Maggie Osterberg

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