Off/on anal irritation, almost like folliculitis, tiny blood. rectal dr hasn't been able to help. should i get 2nd opinion or see a dermatologist?

Pruritus ani?: With these symptoms an exam is mandatory because so many things can cause anal irritation to include hemorrhoids, anal warts, etc. If exam is otherwise clear other than irritated skin this is pruritus ani which over half the time we do not know why it occurs. Most important is to not put anything on the skin including soap and put desitin (zinc oxide diaper cream) cream on skin to protect it

Try something simple: Fecal soiling may be important. Avoid scrubbing, but gentle cleansing in a daily shower using only fingers. After using the toilet, use a lotion (Aveeno, Eucerin, etc.) to clean the anal skin by putting lotion on bathroom paper. Clean outside and inside. Whenever you feel wet or itchy or irritated, go to the toilet and clean the area with the lotion. You may need to do this several times a day. Ou