Description

Anal itching, or Pruritis Ani is a persistent itchy feeling around the back passage (anus). It is a common complaint that can affect adults and children. The most common cause is irritation from faeces (sometimes called stools or bowel motions) or mucus. Less common causes include skin conditions such as eczema or dermatitis, threadworms, thrush and fungal infections, sexually transmitted diseases (e.g. herpes and warts) and haemorrhoids. Even very small amounts of leakage can irritate the delicate skin around the anus.

Symptoms

The main symptom is an urge to scratch the anal area. This urge can be quite severe and difficult to resist. The itching may be worse (or more noticeable) at night or after opening the bowels. It's important NOT TO SCRATCH. Scratching can make the itch worse, which in turn makes you want to scratch more, so you need to do all you can to avoid getting into this cycle.

Diagnosis

A trip to your local GP, where an examination of the area will quickly identify what is causing the itch and ensure that appropriate treatment is identified.

Treatment

Your GP may prescribe a cream or ointment, possibly a short course of mild steroid cream to reduce the inflammation and/or a barrier cream to protect the area from leakage of faeces/mucus. There are also things that you can do yourself

Take great care with anal hygiene, wash the area with plain water after each time you open your bowel
Avoid rubbing the area with toilet paper or facecloths. If you do use toilet paper use soft, white paper, dab or pat the area and dampen with water.
Avoid moisture in the area - make sure it's dry.
Avoid possible irritants - use only plain water on your bottom and, non-biological washing powder for washing your underwear.
Some drinks (especially caffeinated ones) and spicy foods, nuts and tomatoes can make it worse.

Outcomes and further sources of support

The information on these pages is reproduced from material put together by the Colorectal Development Unit at the Royal London Hospital, part of Barts and the London NHS Trust. An information leaflet prepared by the Colorectal Development Unit, Barts and the London NHS Trust will soon be available to download here.