Anal Itching (Pruritus Ani) is so common in people that almost everyone has suffered from it at some point. Sometimes, there are no obvious reasons for the itching, but in some cases, Pruritus can be caused by poor hygiene, allergies, infections, and certain foods and drinks. Some precautions and treatments can be taken to reduce the effect of Pruritus.
1. What is Anal Itching?
Anal itching, also referred to as Pruritus Ani, is a common condition characterised by an itch in or around the anus. This itch could be very embarrassing as well as uncomfortable the irritation may intensify at night or after bowel movement in some cases.
2. What Are The Types of Anal Itching?
Anal itching or pruritus ani can be classified into two categories; Primary or Idiopathic Pruritus Ani and Secondary Pruritus Ani. Let us discuss these categories in a few words.
2.1. Primary or Idiopathic Pruritus Ani
Anal itching is identified as primary or idiopathic when no particular cause is known. However, about 75 per cent cases of pruritus ani have co-existing pathology. Therefore, a detailed history, as well as certain tests, are necessary to determine the exact cause of it.
2.2. Secondary Pruritus Ani
This type of pruritus ani can occur due to various causes. These include infections, systemic diseases, contact dermatitis and other dermatological conditions.
3. Why Does My Anus Itch?
Anal itching or pruritus ani may have various possible causes. These include:
3.1. Using Scented and Rough Products
As the skin in your perianal area is sensitive, using scented products like scented soaps, powders, lotions, creams and ointments may cause an allergic reaction on it. The sensitive skin in your perianal area may also be irritated in case you wipe with rough toilet paper or use a rough washcloth or hot water to clean the area.
3.2. Poor Hygiene and Bowel Movement
It is necessary to thoroughly clean or wipe your anus after defecation or pooping. Your anus may itch if faeces remain in the folds of your anus. Also, how many times you poop a day and its form may play a role in anal itching. People who poop three or fewer times a week (constipation) or have diarrhea are more likely to have pruritus ani.
3.3. Certain Foods and Drinks
Some foods and drinks can make you more susceptible to anal itching or pruritus ani. These foods and drinks include dairy products, carbonated drinks, caffeinated beverages like coffee, tea and soda pop, and acidic or spicy foods such as tomatoes, citrus fruits, hot peppers and raw garlic.
3.4. Wearing Tight Clothing
Wearing tight clothes can also affect the skin in your perianal area. Tight pants and underwear may trap heat and moisture or sweat around your anus and cause anal itching or make the already existing pruritus ani worse.
3.5. Hemorrhoids
Hemorrhoids, also referred to as piles, are swollen and enlarged veins that may form inside or outside your rectum and anus. Hemorrhoids that form outside the anus are known as external hemorrhoids, while hemorrhoids that form inside your rectum are known as internal hemorrhoids.
External hemorrhoids could make it extremely difficult for a person to wipe away feces after using the toilet. Internal haemorrhoids, on the other hand, may cause bleeding as well as faecal soiling or incontinence, which will irritate the skin around your anus, thus, leading to anal itching or pruritus ani.
3.6. Yeast Infections
Yeast infection in the anus is caused due to an overgrowth of candida fungi. Yeast infection may develop in the vagina or anus and cause symptoms like intense and persisting itching and burning sensation. Yeast infections may also cause discoloration, swelling or small cuts or cracks in the skin around your anus.
3.7. Anal Fissures
Tears in the lining of your anus or anal canal, which is the opening through which poop passes out of your body, are called anal fissures. Trauma to the anal area is the leading cause of such fissures and could be caused as a result of constipation, straining while pooping, chronic diarrhoea, anal sex or anal stretching.
3.8. HPV and Warts
HPV or Human Papilloma Virus is a virus that may affect your genitals as well as the rectum and anus. It is a very common virus that causes genital warts. Genital warts are a kind of sexually transmitted infection (STI) that causes small bumps or growths (warts) to form in and around your genitals as well as the perianal area. This infection causes anal itching and may also cause other symptoms like mild bleeding, discomfort and a burning sensation in the infected area.
3.9. Pinworms
Pinworms or threadworms are tiny white or light grey worms that live in the intestines and rectums of infected people. These are parasites that derive nutrients from the hosts. These worms lay eggs at midnight in the folds of the infected person’s anus. That’s why pruritus ani in people with pinworms intensifies at night, leading to increased discomfort and irritation.
4. How Common is Anal Itching?
About 1-5 % of the population has pruritus ani or anal itching. It is 4 times more common in males than females. Also, pruritus ani is more likely to occur in people between 40 to 70 years of age. Almost everyone experiences anal itching from time to time.
5. What Happens If We Scratch Our Anus?
Scratching your anus may intensify the irritation and worsen the itching instead of providing relief. As the skin in this area is sensitive, scratching your nails could also cause skin damage and infection. If you keep scratching again and again or for long periods, you could feel extreme discomfort, soreness and burning in and around your anus.
6. What Symptoms Does Pruritus Ani Cause?
Symptoms of pruritus ani include anal itching, irritation, burning, soreness or excoriations and thick or leathery skin on or around your anus, known as the perianal area.
