Pruritus ani (itchy anus)
Itching of the skin about the anus (opening of the rectum) is a common complaint.
What causes an itchy anus?
Common conditions affecting the anus and contributing to itch include:
- Bacterial infection including streptococci (streptococcal dermatitis) or Corynebacteria minutissimum (erythrasma)
- Yeast infection especially Candida albicans
The anal skin is exposed to irritating digestive products which may result in a rash (irritant dermatitis). The rash is made worse by:
- Frequent stools (diarrhoea)
- Straining at stool (constipation)
- Vigorous use of toilet tissue
- Scrubbing with soap and water
- Acidic or spicy foods.
Treatment of an itchy anus
Specific treatment may be prescribed for infection, infestation with pinworm, or certain skin conditions. General measures are described below.
- Irritation of the anal skin needs to be reduced. It is impossible to eliminate it altogether because the stool continues to be in contact with the inflamed skin.
- Cleanse carefully, thoroughly and gently after bowel movements. If there is faecal leakage, cleanse again after an interval of half an hour.
- Wash the anus using a electronic bidet-toilet, standard bidet, shower or a bucket of lukewarm water. Moistened tissues or soft toilet paper are next best. Use aqueous cream, mineral oil or other soap-free cleanser. Avoid soap and rough toilet paper.
- Apply medicated ointment as directed.
- Ask your doctor to explain your treatment. Various different soothing preparations are suitable, including mild topical steroids and zinc paste. Strong steroid creams should not be applied for more than a few days unless under strict medical supervision.
- Petroleum jelly can be applied frequently to soothe and to act as a barrier preparation and skin protectant.
- Do not apply any other remedy, suppository, or medicine to your rash. They can cause allergic contact dermatitis.
- Avoid constipation.
- Eat plenty of high fibre foods (cereals, fruit and vegetables). Straining at stool causes cracks in the anus which are irritable and harbour bacteria.
- Avoid excessively loose or otherwise irritating motions.
- Don't over-indulge in spicy food, prunes, figs, orange juice, coffee or beer.
- NEVER SCRATCH! Scratching and rubbing is a common reason for the continuing pruritus ani.
Itching of the anus is frequently persistent and recurrent. The above advice should be followed indefinitely.
On DermNet NZ:
- Medscape Reference:
- Pruritus Ani – British Association of Dermatologists
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