Pruritus Ani

What is pruritus ani?

Itching around the anal area, called pruritus ani, is a common condition. The itching may be intractable. This is usually most noticeable and bothersome at night or after bowel movements.

What causes this to happen?

Several factors may cause pruritus. Moisture around the anus from excessive sweating or from moist, stools is one possible causative factor. In some people, a high intake of liquids can cause a loose, irritating stool. Other possible causes or contributing factors include pinworms, psoriasis, eczema, dermatitis, anal infections, hemorrhoids, or anal fissures.

Does this come from not keeping my anal area clean enough?

This is almost never a factor. However, the natural tendency is to wash the area vigorously and frequently with soap and a washcloth. These activities almost always aggravate the problem by damaging the skin and washing away protective oils.

How can a doctor determine what is causing the itching in my case?

A careful examination may show a definite cause for the itching, in which case treatment can be directed specifically to eliminate the problem.

What can be done to resolve the itch?

There are 4 parts to a treatment program:

1. AVOID FURTHER TRAUMA
   1. Do not use soap of any kind on the anal area
   2. Do not scrub the anal area with anything, even toilet paper, and avoid rubbing
   3. For hygiene, use wet toilet paper and blot the area clean, do not rub.
   4. Try not to scratch the itching area; it can lead to more damage and aggravate the itching.
2. USE 1% HYDROCORTISONER CREAM as prescribed. Apply this sparingly to the skin around the anal area three times a day using the finger tip.
3. AVOID MOISTURE in the anal area.
   1. Use either a few wisps of cotton or some corn starch to keep the area dry.
   2. Avoid all medicated, perfumed and deodorant powders.
4. AVOID EXCESSIVE FLUID IN THE DIET
   1. A maximum of six glasses of fluid a day is reasonable. There normally is no health benefit to drinking more fluid than this in the course of a day.

How long does this treatment usually take?

Most people experience improvement within a week when they follow the instructions outlined above. Although these symptoms almost always disappear within 3 to 4 weeks, some patients may need treatment for a longer period of time, or may need to repeat these steps from time to time for recurrent symptoms.