section name header

Information

Editors

MattiV.Kairaluoma

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.