Patient education: Anal pruritus (anal itching) (The Basics)

What is anal pruritus (anal itching)? — Anal pruritus is itching of the anus or the skin around it. The anus is the last part of the digestive system (figure 1). It is where bowel movements leave the body.

Anal itching can cause discomfort and embarrassment. Some people think it means they have colon cancer. But anal itching is usually caused by something else.

What causes anal itching? — There are many possible causes of anal itching, including:

●Part of a bowel movement that gets stuck to the skin around the anus – This is more likely to happen if you have diarrhea or soft bowel movements.

●Hemorrhoids – These are swollen veins in the rectum. They can also cause pain.

●Certain foods or drinks, which can irritate the anus, such as:

•Coffee, tea, beer, and cola

•Chocolate

•Tomatoes

•Citrus fruits, such as oranges or grapefruit

●Diseases that affect the anus, such as:

•An anal abscess – This is a lump that happens when a gland inside the anus gets infected.

•An anal fistula – This is a tunnel that forms between the anal gland and the place where the abscess is on the skin.

•Cancer – Some people who get anal, rectal, or colon cancer have anal itching.

●Skin diseases, such as:

•Psoriasis – A skin condition that can cause a rash and itching.

•Dermatitis – A skin rash that can happen after your skin touches something that irritates it or something you are allergic to. This could be a skin cream, laundry detergent, or something else that touches the area around your anus.

●Diseases caused by infection with a bacteria or fungus.

Is there anything I can do on my own to get rid of anal itching? — There are some things you can try. These include:

●Keeping the anus and skin around it clean and dry – You can:

•Wipe gently after a bowel movement, using a moist pad or tissue

•NOT use a cleaning lotion, such as witch hazel – This can make symptoms worse.

•Take a bath after you have a bowel movement – Use mild, unscented soap. Pat the area dry with a soft towel or use a hair dryer on the cool setting.

•Put some unscented talcum powder on the skin around the anus – This can help keep the area dry.

●Putting an anti-itch ointment on the area – You can use an over-the-counter hydrocortisone cream (sample brand names: Preparation H, Anu-med HC). But do not use anti-itch cream for more than 2 weeks.

●Putting a zinc oxide skin ointment or paste on the area (sample brand names: Desitin, Balmex)

If the itching is worse at night, you can take medicines called antihistamines (sample brand names: Benadryl, Aler-Cap).

You can also try NOT eating or drinking things that can cause anal itching or diarrhea. For example, some people get diarrhea when they drink milk or eat foods made with milk.

Will I need tests? — Maybe. Your doctor or nurse will do an exam and learn about your symptoms. You might also have the following tests:

●Biopsy – If the doctor or nurse finds a growth, they will take a small sample of tissue from the area. Another doctor looks at the sample under a microscope to check for cancer.

●Colonoscopy – This test looks at the inside lining of a person's large intestine, called the "colon." During a colonoscopy, the doctor puts a tube with a tiny camera into your anus and up to your colon. This lets the doctor look for cancer or other problems. Before a colonoscopy, you get medicine to make you relax.

How is anal itching treated? — If a medical condition is causing the anal itching, doctors can treat that condition. This usually gets rid of the itching.

A few people have anal itching even after trying different things to stop it. If this happens, doctors can give other ointments and in rare cases an injection (shot) of medicine around the anus. This can stop the itching.

Can anal itching be prevented? — You can reduce your chances of getting anal itching by:

●Keeping the area around the anus clean and dry

●Not eating foods that can cause anal itching or diarrhea

More on this topic

Patient education: Hemorrhoids (The Basics)
Patient education: Anal abscess and fistula (The Basics)
Patient education: Pinworms (The Basics)

Patient education: Anal fissure (Beyond the Basics)
Patient education: Hemorrhoids (Beyond the Basics)
Patient education: Gonorrhea (Beyond the Basics)