Anal Itch (Pruritus ani)
Anal itch, also known as pruritus ani, is an itch around the anus (the opening where stool passes). Anal itch is a symptom, not an illness, and it can have many causes. In most cases, a person with anal itch has no disease of the anus or rectum. Instead, the itch is a sign that the anal skin is irritated.
When you have anal itch, it is human nature to wash the area too often with soap and a washcloth. This almost always makes the problem worse by harming the skin and washing away natural oils that protect the skin.
Anal itch is a very common problem that occurs in up to 45% of people at some time during their lives. Men are affected two to four times more often than women. People, who are overweight, perspire heavily or routinely wear snug underwear or stockings have an increased risk of anal itch.
- Intense cleaning after a bowel movement — Although the anal area should be cleaned after each bowel movement, this cleaning must be gentle. Rubbing and scrubbing with soaps or other skin cleansers can irritate the skin and trigger more problems.
- Stool on the skin around the anal opening — If the anal area isn't cleaned properly after a bowel movement, a small amount of stool may be left behind on the skin, leading to anal itch. Less often, watery stools may leak out of the anus and cause anal itching. This leakage sometimes happens in healthy people whose diets include very large amounts of liquids.
- Foods and drinks that can irritate the anus — these include spices and spicy foods, coffee (both caffeinated and decaf), tea, cola, milk, alcohol (especially beer and wine), chocolate, citrus fruits, vitamin C tablets, and tomatoes. These foods can inflame the bowel and increase the number of stools or amount of mucus secreted from the rectum.
- Treatment with antibiotics —antibiotics can trigger anal itch by changing the normal health of the bowel.
- A skin allergy in the anal area —This includes dyes and perfumes used in toilet paper, feminine-hygiene sprays and other deodorants, talcum powders, and skin cleansers, soaps, and laundry detergents. It may also include suppositories, creams and ointments.
- Other conditions: such as:
- Hemorrhoids, skin tags, rectal fistulas, rectal fissures or (rarely) cancer
- Pinworms, scabies, lice, anal warts and skin infections due to yeast or fungus
How to Treat and Prevent Anal Itch
- Practice good anal hygiene — Gently clean the anal area after each bowel movement by using wet toilet paper (unscented and dye-free) or a wet washcloth. Wipe gently or blot the area. Never rub or scrub. You may want to use a hair dryer on the low heat setting to dry the area. If you are in a public toilet, use dry toilet paper, and then finish your cleansing routine when you return home.
- Use only water to clean the anal area, never soaps.
- Wear loose-fitting cotton underwear.
- Use cotton pads, gauze 4X4s or sheets of toilet paper in the skin cleft to absorb moisture away from the anal area. Change as often as needed.
- Avoid using medicated powders, perfumed sprays or deodorants on the anal area.
- Avoid using over-the-counter products for treatment of anal problems, unless your doctor tells you to use them.
- Eat a diet that is low in the foods and drinks known to cause anal irritation.
- Drink 8 (8 oz.) glasses of water daily
- Avoid constipation. Eat plenty of high fiber foods (cereals, fruit, and vegetables). Straining to have a bowel movement causes cracks in the anus, which are painful and harbor bacteria.
- A stool-bulking agent such as Metamucil® (just one teaspoon per day) can help make the stool more bulky, which is often less irritating to the skin.
- If you are taking oral antibiotics, eat yogurt to help restore the normal health of your colon.
Be sure to discuss your treatment with your doctor or nurse practitioner.
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 02/09/2011
Copyright © 02/09/2011 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#4270
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