Refractory Anal Itching: Treatment via Injection of Methylene Blue with or Without Associated Corticosteroids

Fernando Fernández López* and Jesus Pedro Paredes Cotore

Department of Surgery, University of Santiago de Compostela (USC), Santiago de Compostela, Spain

^*Correspondance to: Fernando Fernández López 

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Abstract:

Background: The objective of this study was to determine whether there are differences in the efficacy of intradermal injection of methylene blue with and without corticosteroids for the treatment of refractory anal itching. Material and Methods: Twenty patients whose anal pruritus was refractory to topical treatments were randomly divided into two groups. In Group A, 10 ml of 1% methylene blue and 100 mg of hydrocortisone were injected. In Group B, only 1% methylene blue was injected. A follow-up was carried out at 15 days post procedure, and a face-to-face consultation was held at 30 days post procedure. The condition was considered cured when the urge to scratch disappeared. Result: At 8 weeks, 9 patients in Group A (AM+HC) and 3 in Group B were symptom-free. In those in whom treatment failed, four underwent a second injection of methylene blue, which provided complete relief at three to 8 weeks. Conclusion: Perianal intradermal injection including methylene blue was effective in alleviating symptoms in 70% of patients. However, the study revealed that combined injection of methylene blue with corticosteroids did not improve the control of refractory anal itching symptoms.

Keywords:

Methylene blue; Anal itching; Refractory; Hydrocortisone.

Cite the Article:

Fernández López F, Pedro Paredes Cotore J. Refractory Anal Itching: Treatment via Injection of Methylene Blue with or Without Associated Corticosteroids. Clin Case Rep Int. 2025; 9: 1735.