Don’t Scratch Your Bottom

Itching around the anal area is called Pruritus Ani. This condition is an unpleasant skin sensation that produces the desire to scratch.

Why this does happen?

There are a number of possible reasons. Some of them are moisture due to perspiration, a small amount of residual stool around the anus, hemorrhoids, fissures, fistulas, certain foods, smoking and drinking. Foods and beverages that are associated with Pruritus Ani include coffee, tea, carbonated beverages, milk products, cheese, chocolate, nuts, and spicy food. Rare anal malignancies can cause itching.

Lack of cleanliness is rarely the primary cause. Once the patient develops this condition, they have the tendency of washing the area vigorously with soap and a washcloth. This is usually counterproductive due to damage to the perianal skin and washing away protective natural oils.

Perianal dermatitis, anal warts and hypertrophic skin are other causes for this condition.
Parasites that cause anal itching are very rare in the United States.

What can be done to make the itching go away?

A careful examination by a specialist can identify a definite cause for the itching. At least half of these patients never identify the reason for their problem, but they are still treated for their symptoms. A biopsy is rarely needed in the work up of this condition. The goal should be to achieve clean, dry and intact skin.

Some general recommendations include:

  1. Avoid certain foods that cause this condition. Gradually reintroduce the offending foods; this helps identify which group is responsible and threshold for tolerance.
  2. Avoid moisture in the anal area.
  3. Avoid further trauma to the affected area. Anal hygiene is important. Use baby wipes or wet toilet paper to clean the area. Pat it dry. Never rub.
  4. Do not scrub the anal area with regular toilet paper.
  5. Minimize the use of soap in the anal area.
  6. Try not to scratch the itchy area. Scratching produces more damage to the skin, which in turn makes the itching worse.
  7. Use only medications prescribed by your physician.
  8. If symptoms persist after 6 weeks, make another appointment with your physician.
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