Mrs. T. was an excellent office administrator. She made sure that all the Is were dotted and the Ts were crossed. She was, however, under a great deal of tension and stress, which was reflected on her face.
Upon visiting my office, it was evident that she was experiencing more than mental stress. She revealed that she was uncomfortable most of the day due to itching around her rectal area. In fact, she stated, she felt like she had ants in her pants, which made it almost impossible to sit still at her desk. On many occasions, it was almost impossible to sit at her desk or sit comfortably at a staff meeting.
Examination of the rectal area revealed angry, inflamed skin. She related that she had used many over-the-counter preparations, but they relieved the itching only temporarily and sometimes caused the area to become more irritated. Mrs. T. had been to several physicians, who suggested that she change her laundry detergent to a milder soap and eliminate tight-fitting undergarments. She followed their instructions, but to no avail.
Questioning her further, I inquired about the type of toilet tissue that she used. She replied that she was very particular about the quality of tissue that she bought. In fact, the tissue was color-coordinated with her bathroom, which was pink, and had the odor of roses. I told Mrs. T. that I was sure that the color and fragrance of her tissue was the cause of her problem.
Often, the moist skin around the rectal area becomes very sensitive to dyes and chemicals, which can cause an itch/scratch cycle due to an allergic reaction. The area is further irritated by vigorous wiping and washing. Many persons are sensitive to red and blue dyes, which are often used in tissues. Many perfumes and feminine sprays may also cause rectal itching.
I advised Mrs. T. to do the following:
- Discontinue the use of all colored and accented tissues.
- When washing undergarments, use a mild soap rather than a caustic laundry detergent.
- Avoid very spicy foods for a while.
- Practice very gentle wiping and washing in the rectal area.
- To sooth the skin, use an astringent such as witch hazel. Medicated cooling pads such as Tucks can also be used.
- Do not use lotions that have a topical anesthetic in them or products with “-caine” at the end of the word.
I suggested that these instructions be followed to a T. In the following weeks, the itching had subsided completely without the use of any medications, and the “ants in her pants” were never given another thought.