Pruritus Ani - Definition, Causes, Symptoms and Treatment

Definition

Itching around the anal area, called pruritus ani, is a common condition. An irresistible urge to scratch results. It may be most noticeable and bothersome at night or after bowel movements. The skin of the perirectal area is exposed to irritating digestive products in the stool; this may lead to an itchy rash, especially when stools are frequent. Often the rash is worsened by vigorous use of toilet tissue or scrubbing with soap and water. Pruritus ani is a symptom, not a final diagnosis. Various conditions may cause pruritus ani. However, in many cases the cause is not clear. This is called idiopathic pruritus ani which means itchy anus of unknown cause. At its most intense, anal itching causes intolerable discomfort that often is described as burning and soreness.

Causes

1. Thrush and fungal infections are also major cause in this problem. These like it best in moist, warm, airless areas, such as around the anus. Thrush is more common in people with diabetes.
2. Some soaps, perfumes, creams, ointments, or the dye in some toilet tissue may sensitize the skin around the anus in some people.
3. Infections such as scabies, herpes, anal warts and some other sexually transmitted diseases can cause itch around the anus. You are likely to have other symptoms too such as a rash, lump or discharge.
4. Skin conditions may also affect the skin around the anus to cause itch. For example, eczema, psoriasis, lichen sclerosus and seborrhoeic dermatitis can lead to this problem.
5. Excessive wiping with dry, harsh toilet paper or excessive scrubbing with harsh soaps and a washcloth can cause or aggravate anal itch.

Symptoms

1. Sharp and intense itching is the major symptom. The itching occurs badly in nights.
2. Skin changes occur which are due in part to scratching hyperemia, excoriations, abrasions, thickening, and lichenification.
3. It causes irritating sensation around the anus that is relieved temporarily by scratching or rubbing.
4. If anal itch becomes a chronic (long-term) problem, the skin around the anus may become raw and tender from repeated scratching, or it may thicken and become leathery.
5. Repeated scratching also can cause breaks in the anal skin that can lead to painful local infections.

Treatment

1. You may be advised to use a steroid cream for a short while if there is eczema around the anus.
2. Wash the anus after going to the toilet to pass faeces. The aim is to clear any remnant of faeces which may irritate the skin.
3. Bath or shower daily. If possible, wash the anus with water only. If you use soap around the anus, rinse well.
4. After cleansing, pat the area dry with toilet paper or a towel. Or dry thoroughly with a hair dryer. Once dry, place a dry cotton ball or a piece of cotton gauze against the anus.
5. A bland soothing ointment may be recommended to use after going to the toilet and at bedtime.
6. Wear soft cotton gloves while in bed if you scratch at night or in your sleep.