Pruritus Ani

What is pruritus ani?

Pruritus ani refers to itching or irritation around the anus (the opening at the end of the digestive tract through which stool exits the body). This condition can be uncomfortable and may be accompanied by redness, inflammation or persistent urge to scratch the affected area.

What are the causes of pruritus ani?

Pruritus ani can have various causes, and it may be a symptom of an underlying condition. Common causes include:

  • Poor hygiene

  • Excessive moisture: Prolonged exposure to moisture such as sweating, wearing damp undergarments or excessive use of wet wipes.

  • Dietary factors: Certain food or beverages such as spicy foods, caffeine or artificial additives may contribute to anal irritation and itching.

  • Skin conditions: Skin conditions including dermatitis, psoriasis or eczema can affect skin around the anus and cause itching.

  • Infections: Fungal infections. (e.g., candidiasis) or bacterial infections in the perianal area can lead to pruritus ani.

  • Inflammatory bowel disease: Conditions like Crohn’s disease or ulcerative colitis may cause symptoms, including pruritus ani.

  • Contact dermatitis: Allergic reactions to certain substances such as soaps, lotions, laundry detergents or toilet paper, can contribute to itching.

  • Anal warts

  • Faecal incontinence: Involuntary leakage of faeces, even in small amounts, can irritate skin and cause itching.

How is pruritus ani managed?

Treatment of pruritus ani depends on the underlying cause. General strategies may include:

  • Good hygiene practices.

  • Avoidance of irritants.

  • Wearing a breathable cotton underwear.

  • Dietary modification.

  • Stool bulking with fibre supplements.

  • Topical treatments – low potency topical steroids or topical capsaicin.

  • Methylene blue injection has been described in the literature for patients who fail medical management.