Itchiness and burning are common symptoms around the anus that most of us will experience from time to time. I think for most it will evoke dreadful memories from childhood when worms were the commonest cause. Fortunately worms is an easily treatable condition with complete resolution of symptoms. Roll onto adulthood and sadly the same is not true of the adult itchy bum!

Since setting up my clinic in 2020, I have encountered many patients with itchiness or burning around the anus. I have come to realise what an incredibly bothersome and difficult symptom this is for people to live with. The impact on well being and the ability of sufferers to live a normal life is much larger than I previously realised.

As a colorectal surgeon I have been treating itchy bum related to haemorrhoids (mostly!) for about 25 years. Haemorrhoids can cause an itchy bum because the swelling of anal tissue and prolapse out of the anal canal can lead to bowel related mucus and blood irritating the sensitive genital skin. In treating the haemorrhoids, the itch should resolve with time. So far so good…….?

Well what about all of the other patients where haemorrhoids aren’t the cause?

This is where the treasure lies. I have found a ‘gap in the market’ where Dermatology may not feel comfortable and Colorectal surgery may have nothing to offer aside from haemorrhoid treatment.

My focus in 2026 is to expand my expertise in Anogenital Dermatology. The express intention is to provide better care and more treatment options for anyone suffering with a long term anal skin condition with no obvious cause.

I believe that the skin around the anus/genitals is uniquely special with it’s own microbiome. The area is damp, warm, has skin folds and rarely sees the light of day. The skin regularly comes into contact with liquids such as urine, poo, mucus from anus and genital related discharge. It has to withstand a lot in order to keep us feeling healthy and comfortable throughout the day. The added pressure of maintaining our continence throughout exercise and also long days at the office is also quite a big job. There is also the change in anatomy that comes with age – natural thinning of the skin, weakening with loss of collagen and the impact of stretch (weight loss/gain and childbirth) that will also play a large part in the function of the genitals.

There are many skin conditions that affect the genital area which may look different when down below. This can lead to diagnostic uncertainty and feel frustrating when cream after cream doesn’t work. Your pharmacist is certainly a good person to go to first. Be careful with online products self researched as the genital skin is sensitive and some products are not tested/robust enough to cope with the genital area.

In my clinic I will be focussing this year on increasing diagnostic ability with anogenital dermatolgical conditions with a view to offering more tailored treatment options. I am branching out into newer treatment options such as methylene blue injections.

Contact us if you would like an initial consultation!