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Pruritus Ani

(Anal Itching)

Definition

Pruritus ani is an intense itching in and around the anus. This can cause you to feel the need to scratch. Anal itching is a common problem that many people experience at one point or another.

The Anus

Causes

Pruritus ani can be caused by many things, including:

Infections (eg, pinworms, fungus, streptococcuss skin infections)

Skin disorders (eg, contact dermatitis, psoriasis)

Hemorrhoids

Certain foods, such as caffeinated drinks, alcohol, peanuts, tomatoes

Too much moisture

Certain medications, such as laxatives

Risk Factors

There are no common risk factors associated with anal itching.

Symptoms

The irritation in and around your anus can be a temporary condition or it may continue to bother you. Pruritus ani produces itching, soreness, and burning.

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. Your doctor will try 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 treated. For example, antibiotics may be prescribed to treat an infection. Treatment for the itching and irritation may include:

Self-care

Gently cleanse the area with water when bathing

Take a sitz bath

Dry thoroughly

Use cotton, gauze, or cornstarch to absorb moisture

Don’t scratch

Use unbleached, unscented toilet paper

Wear loose cotton clothing and underwear

Avoid irritants (eg, bubble baths, certain foods)

Medication

Over-the-counter or prescription cream or ointment containing hydrocortisone or other corticosteroids to reduce itching and provide protection

Zinc oxide ointment—to provide protection

Topical capsaicin—to reduce itching

Certain medicines to treat infection if this is thought to be the cause of your itching

Prevention

Avoid tight-fitting, synthetic clothing

Try to keep the area clean and dry

Avoid scratching at the area

Avoid using perfumes, dyes, and any other irritants on the area

Eat a healthy diet

Exercise regularly

Avoid certain medications (eg, narcotics, laxatives)

RESOURCES:

American Academy of Dermatology

http://www.aad.org

American Academy of Family Physicians

http://familydoctor.org

CANADIAN RESOURCES:

Canadian Dermatology Association

http://www.dermatology.ca/

Dermatologists.ca

http://www.dermatologists.ca

References:

Pruritus ani. American Society of Colon & Rectal Surgeons website. Available at: http://www.fascrs.org/patients/conditions/pruritus_ani/ . Updated October 2012. Accessed December 4, 2012.

Pruritus ani. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed . Updated June 13, 2012. Accessed December 4, 2012.

Siddiqi S, Vijay V, Ward M, et al. Pruritus ani. Ann R Coll Surg Engl . 2008 September; 90(6): 457–463.

Last reviewed March 2013 by Brian Randall, MD

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.