Perianal strep is a bacterial infection impacting the skin around the anus. Unlike minor skin issues, perianal strep usually requires medical treatment and will not go away on its own.
Understanding Perianal Strep
Perianal strep, also known as perianal streptococcal dermatitis or perianal cellulitis, is an infection of the skin surrounding the anus. The cause is Streptococcus pyogenes, commonly known as Group A Strep (GAS), the same bacteria responsible for strep throat. This infection primarily affects children between six months and 10 years of age, though it can occur in adults.
Transmission often occurs through direct contact with infected individuals or contaminated objects. Poor hygiene, such as touching the mouth then the perianal area, can spread the bacteria. Symptoms include a bright red rash around the anus, which can appear moist and is often described as “beefy red.” Other common signs are itching, pain during bowel movements, and sometimes blood in the stool.
The Need for Treatment
Perianal strep is a bacterial infection that requires antibiotics for eradication and does not resolve without medical intervention. Unlike superficial skin irritations, this infection affects deeper layers of the skin. Group A Strep thrives in the warm, moist perianal area, making natural clearance difficult.
Without proper treatment, the infection will persist and can worsen over time, leading to prolonged discomfort. Potential complications include cellulitis, which is a deeper skin infection, and perianal abscess formation. Untreated infections can also increase the risk of spreading the bacteria to others.
Treatment Approaches
Diagnosis of perianal strep typically involves a physical examination, followed by a rapid strep test or a bacterial culture from the affected area. A swab from the perianal region confirms the presence of Group A strep. This testing helps differentiate perianal strep from other conditions with similar symptoms, such as diaper rash or fungal infections.
The primary treatment for perianal strep is a course of oral antibiotics. Commonly prescribed antibiotics include penicillin, amoxicillin, or cephalexins. It is important to complete the entire course of antibiotics, typically lasting 10 days, even if symptoms improve quickly, to ensure the bacteria are fully eradicated and to prevent recurrence. Supportive care, such as warm sitz baths after bowel movements, can help alleviate pain and itching. Topical mupirocin may be used as an adjunctive therapy, but it is not sufficient as the sole treatment due to the infection’s depth.
Preventing Recurrence and Complications
Preventing the recurrence of perianal strep involves consistent hygiene practices. Thorough washing of the perianal area is important, along with proper wiping techniques (front to back) to minimize bacterial spread. Frequent handwashing, especially after using the toilet or changing diapers, helps reduce the transmission of bacteria.
Avoiding the sharing of towels and clothing can also prevent the spread of the infection within a household. Even after treatment completion, it is advisable to monitor for any returning symptoms, as recurrence can happen. Seeking medical advice promptly if symptoms reappear ensures timely intervention and helps prevent further complications.