Your Bottom & TCB (Taking Care of your Bottom):

YOUR BOTTOM IS NOT CLEAN. No…I’m not trying to make you feel bad. Seriously…nobody’s is. I can say that because all of us have bacterial germs living on our bodies and in the rectal area, we have a whole slew of germs in the vicinity of the anus and it cannot be sterilized. It’s impossible!

That said….relax…it’s not a worry. In fact, it is completely normal. Getting used to the fact that we are covered with germs, more or less, will allow you to understand how to TCB (Take Care of your Bottom)….when you have issues.


This is a common experience and occasionally it is so bothersome that it rises to a level that requires comment from the doctor. A patient will come in complaining specifically about this issue and there are a variety of conditions that can cause rectal itching, but generally it’s just an irritation. Other possibilities include a fungal/yeast infection, hemorrhoids, or even pinworms (unlikely!)

Figuring out which issue is causing the problem may be necessary, but without worry about the specifics, we can try a treatment approach that works for all issues in general. If this suffices, then no need for further investigation.

Basics of TCB:

1. DO NOT USE SOAP. This may come as a surprise, but remember, we spoke of the fact that your bottom area has germs. There is no way to sterilize the area and generally speaking, your bottom is happiest when it has some germs around, as this is its normal situation.
2. WASH YOUR BACKSIDE WITH EITHER PLAIN WATER OR CETAPHIL LIQUID CLEANSER (available over-the-counter at any CVS, Waglreens, etc.….) Avoiding soap will prevent harsh irritants from perpetuating the irritation in the area and it will prevent the area from getting ‘dried out’ as soaps often do.
3. DRY YOUR BOTTOM THOROUGHLY. Probably the best way to do this is to use a hair blower on medium heat. Alternatively, you can ‘pad’ the area dry with a dry towel or air dry by leaving your bottoms off and letter nature dry things up.
4. POSSIBLY USE A CORTISONE CREAM…A VERY SMALL AMOUNT. If you have been doing items 1-3 for a few days and it’s just not working, then using a small amount of steroid/cortisone cream is fine. Best to apply a small amount to the fingers and then while the bottom is moist after a shower, apply the cream to the bottom area. Then dry the area as mentioned in #3.

This approach is 90+% likely to fix your bottom irritation, no matter what the cause. In fact, it works on the groin areas as well and should be tried if you have irritation in that area as well (or for women with mild vaginal irritation).

So…try these simple steps before worrying about coming into the office for a check on things or worrying about the specific cause of the issue. If it resolves the situation….you’re all set.

Elvis lived by the moniker TCB….Taking Care of Business. Now you too can TCB (only a in a little different way!)