Pruritis Ani is the medical term used to describe severe itching around the anus. Sufferers of the condition have an overwhelming urge to scratch the area, the itching can become worse at night or just after a bowel movement. It is a common problem, which tends to affect men more than women or children.
Symptoms of Pruritis Ani
There are a number of causes of pruritis ani.
It can be a symptom of other anal conditions, such as haemorrhoids (also known as piles) or anal fissures (a tear or crack in the lining of the skin of the anal canal). In these cases it is likely that a tiny amount of leakage causes irritation to the skin and then itchiness.
In some cases the presence of external anal skin tags makes it difficult to clean and this can cause itching.
Excessive moisture caused by sweating around the anal area is a common cause, Cleanliness can be a contributing factor and traces of stool or excessive moisture left behind, can cause skin irritation.
Skin irritation may be caused by underlying skin conditions such as, anal intraepithelial neoplasia (AIN).
A fungal infection of the skin around the anus can also cause intense itching.
Some foods and drinks have been associated with causing skin irritation around the anus after a bowel movement. These may include tea, coffee, carbonated drinks, milk, tomatoes, alcohol (especially beer and wine) cheese, chocolate, citrus fruits and spices.
Some types of perfumed soaps etc may cause local irritation and should be avoided.
Threadworms are a common cause of anal itching in children and can be passed on to the rest of the family.
Investigating Pruritis Ani
A full clinical history and a careful examination of the anal skin, the anus itself and the rectum is always required. This will involve inspection of the lower part of the bowel by proctoscopy or rigid sigmoidoscopy. The aim of clinical investigation is to establish the underlying cause.
Sometimes a skin biopsy may be required for diagnosing underlying skin conditions such as anal intraepithelial neoplasia (AIN) or fungal infections.
Pruritis Ani Treatment
Underlying skin conditions such as anal intraepithelial neoplasia (AIN) may require surgery and / or close monitoring.
Fungal infections usually respond well to an appropriate cream. The consultant would advise their use. It is important to follow instructions carefully as over use of some creams, particularly those containing a steroid, can damage the skin and cause worsening symptoms.
Threadworm usually requires treatment of the whole family to prevent re-infection.
Where the cause is not immediately obvious, careful hygiene, avoidance of certain foods etc is usually recommended - see pruritis ani advice sheet for more information.
What are the next steps?
If you think you have this condition or any of these symptoms you will need to seek medical advice.
For more information or to make an appointment:
If you have private medical care or wish to pay to see a consultant:
Take this factsheet along to your own GP and request a referral to one of our consultants.