Rules of treatment patient education

1. Scratching. Stop—it's taboo! If you scratch at night, wear light cotton gloves to bed.

2. Bathing. Avoid hot water. Excessive showering and scrubbing is also bad for this condition. Use a cream such as bland aqueous cream or Cetaphil lotion or a mild soap substitute for cleaning rather than soap.

3. Drying. Keep the area as dry and cool as possible. After washing, dry gently and thoroughly with a soft towel or soft tissue: do not rub. Warm air from a hair drier is very useful.

4. Bowel movements. Keep bowels regular and smooth by eating plenty of high-fibre foods such as bran, fresh carrots and apples. Some doctors claim that your bowel actions should be so smooth and complete that toilet paper should hardly be necessary.

5. Toilet. Clean gently after bowel movements. Soft paper tissue (avoid pastel tints) may be used, and then clean with tufts of cotton wool with aqueous cream or bland soap and water. The best way is to use cotton wool in warm water.

6. Soaps and powder. Do not use perfumed soaps and talcum powder, including baby powder. Zinc powder, e.g. Curash, is suitable to keep the area dry and relieve itching.

7. Clothing. Wear loose clothing and underwear. In men, boxer shorts should be used in preference to jockey shorts. Cottons should be used. Let the air circulate in the area. At times a skirt but no underpants (in women) is desirable. Avoid pantyhose if possible.

8. Topical creams. Do not use ointments unless your doctor has prescribed them. If a cream has to be used, simple creams may be the most soothing (e.g. toilet lanoline).

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