What is pruritus ani?
Pruritus ani (anal itchiness) is a common condition that generally affects healthy people. It is not 'serious' but can interfere with daily life and is sometimes difficult to treat.
What causes pruritus ani?
Pruritus ani results from the irritation of damaged skin around the anus by either faeces or mucus from the anus. The irritation causes itchiness, which prompts scratching and further damage to the skin. This damaged skin then becomes sensitive to even tiny amounts of contamination from faeces, which causes further irritation. The root cause can be a condition such as haemorrhoids, a fissure, fistula or skin disease. Often, however, there is no obvious cause.
What is the treatment for pruritus ani?
Your general practitioner can examine you to investigate the possible cause of the itching, which they can then treat. If there is no clear cause, treatment aims to break the circle of irritation, itching, irritation etc.
What can I do to prevent or treat pruritus ani?
The main aims are to avoid scratching, keep the area scrupulously clean and avoid irritants.
General advice:
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Do take daily baths or showers;
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Do wear cotton underwear;
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Do wipe gently with toilet paper;
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Don't scratch or rub the area.
In addition, if you have or are susceptible to pruritus ani:
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Do wash the skin around the anus after passing faeces;
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Do use damp toilet paper or baby wipes and pat dry with dry tissue afterwards (or you can use a hairdryer) to clean thoroughly but gently;
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Do wear loose clothing and underwear;
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Do try placing a small piece of cotton wool at the opening of your anus to prevent minor soiling;
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Don't use scented toilet paper, in case you are allergic to it.
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Don't use scented soap, medicated, perfumed or deodorant talcum powders, or cleansing pads that contain alcohol or lanolin, which can increase irritation.
Can what I eat make pruritus ani worse?
Some drinks and foods can aggravate pruritus ani. These include beer, caffeine-containing drinks (eg coffee, tea, colas), citrus fruit juices, tomatoes, chocolate and nuts. At first, you can try to avoid these foods and then, when the condition is controlled, you can try reintroducing them slowly.
Are there any medicines and creams that are useful?
A wide variety of medications are available for pruritus ani, and these can be used sparingly under the direction of your doctor. If they are used on their own, they are unlikely to 'cure' the condition, but they might be helpful alongside the measures outlined above. In general, it is best to avoid using any medications in the anal area if possible because they can sometimes irritate the skin.
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