Anal Itching

Anal itching is a common but annoying problem. Anal itching occurs more often in men, and, most of the time, no cause can be identified. Anal itching occurs around and near the anus, which is the opening for the bowels.

• Factors that put people most at risk for anal itching are as follows:
  
  
  • Diabetes
    
    
  • Recent antibiotic use
    
    
  • Chronic dry skin conditions such as psoriasis and seborrhea
    
    
  • Profuse sweating

When a cause can be found, the itching is usually due to irritation of the skin around the anus.

• Some of the most common irritants include these:
  
  
  • Perfumes, chemicals, or dye on toilet paper can cause an allergic reaction.
    
    
  • Moisture from sweat or diarrhea may cause itching. If the anal skin stays wet, the skin begins to break down.
    
    
  • Some foods irritate the anus when they are expelled during a bowel movement. The most common culprits are caffeine, chocolate, beer, nuts, dairy products, and spicy food.
    
    
  • Infections such as pinworms, yeast, and genital warts can cause itching.
    
    
  • Hemorrhoids, which cause painful swelling of blood vessels in the anal area, can cause itching.
    
    
  • Cancer, in rare instances, may be a cause.

The most common symptom of anal itching is itching especially at night and after a bowel movement. There may be a rash in the anal area with skin breakdown or a weeping discharge.

• If the anal itching is associated with any type of rash, lump, discharge, or fever, call your doctor. You may need prescription medicine to make the problem go away.

• If small children are having trouble sleeping at night because of intense itching, this could be a sign of pinworms and will require medical attention.
  
  
• It would be extremely rare that you would need to go to the hospital's emergency department for anal itching. Contact your doctor if you think you need medical help.

Most cases of anal itching can be diagnosed by taking a history and doing a physical exam. If there appears to be an infection, your doctor may want to do cultures to determine what type of germ is causing the problem.

|Self-Care at Home|

Try not to irritate the skin even more by scrubbing the area with soap. This will only cause more irritation and itching. Gentle cleaning with water helps the area heal.

• You may try other home therapies.
  
  
  • Change to a plain, soft, unscented toilet paper.
    
    
  • If toilet paper feels too abrasive, try cleaning with baby wipes or cotton moistened with mineral oil. Dry with cotton afterward to remove any moisture.
    
    
  • Wear loose-fitting cotton underwear that allow sweat to evaporate. Do not wear panty hose.
    
    
  • Do not apply any creams or ointment without consulting a doctor.
    
    
  • Avoid food irritants and eat a high-fiber diet.

|Medical Treatment|

Most causes of anal itching can be readily treated.

• Pinworms and bacterial infections are treated with pills.

• Yeast infections and many rashes improve with creams.

• Skin lesions such as warts or hemorrhoids are removed with minor surgical procedures.

|Prevention|

Some simple strategies can help you prevent anal itching:

• Avoid known food irritants.

• Do not wear tight-fitting underwear.

• Do not use scented or printed toilet paper.

• Dry anal area after excessive sweating.

|Outlook|

Anal itching improves with treatment.

rectal itching, pruritus ani, anus, skin irritation, allergic reaction, anal skin, pinworms, yeast infection, genital warts, hemorrhoids, rash, anal itching

Author: Frederick B Gaupp, MD, Consulting Staff, Department of Family Practice, Assumption Community Hospital.

Editors: Scott H Plantz, MD, FAAEM, Research Director, Assistant Professor, Department of Emergency Medicine, Mount Sinai School of Medicine; Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, ; Anthony Anker, MD, FAAEM, Attending Physician, Emergency Department, Mary Washington Hospital, Fredericksburg, VA.