Pruritus ani refers to itchiness of the skin surrounding the anus. It is a common ailment which can trouble people recurrently throughout their lives. For some patients the itch can lead to almost involuntary scratching with the subsequent skin irritation worsening the itch. The vicious cycle of itch and scratching can lead to skin breakages and bleeding.
Often the cause of the itch is leakage of faecal material or mucus on to the skin around the anus. With time there may be superficial skin ulceration and even fungal colonisation of the skin. Haemorrhoids, anal fissures, anal fistulas and inflammatory bowel disease may all contribute to itching and these conditions need diagnosis through colonoscopy and or examinations of the anus under general anaesthetic. If diagnosed, these specific conditions have their own medical and surgical treatment.
For many patients there is no treatable cause of itching and therefore management is aimed at decreasing the symptoms. Generally, a number of measures are required:
- Clean the bottom softly after wiping not with vigorous strokes
- Using moist wipes and the softest paper available is recommended
- Avoid harsh soaps or disinfectants on the delicate skin around the anus
- Take care with ointments as they may dry out or thin the skin of the bottom
- Wear soft cotton underwear rather than harsher synthetic fibres
- Maintain a high fibre diet with increased fluids to avoid constipation
