Pruritus Ani
(Anal Itching)
Definition
Pruritus ani is an intense itching in and around the anus. This itching tends to be worse at night or after a bowel movement. The itch may be so intense that the urge to scratch is irresistible. Anal itching is a common problem that most people experience at one point or another.
The Anus
Causes
Most cases of anal itching are caused by harmless problems. On rare occasions it can be a sign of malignant skin conditions.
Below are some causes. Scratching removes the lining of the skin around the anus allowing for more irritation to occur. Scratching or excessive washing compounds the problem.
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Skin disorders
- Fistulas (tunnels beneath the skin)
- Fissures (cracks in the skin)
- Cancer (rarely)
- Psoriasis
- Eczema
- Allergic or contact dermatitis
- Seborrheic dermatitis
- Hemorrhoids
- Infections
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Other causes
- Dry skin or too much moisture
- Excessive washing; soap contains chemicals that can irritate the skin
- Excessive wiping with dry, harsh toilet paper
- Chemical irritants such as laundry detergent, cologne, and birth control products
- Frequent diarrhea
- Overuse of laxatives
Risk Factors
A risk is anything that increases your chances of developing a disease or condition. The following may increase your risk of pruritus ani:
Symptoms
The irritation in and around your anus can be a temporary condition or it may be more persistent or bothersome. Pruritus ani produces itching, soreness, and burning.
Diagnosis
Your doctor will ask about your symptoms and medical history and perform a physical exam. He or she will attempt to determine the cause of your condition.
Treatment
Talk with your doctor about the best treatment plan for you. Ideally, the cause of the problem will be identified and effectively treated. For example, antibiotics may be prescribed to treat an infection. In addition, treatment for the itching and irritation may include:
Self-care
- Cleanse gently after bowel movements
- Dry thoroughly
- Talcum powder after bowel movements
- Don’t scratch
- Use unbleached, unscented toilet paper
- Wear cotton underwear
- Avoid irritants (bubble baths, foods, etc.)
Medication
- Over the counter or prescription cream or ointment containing hydrocortisone or other corticosteroidss to reduce inflammation
- Protective ointment, with zinc oxide
RESOURCES:
American Academy of Dermatology
http://www.aad.org
American Academy of Family Physicians
http://www.aafp.org
CANADIAN RESOURCES:
Canadian Dermatology Association
http://www.dermatology.ca/english
Dermatologists.ca
http://www.dermatologists.ca/index.html
References:
Anal Itching. Mayo Clinic website. Available at: http://www.mayoclinic.com/invoke.cfm?id=DS00453 . Accessed September 26, 2005.
Pruritus Ani. Colorado Center for Digestive Disorders website. Available at: http://www.gastromd.com/education/print_pruritisani.html . Accessed September 26, 2005.
Last reviewed November 2008 by Ross Zeltser, MD, FAAD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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