Female
I was recently approached by a potential patient, seeking information about her "strange symptom" she said. She followed that up saying " Chinese medicine can treat all kinds of strange things right?" ( I thought that was funny)
female age 33 - c/c anal and perineal itching for over 7 years
Approx 7 years ago noticed occasionally intense itching on her perineum and around her anus. Every few days she would find that the itching would start and be incredibly intense and not relieved until she aggressivley itched it. It was always worse at night.
Over the last few years it has gotten progressivley worse. The itchiness is experinced daily and it is common for her to itch so much that there is damage to the local skin and oftem bleeds while she is itching. She notices it is worse at night, around bowel movements, and then sometimes just out of the blue.
She has even used a lancane cream to numb the local area.
She has modifed her diet, hoping that would help - but there is no change. She said that she has permanent scars and small scratches on her perineum and around her anus from all of the scratching.
During more inquiring she mentioned that once about 5 months ago, she had an outbreak of small blisters which turned to one large ulcer in the exact same area she gets the itching. Through a swab and exam with her GP, it wqas discovered that she had had an episode of genital herpes. Sonce then she has had no other outbreaks but she remarked that it seemed strange that the areas were the same.
I asked her about her history if any of other vaginal infections - she has had none that she reported. No yeast infections or any other kinds. No morbid leukorrhea.
She seems quite healthy.
Energy and appetite are good.
She experiecnes occasional constipation but generally her bowel movements are regular and not too loose or hard. No abdominl complaints. Her mentrual cycle is regular and comfortable. Sleep is sound and enough. She leads a healthy lifelstyle with exersice rest and play... good quality locally grown orgnic foods.
Her tongue is slightly pale and puffy with teeth marks and a thin white wet coating which is thicker and greasier at the root.
Pulse is weak.
I am exploring and researching to see what i can do for her. I am looking into parasites, hemerroids, yeast, dryness ????
Any tips, suggestions, or pointers from the community.
Hi andrea, There are many
Hi andrea,
There are many western reasons for anal itching including: hemmorhoids, eczema, psoriasis, fungus/ yeast, and lichen simplex (neuro dermititis).
In terms of chinese medicine I would look for damp heat in the lower Jiao. The thick coating at the root of the tongue and the itch which is worse at night, suggests this. Scratching until bleeding is coomon when there is a severe itch. This is because pain trumps itch, it is easier to deal with pain then it is itch.
A wash with She Chuang Zi, Di FU Zi, Ku Shen, and Huang Bai would be a start.
Internally the modified decoction- Bie Xie She Shi Tang
Bi Xie 9
Niu Xi 9
Yi Yi Ren 15
Huang Bai 9
Chi Fu Ling 9
Ze Xie 9
Cang Zhu 9
Bai Xian Pi 9
Bai Ji Li 12
Di Fu Zi 9
Mu Dan Pi 9
Hua Shi 15
Adjust accordingly- if there is lots of redness- (more resolve Fire Toxin)
Hopes this helps
Trevor