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Pruritus Ani

What is pruritus ani?

Pruritus ani simply means 'itch of the anus' or 'itchy backside'. It is a very common disorder of the skin surrounding the anus. In children threadworms may be suspected; however, it is usually seen in adult males with considerable inner drive, often at times of stress and in hot weather when sweating is excessive.

What are the causes and aggravating factors?

It can be caused or aggravated by:

• medical problems such as eczema, threadworms, antibiotic treatment, diabetes and fungal infection
• local anal disorders such as piles, fissures and warts
• poor hygiene
• excessive sweating (e.g. due to tight clothing such as panty hose in summer)
• contact dermatitis caused by dyed or perfumed toilet tissue, soap, powders or clothing

Rules of treatment

1. Scratching

Stop-it's taboo! If you scratch at nit, wear light cotton gloves to bed.

2. Bathing

Avoid hot water. Excessive showering and scrubbing is also bad for this condition. Use a cream such as bland aqueous cream for cleaning rather than soap.

3. Drying

Keep the area as dr and cool as possible. After washing, dry gently and thoroughly with a soft towel or soft tissue: do not rub. Warm air from a hairdryer is very useful.

4. Bowel movements

Keep bowels regular and smooth by eating plenty of high-fibre foods such as bran, fresh carrots and apples. Some doctors claim that your bowel actions should be so smooth and complete that toilet paper should not be necessary.

5. Toilets

Clean gently after bowel movements. Soft paper tissue (avoid pastel tints) may be used, then clean with tufts of cottonwool with aqueous cream or bland soap and water. The best way is to use cottonwool in warm water.

6. Soaps and powder

Do not use perfumed soaps and talcum powder, including baby powder.

7. Clothing

Wear loose clothing and underwear. In men, boxer shorts should be used in preference to jockey shorts. Cottons should be used. Let the air circulate in the area. At times a skirt but no underpants (in women) is desirable. Avoid panty hose if possible.

8. Topical creams

Do not use ointments or creams unless your doctor has prescribed them. If a cream has to be us, simple creams may be the most soothing (e.g. toilet lanoline).

Seek your doctor's advice before using 'over-the-counter' prescriptions. Your doctor may prescribe a special cream.

Remember

Pruritus ani will certainly settle with this plan of management.

Copyright 1995: John Murtagh, Professor of General Practice
Monash University, Melbourne, Australia