I suffered with this for over 10 years. The last year, it worsened and began to look like lichen something. I was extremely worried at that point.
I had tried the prescription cream in the beginning, which didn't really work and started to thin my skin. I also tried coconut oil which helped to soothe it, but didn't treat it. Witch hazel also was soothing, but again, didn't treat it.
One day I was reading about something and aloe was mentioned. I had a plant, so I cut off a big piece and washed it. Then I cut it almost in half width-wise. I opened it up, and just applied all the gel directly onto my anal and perineum area. I did this for probably a week and IT WAS HEALED!
I couldn't believe it was so simple! I stopped, and then it started up again, so I repeated the treatment and it has been gone for about 2 years now!
I hope this helps someone; this is such an embarrassing and debilitating problem.