When itchy symptoms appear outside the anal opening, it is first recommended not to scratch excessively with your hands to avoid further hypertrophy of the local skin, or the appearance of chaps and fissures that can cause other skin changes. You can choose light salt water, bitter ginseng lotion for local external washing, or pepper water for external washing to kill insects and stop itching treatment, and you need to further clarify the cause of local itching in the anus through examination. Common causes of perianal itching include internal hemorrhoids, anal sinusitis, intestinal parasitic infections and perianal eczema. Certain neurological diseases or systemic lesions, such as diabetes, can also cause itching of the perianal skin. If it is caused by internal hemorrhoids or sinusitis, it can be treated with chitosan gel plugs; if it is an intestinal parasitic infection, it needs to be treated with oral anthelmintic medication; perianal eczema can be relieved with topical application of Ma Yinglong musk hemorrhoid cream. If it is accompanied by neurodermatitis or itching is more intense, causing perianal skin pruritus, direct methylene blue injection nerve block can be performed.