Pruritus Ani

I. Definition:

Pruritus ani is a chronic itching of the skin around the anus. 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.

II. Causes:

• Anal itching is usually an isolated skin complaint in otherwise healthy people, but in some it's part of a disorder involving other areas of the skin. Whether pruritus ani is an isolated problem or part of another skin disorder, irritation from stools and from cleansing after bowel movements keeps the rash going.
• You may find that alcohol, coffee, tea and spicy foods make pruritus ani worse. These foods irritate the digestive tract and increase the number of stools or amount of mucus secreted from the rectum.
• Pruritus ani usually occurs in men. The reason is unknown.
• Sometimes hemorrhoids will start off as anal itching.  For this reason it is important to be examined by a physician.
• Pinworms can cause sever anal itching and should be thought of if several members of the family have this problem.  One can see the worms by putting scotch tape over the area than looking at the tape.  This problem requires treatment by a physician.

III. Treatment:

• Treatment is intended to reduce irritation of the anal skin. Careful, thorough, gentle cleansing after bowel movements is very important. Moisten toilet paper with lukewarm water, as dry toilet paper doesn't cleanse as well as wet and also irritates your skin.
• Never use soap on the anal area. Cleansing with plain water, in either the shower or bathtub, will do the job.
• Medications which have been succesful for this condition include:

  - Lotrimin cream mixed with hydrocortisone 1% cream applied daily. Both of these are available over the counter at your local drug store.

    - A mild alpha hydroxyacid applied each day.

    - Plain vaseline applied each day to the anal area.

• Pruritus ani is frequently stubborn and requires months of local medication and gentle skin care.
• Some people need to continue the medication once or twice daily indefinitely since the itching returns whenever they stop.

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