The more you scratch perianal eczema, the itchier it gets.

Increased itching from scratching around the anus in cases of perianal eczema may be caused by skin damage, accelerated blood circulation, nerve transmission, aggravated inflammatory response, or anal fistula. It is recommended to seek timely medical attention and receive treatment based on the specific cause. Detailed analysis is as follows:

1. Skin Damage

Perianal eczema often causes itching, prompting patients to scratch. Excessive scratching can lead to skin injury, which may compromise the skin’s barrier function and worsen the eczema. Prompt cleaning with normal saline, iodophor, or alcohol is necessary to disinfect the area and prevent infection.

2. Accelerated Blood Circulation

Prolonged scratching increases local temperature and accelerates blood flow, causing more blood to rush to the skin around the anus, thereby intensifying the sensation of itching. Applying cold compresses can help reduce local temperature and alleviate symptoms.

3. Nerve Transmission

Scratching the affected area may stimulate nerve endings. Through neural signaling mechanisms, this stimulation can amplify the sensation of itchiness, creating a cycle of "the more you scratch, the more it itches." Patients should follow medical advice and use medications such as calamine lotion, zinc oxide ointment, or hydrocortisone butyrate cream for treatment.

4. Aggravated Inflammatory Response

If scratching causes skin breaks and proper local care is not maintained, the area may become infected, leading to more severe swelling and itching. Under a doctor's guidance, patients may apply topical antibiotics such as roxithromycin ointment, mupirocin ointment, or fusidic acid cream to manage the condition.

5. Anal Fistula

Anal fistulas, often caused by poor habits or infections, can result in recurrent discharge around the anus that irritates the surrounding skin and triggers eczema. Scratching can break the skin, increasing the risk of infection and worsening both the eczema and itching. It is advisable to use medications such as potassium permanganate tablets (for external use), Kangfuxin solution, or cefixime dispersible tablets under medical supervision to relieve symptoms.

During recovery, it is important to maintain good hygiene habits and keep the skin clean. Avoid consuming spicy and irritating foods such as chili peppers, ginger, and mustard, which may aggravate skin lesions.