7. When to see a doctor for Anal Itching?
You need to see a doctor in case the anal itching and irritation get worse or cause additional symptoms. You also need to seek immediate medical attention in case your pruritus ani is not getting better with treatment or you see symptoms such as discolouration and swelling in or around your anus.
8. What To Do If I Have Anal Itching?
Here are some of the things that you should do if you are living with an itchy anus.
8.1. Resist the Urge To Scratch Your Anus
Please avoid scratching your anus, no matter how intense the itching sensation is. Even if the irritation worsens, the last thing you should do is scratch your anus or the perianal area. Scratching is likely to cause some damage to the skin around the perianal area, which is very sensitive and can lead to infections, swelling, increased discomfort, and irritation.
It would be good if you apply something to reduce irritation and wear loose cotton clothing to prevent further irritation, especially at night, as pruritus ani usually gets worse at night. Also, you may scratch your itchy anus unconsciously at night so it is best to go to sleep with cotton gloves on when you have pruritus ani to prevent infection and irritation.
8.2. Keep the Perianal Area Clean and Dry At All Times
Proper hygiene of the perianal area is important to prevent or relieve symptoms of pruritus ani or anal itching. Make sure you clean the area around the anus thoroughly after every time you defecate (poop). Make sure you gently pat the area dry with toilet paper or a towel after defection. You could also use a hair dryer on a low setting.
8.3. Apply Products That Absorb Moisture From Your Skin
Products that absorb moisture could be applied to the perianal area to prevent or relieve anal itching. You could apply a small amount of cornstarch, unmedicated talcum powder or a piece of cotton to absorb moisture from the perianal area.
8.4. Be Gentle When You Clean the Perianal Area
Be gentle when you wipe the skin around your anus, as the skin there is sensitive. Avoid using soap while cleaning the area, and do not scrub the perianal area with toilet paper or a washcloth. This will prevent damage to the sensitive skin, thus preventing pruritus ani or already existing pruritus ani from worsening.
8.5. Avoid Using Scented Products
Avoid using scented soaps, creams, lotions, bubble baths and other such products. These products are likely to trigger allergic reactions or cause irritation and discomfort, leading to an itchy anus.
8.6. Eat Foods That Are High in Fibre
Eat a balanced diet which has an adequate amount of fiber. Eating foods high in fiber and a healthy diet will reduce the chances of constipation or diarrhea and ensure regular and healthy bowel movements.
8.7. Use Topical Creams and Ointments As Instructed
Do not use topical creams and ointments more frequently than your healthcare provider advises. You should discontinue using them if the itching does not go away or gets worse.
9. How is Anal Itching Treated?
Anal itching or Pruritus Ani can be treated variously and the treatments depend on one’s individual conditions. Here is a list of medical treatments as well as home remedies that can help you get rid of an itchy anus.
9.1. Creams & Ointment
Over the counter (OTC) hydrocortisone is a kind of corticosteroid that is combined with an anaesthetic pain reliever that you have to rub on the affected area about 2 to 3 times a day. Studies also suggest capsaicin topical cream is a great alternative to corticosteroids in case you have chronic or long lasting pruritus ani.
9.2. Antibiotics & Antifungal Medication
Suppose your healthcare provider suspects that you have an itchy anus due to an infection. In that case, he/she is likely to prescribe antibiotics or antifungal medications to cure it and reduce irritation and discomfort.
9.3. Methylene Blue Injection (Anal Tattooing)
In case your body does not respond to any other form of treatment, your doctor may treat your itchy anus with a methylene blue injection. The brand name for this medicine is Provayblue®, which is primarily used to treat methemoglobinemia, a condition where your blood loses its ability to carry oxygen through your body. In some cases, Methylene blue is injected under the skin in one’s perianal area to treat pruritus ani. It relieves pain and itching by deadening the nerve endings in the area injected.
9.4. Dye-Free & Unscented Toilet Paper
Using dye-free and unscented toilet paper is the best, as minimal allergic reactions or irritation changes occur. Use unbleached and hypo-allergic toilet paper to stay safe.
9.5. No Harsh Soaps, Scents or Deodorants
Avoid harsh soaps, scents, and deodorants as these products may contain allergens or chemical irritants, which may give you an itchy anus or make your symptoms worse.
9.6. Wearing Cotton Underwear
It is necessary to wear loose cotton clothing if you have anal itching to prevent irritation. You must change your underwear often and use fragrance-free detergents when washing your underwear.
9.7. Avoiding Certain Foods and Drinks
Try to avoid spicy foods, dairy products, caffeinated beverages and carbonated drinks to prevent pruritus ani from getting worse or recurring. If a particular food or drink is giving you an itchy anus, it is best to avoid that food item completely.
10. Conclusion
Anal itching is not only embarrassing and annoying but also unbearable sometimes. Good hygiene, diet, medications and gentle care will help relieve symptoms of pruritus ani. In most cases, an itchy anus is not due to any serious issue, so you can quickly get rid of it with the help of OTC medications and home remedies. See your doctor if your symptoms don’t go away or worsen.
Last Updated on March 24, 2024 by Gautam
