PRURITIS ANI

General Information

DEFINITION--Intense chronic itching of the anus and skin around the anus.

BODY PARTS INVOLVED--Anus.

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS

• Itching, often intense and worse at night.
• Redness of skin around the anus.
• Abrasion of the skin due to scratching.

CAUSES

• Yeast infection.
• Pinworms, scabies, lice.
• Contact dermatitis caused by soaps, contraceptive foams or jellies, perfumed toilet paper, deodorant sprays, douches or underwear made of synthetic fabric.
• Various skin disorders, including psoriasis or seborrheic dermatitis.
• Vaginal discharge or skin atrophy in women caused by low estrogen levels.
• Chronic diarrhea.
• Excessive coffee intake.
• Unknown (often).

RISK INCREASES WITH

• Stress.
• Diabetes mellitus.
• Excessive sweating.
• Overweight.

HOW TO PREVENT

• Keep the body clean with regular showers or baths.
• Cleanse carefully after bowel movements with moistened tissue.
• Avoid contact with substances to which you are sensitive (see Causes).
• Avoid tight underclothing made from synthetic material.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory studies, such as cultures for fungi, or microscopic examinations for pinworm eggs or scabies in skin burrows.

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment, if self-care is not successful.

POSSIBLE COMPLICATIONS

• Skin damage, allowing secondary bacterial infection to develop.
• Skin thickening and chronic inflammation.

PROBABLE OUTCOME--Symptoms can be controlled with treatment, even if the cause cannot be determined. Problem may recur.

How To Treat

GENERAL MEASURES--

• Keep showers or baths brief to minimize dryness and soap irritation. Use plain, unscented soap if any.
• Keep the rectal area clean, dry and cool. Wear loose clothing and underclothing. Clean carefully after bowel movements, using moist tufts of cotton or plain soap and water.
• Don't use irritants listed as causes.
• Wear underwear with a cotton crotch or underwear made of cotton, rather than nylon or other synthetics.
• Use plain, non-colored, non-scented toilet tissue.
• Use talcum powder in the area of itching.
• Women may be more comfortable using tampons for menstrual periods, rather than sanitary napkins.
• Wear soft mittens at night, if scratching while asleep.
• If you are unable to completely empty rectum with bowel movement, use a small plain water enema (infant bulb syringe) after each bowel movement. This may prevent irritation.

MEDICATION--

• You may use non-prescription cortisone ointment or cream. Apply 3 times a day and rub in gently until it disappears. Avoid laxatives.
• Your doctor may prescribe more potent topical cortisone drugs.

ACTIVITY--Avoid activities that cause excessive perspiration.

DIET--Avoid spicy or highly seasoned foods. These irritate mucous membranes of the anus.

Call Your Doctor If

• You have symptoms of pruritis ani that persist, despite self-care.
• You develop a fever.
• The irritated area seems infected.