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Pruritus Ani

(Anal Itching)

by Dianne Scheinberg, MS, RD, LDN

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

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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    TOP

There are no common risk factors associated with anal itching.

Symptoms    TOP

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    TOP

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    TOP

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    TOP

  • 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
Last Updated: 03/15/2013