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Affecting anywhere from 1 to 5 percent of the population, pruritus ani is a condition more commonly known as anal itching.

Characterized by a strong urge to itch, it's a potentially embarrassing and uncomfortable condition that sometimes has an underlying cause, such as hemorrhoids or an infection.

Once a cause has been determined, pruritus ani is usually manageable with the right approach to treatment.

Types of Pruritus Ani

More common in men than women, anal itching can be classified as either primary or secondary. Primary pruritis ani is anal itching with no underlying cause. This is the most common type of pruritus ani. The secondary form of this condition has an underlying cause, such as contact dermatitis, infections, or some type of systemic disease.

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Contributing Factors and Symptoms

Infants sometimes develop anal itching due to fecal incontinence and problems with long-term diarrhea. In adults, sexually transmitted infections may be a contributing factor. Mineral oil and certain topical medications have also been linked to pruritis ani. Stress and anxiety can be contributing factors for some individuals with anal itching problems. Symptoms associated with either form of pruritus ani typically include:

  • Itching and irritation
  • Visible redness
  • Soreness and burning sensations

Diagnosing Pruritus Ani

A physical examination that includes a review of a patient's medical history is typically done to determine if there are underlying causes associated with anal itching. The affected area is also evaluated to determine how the skin is affected. In some instances, a test may be done for pinworms may be done if this is a suspected contributing factor. Skin specimens are sometimes tested as well to look for signs of infection. It's also possible that a conclusive reason for anal itching may not be discovered.

Treating Anal Itching

If no clear source of anal itching has been identified, topical steroids or creams may be recommended to manage symptoms. Antibiotic or antifungal medications may be prescribed if an infection is confirmed. Should topical medications be ineffective, an injection of methylene blue might be recommended. Also referred to as anal tattooing, this type of injection improves the way oxygen is carried throughout the body.

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Topical treatment may also be recommended if there is an underlying source of pruritus ani like hemorrhoids. Lifestyle and home remedies can be beneficial for some anal itching sufferers as well. Such recommendations may include:

  • Lukewarm oatmeal baths to help with itching
  • Avoiding the temptation to scratch
  • Wearing breathable, non-binding underwear
  • Eating high-fiber foods to minimize issues with constipation or diarrhea that sometimes contribute to pruritus ani symptoms
  • Avoiding irritants that may contribute to anal itching (e.g., heavily perfumed or hash soaps, genital deodorants, scented toilet paper, and bubble bath)

There are times when there is no clear reason for anal itching. Even when this is the case, topical medications usually help minimize symptoms. If an underlying reason for pruritus ani is suspected, such as issues related to diabetes or thyroid disease, focusing on the underlying source may result in noticeable improvements. The only "preventive" advice is to maintain a healthy weight, eat digestive-friendly foods, get regular exercise, and practice good anal and bathroom hygiene.

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