Information
Editors
Pruritus Ani
Essentials
- Exclude rectal causes that need treatment (proctoscopy is often indicated)
- Do not confuse superficial skin excoriations with anal fissure.
- Remember pinworms as a cause for anal itch Pinworm (Enterobiasis).
- For the majority (60%) of patients, no specific cause for anal itch can be established. Washing habits, haemorrhoids (that keep perianal skin moist), and local reactions to topical drugs may be the cause of perianal dermatitis.
Symptoms
- While itch is the main symptom, many patients also complain of poignant pain.
- The area of affected perianal skin may be considerable.
Treatment
- Pruritic skin needs air, and anal hygiene is mandatory (showering or washing after defecation followed by gentle drying).
- Zinc ointment can be used topically. For severe itch, 1% hydrocortison cream or fungisidic preparations (in combination with hydrocortison) can be used as topical treatment. Avoid sensitizing combinations of topical drugs.
- Underwear made of cotton is recommended.
- In persistent cases a skin biopsy from the affected skin may be indicated.
- Dermatological consultation may sometimes be necessary.