Perianal strep

[Summer200]

Can anyone give me some advice? Both my children have what I believe to be perianal strep. Bright red demarcated patch around anus. This has been going on since November.

Swabs didn’t pick up strep however doctor was still willing to let us try 10 days of penicillin V which didn’t work. We then tried flucloxacillin with mucipiron ointment which also didn’t work.

We’ve also tried work medication and every antifungal cream under the sun, canesten, daktarin, nystaform, Trimovate.

My gut tells me this is still a strep infection as it looks identical to images I’ve seen. We are now waiting for a referral to dermatologist which will take three months. Has anyone got any advice of what I can do in the meantime? I’m pulling my hair out and very anxious about the whole thing, especially as we’ve been to and fro the doctor for over five months now. Thank you!

How old are your children and are they potty trained?

Sounds like you are setting your children and household up for antibiotic resistance.
What issue is this patch causing them?

11 months and 2 and a half

Eldest is potty trained (with some accidents still)

But what issue does this patch cause? Itching burning bleeding?

Eldest is constantly complaining it hurts. Causes him to withhold his poo. Both bleed when wiping

If strep is not growing on the swab then it is unlikely to be strep. Also, all the treatments for strep have failed.

Possibly candida? Or threadworms?

Swabs negative for candida. We also did tape test for threadworms which was also negative. Still took the worm medication just in case to rule that out too

Skin scraping for fungus also came back with nothing.

Try wet wipes vs toilet paper.
moisturize the area with a bit of petroleum jelly only after bath time when the skin is clean.

I’d ask the pharmacist for a perineal wipe with witch hazel. Keep in the fridge, lovely soothing and should help healing.

I’ve also tried all the usual barrier creams, Sudacrem, Bepanthen, Metanium, Drapoline

Did you specifically try petroleum jelly? another moisturizer Lanoline?

It can be irritation from wipes or tissue.

With DS we had to use just water and cotton wool changing his nappy. We could use baby oil to cleanse- and I think baby lotion.

Do they get a lot of soft stool? DS had milk intolerance so his stool was acidic and vinegar smelling. We had to let him kick about with no nappy til it was totally dry, when we could.

Letting it get dry, with talc if necessary (applied with a cotton wool ball), avoiding soaps/wipes/tissue and using moisturising oils/creams to do mucky cleans were the way we beat it in the end.

Can you be referred to dermatology? Potentially an allergy or from over wiping? Milk allergy?

It’s just strange neither of them had it before then in November they both developed it. We didn’t change wipe brands or anything like that. And it’s very specifically just around the anus not the whole nappy area

My son has just had a rash totally clear up from switching from our lovely dye free nappies to Huggies. The doctor said she thinks the eco nappies are just not as absorbent, so babies don’t stay as dry. Worth a shot to change to a different nappy type?

We also stopped using sudacrem etc to let it totally dry out, and in this warm weather spending a lot of time nappy free. This has been an issue for over a year for us and is now clearing up finally.

Hi @Summer200 did you get any answers on this? My 2 dc (DS nearly 4 and DD 8 months) have both got the same symptoms - eldest first and now developing on the youngest. Out of hours doctor said not strep and just to monitor but like you, it looks identical. Both have spots too. Need to try and get a GP appointment this week. I'd really appreciate any advice! Hope your little ones are ok and improving.

It sounds like an intolerance, it's just strange both would have it appear at the same time.

Have you changed the brand of anything they eat or drink around when this started?

I have some intolerances. Here comes the tmi but whatever. I have been known to ignore what's good for me, or slip up repeatedly with new foods, and cause either acidic bowel movements and/or acidic wind. Both can leave me with badly inflamed and sore itchy skin around my anus.

It's usually a cold soothing cream and a do over of my fridge contents

Still no answers on this. We saw a dermatologist who said not strep and to just use Bepanthen and cotton wool with water to wipe but it’s made absolutely no difference. I’ve been thinking about intolerances but can’t pinpoint anything that they both eat as it started when the youngest was only six months and wasn’t eating very much. Just really want answers!

@glittercunt thanks I'll have a think about intolerances too. It'd make sense for dd with starting solids but I can't think what would have changed for ds.

@Summer200 thanks and sorry it's not sorted yet. Very stressful to have been going on for so long. If I get any useful answers I'll report back! Good luck!

@fairydell21 thank you! I’ll report back too if we get anywhere!

just reading up on this. If it’s both of them and you can’t get any answers about an infection I can only suggest the following:

• use a different washing detergent (non-bio)
• different bath soap than you use now
• stop using bepanthon. A few months ago they added almond oil.
• try and cut out dairy from their diet for a month and see how that goes
• try a different cleaning product for the bath
• buy a different brand of nappies

Hopefully you’ll get there. I can only think of things you can control. Getting answers from medical experts can be long and you might not even get there. It’s sometimes a lot to do with diet and environment. wish you all the luck. These things in motherhood can be so frustrating (speaking from a mother of a constantly very constipated toddler)

@Summer200 hi just wanted to know hows your little one now? I hope things got sorted