Pruritus Ani

Written By Guest User

What is pruritus ani? 

A skin condition characterised by an unpleasant itching or burning sensation in the perianal region, which may become worse at night or after bowel movement. It affects men more commonly than women.  

Causes of pruritus ani

Up to 50% could be primary / idiopathic (i.e. no obvious cause found). 

Secondary pruritus ani may include many different causes: 

  • Poor anal hygiene 

  • Perianal infections e.g. fungal (yeast), parasite (pinworm), viral (HPV, warts)

  • Allergic reaction to e.g. scented soap, powder, lotions, creams, ointments

  • Food allergies include dairy products, caffeinated drinks, acidic or spicy food types 

  • Systemic diseases 

  • Dermatological conditions 

  • Local trauma e.g. wiping with rough toilet paper, washing with hot water

  • Excess sweating from tight underwear trapping heat and moisture

Symptoms of pruritus ani

Anal itching usually causes an uncontrollable urge to scratch the anus, with subsequent skin damage or infection, perpetuating the itch-scratch cycle; thereby worsening the symptoms of discomfort and / or burning sensation. 

How is pruritus ani treated?

Don’t be embarrassed about seeing a doctor. This condition is very common. A consultation with your GP is vital to ensure that the secondary causes are assessed and treated accordingly. 

Surgery is not necessary in the first instance. The important keys to management involves maintaining good anal hygiene, avoid scratch and use the prescribed medication appropriately. 

Conservative measures should be trialled initially. Improvement follows diligence. If it recurs be patient and continue with the below measures.

Appropriate clothing

Wear well fitted cotton underwear that absorbs moisture

Use fragrance free detergents to wash your inner clothings 

Dietary changes 

  • Normalisation of bowel motion (regular high fibre diet or usage of supplement)

Optimal anal hygiene + Avoid the urge to scratch 

  • Ensure the skin around the anus is dry by gentle dabbing with soft tissue 

  • To remove any small particles of motion, by washing with warm water after each bowl motion.

  • Avoid rubbing with soap or applying antiseptics as this may increase irritation

Medication 

  • Barrier protection: Calmoseptine may be applied after cleansing  

  • Hydrocortisone cream: your GP may trial this for inflammatory type disease (e.g. dermatitis, scleroderma) to break the cycle of itch. This is not a cure 

  • Antibiotics and anti-fungal: Your GP may prescribe this if infection is present 

  • Topical capsaicin: effective but persistent usage may be needed 

Referral to a colorectal surgeon for consideration of examination under anaesthetic +/- colonoscopy to assess for premalignant, malignant diseases and presence of other anorectal diseases (e.g. anal fissure, haemorrhoids, fistula in ano, and rectal prolapse etc). 

Guest User
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