Itchy anus

Author: Vanessa Ngan, Staff Writer, 1997

What is pruritus ani?

Pruritus ani, or itching of the skin about the anus (opening of the rectum) is a common complaint.

Anal itching is usually an isolated skin complaint in otherwise healthy persons, but in some it is part of a disorder involving other areas of the skin, especially the vulva in women and children.

What causes an itchy anus?

Common conditions affecting the anus and contributing to itch include:

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)
  • Scratching
  • 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.

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