PERIANAL DISEASE (PAD)
By Dr. Nektarios Logaras – Dermatologist/Venereologist
The anal area is sensitive and is often affected by various diseases. Often, the diagnosis and treatment are delayed due to the justified contraction that the patient feels in order to speak and be examined in the specific area. An important role for someone to decide to be examined, is to feel comfortable and that he will not be judged by his doctor.
The most common of these diseases are the following:
-Anal Itching or Anal Pruritus
–HPV (Human Papilloma Virus)
-Pilonidal Cyst – Cutaneous Fistulas
-Atopic – Allergic, Irritant Dermatitis
ANAL ITCHING or ANAL PRURITUS
The anal itching (or anal pruritus) in the perianal area can be created by several causes.
The most common are the following:
-Infection by fungi, bacteria, parasites
For the proper protection of sensitive skin in the anal area, we must washthis sensitive area with lukewarm water and mild soap, without using fragrances and chemicals that may cause irritation, after each bowel movement and wiping with a soft cotton towel.
What is Anal Fissure?
Anal fissure is a painful sore on the sphincter mucosa, and is associated with constipation.
Where is it located?
If we compare the anal sphincter with a clock, the 12 is up and the 6 is down, the fissure is located at the 6th and 12th hour, i.e. at the top or bottom of the sphincter fissure, and it is created after a difficult bowel movement. It bleeds and causes intense, acute, pain and anxiety as it is incorrectly associated with internal bleeding. The blood is fresh red and is visible in the toilet and during wiping. The pain persists after a bowel movement and is intensified in the sitting position. It follows an inflammation and if the diet is not improved and constipation is not treated, with medication, it bleeds again after each bowel movement.
Which are the causes of Anal Fissure?
The most common cause is constipation. The most common cause of constipation is stress. The severe stress, the change of diet that is low in fibers, the lack of water and the sedentary lifestyle without exercise cause constipation, and constipation (hard stools) causes unpleasant and painful anal fissures.
Other risk factors that may cause or worsen anal fissures include:
-Anal Sex, without the use of lubricant
-Sexually Transmitted Diseases (Herpes, Syphilis, Gonorrhea, Chlamydia, HIV), to avoid
them, a condom should always be used.
-Anal Cancer (usually from HPVs).
Anal Fissure Treatment
The rectal examination will confirm whether there is a fissure or not. Once the diagnosis is confirmed, nutritional advice will be given to keep the stools soft.The diet should include fruits such as plums, kiwis, vegetables and avoidance of foods that may cause constipation such as rice, bananas, etc. Medication other than painkillers includes lactulose and topical ointments to fight inflammation as well as healing ointments for rapid healing. Cleaning is very important to do after each bowel movement with plenty of lukewarm water and antiseptic – disinfectant soap and wiping with a soft cotton towel. If the necessary prevention and treatment is not done (Stress maybe treated with the help of a psychologist or psychiatrist, constipation maybe treated with the help of a gastroenterologist) the problem may remain for years and surgery may be required.
What is Hemorrhoids?
Hemorrhoids are small, swollen veins in the anus filled with blood. Before they swell, they are small vessels and are present in everyone. Hemorrhoids are directly linked to constipation and they grow from the constant and intense effort to defecate. Improving your lifestyle with regular exercise, a balanced diet rich in fibers, the consumption of 1.5-2 liters of water per day and lactulose intake, the constipation is treated, and therefore the causes that create hemorrhoids. When they first appear, they are small and it is easier to be cured by changing the diet and taking diosmin.Without the treatment of constipation, hemorrhoids may grow, bleed, and require surgery in order to treat them.
The coccyx or pilonidal abscess is a cyst inside the skin, in the last skin layer, the subcutaneous tissue, near the tailbone at the top of the cleft of the buttocks. It contains hairs and often after adolescence becomes inflamed and infected. The causes of inflammation are the presence of hair, the sedentary lifestyle, the skin friction and obesity. When it is inflamed, it causes intense pain, making daily life difficult. It is produced pus and other fluids which are leaked to the surface of the skin. Pilonidal cyst most often affects young people and usually men with increased hair growth at this point, and more often occupations that require a sitting position.When it is inflammatory and painful, antibiotics are given and when the inflammation is gone, then an appointment is scheduled for its treatment.
Treatment with CO2 Laser (Non Ablative)
The CO2 Laser treatment is an excellent photothermal method of purification and bloodless cross-section. It is effective with minimal bleeding and without postoperative swelling and infections. The C02 (Carbon Dioxide) Laser has the advantage of short recovery time, without postoperative pain, and the possibility of the cyst relapse is almost eliminated.
Treatment and Prevention with Alexandrite and Nd:YAG Laser (Laser Hair Removal)
The Alexandrite and Nd:YAG Lasers are the most effective method of permanent hair removal.
The difference is that Nd:YAG can also be used on tanned skin. In the case of the pilonidal cyst, the laser hair removal works as a prevention. Making laser hair removal at this area, after the treatment of the pilonidal cyst with CO2 laser or surgery, we eliminate the possibility of recurrence and relapse of inflammation and pain in another area after the permanent removal of the hair that is the cause of its appearance.
To achieve a permanent result without hair regrowth, we will need 5 to 7 sessions every 40 days.
The Doctor’s experience
Dr. N. Logaras MD
Laser Dermatologic Surgeon
Graduate of Nottingham and Birmingham Universities of England.
-Specialization in Dermatologic Surgery, Department of Plastic Surgery, Hospital of Dermatology & Venereal Diseases “Andreas Syggros”
-Specialization in Digital Dermoscopy – Mole Mapping, at the Department of Dermoscopy and Melanoma, Hospital of Dermatology & Venereal Diseases “Andreas Syggros”
-Degree in Medicine, Bachelor of Medicine and Bachelor of Surgery, The University of Nottingham, UK.
CAREER AND PROFESSIONAL EXPERIENCE
-Dermatologist – Venereologist, Private Clinic – Athens South Dermatology & Laser Center, Alimos
-Dermatology – Venereology Specialty, Hospital of Dermatologic & Venereal Diseases “Andreas Syggros”
-Former Doctor, Royal Derby | Derby Teaching Hospitals NHS Foundation Trust, England
-Former Doctor, Taunton and Somerset Hospital NHS Trust-Musgrove Park, England
-Former Doctor, Worthing and Southlands Hospitals NHS Trust, England
-Former Doctor, Queen Alexandra Hospital, England
-Former Doctor, Portsmouth Hospital NHS Trust, England
-Former Doctor, Brighton and Sussex University Hospitals NHS Trust, England
19 years of medical experience
Phone No. for Appointment: +302109821431