The most common cause of painful itching and cracking around the anus is anal fissure, and to a lesser extent, it can also be caused by pruritus ani. Anal fissure is a longitudinal tear in the skin around the anus, most of which are associated with constipation, poor bowel movements and improper eating. When an anal fissure occurs it causes painful defecation, which is relieved after defecation and the pain recurs later. As there is secretion formation from the fissure, if it is not cleaned up in time, causing irritation to the skin outside the anus, it may be accompanied by perianal itching or formation of perianal eczema. After the occurrence of anal fissure, you can choose to take a warm water sitz bath after defecation, or add a small amount of potassium permanganate in warm water to relieve the spasm of the anal sphincter and clean the anus. Usually need to keep the perianal area clean and dry, if the pain is more serious, you can take oral laxative medication, such as Ma Ren soft capsule, etc., to alleviate defecation, to avoid the fissure around the anus to prop open again. If the symptoms of perianal pain, itching and fissure are not relieved after taking a sitz bath, you can relieve the symptoms with local topical medication such as compound keratanate cream. If the perianal fissure is deeper and is prone to narrowing after self-healing, or if the perianal pain, itching and fissure does not improve after local medication and relief of constipation, you should go to the hospital. After anal fingerprinting and other related examinations, anal dilatation treatment or surgical treatment can be carried out according to the doctor’s guidance and suggestions, and the commonly used surgical procedures include anal fissure excision, perianal eczema closure, and so on. In addition to anal fissure, perianal pruritus ani may also cause perianal fissure and pain due to scratching by the patient, which can be relieved by local application of drugs such as hydrocortisone cream, or treated by surgery with subcutaneous drug closure or subcutaneous free surgery.