Anal itching—known medically as pruritus ani—is generally regarded by physicians as a simple problem that home remedies can alleviate.
Symptoms of Anal Itching
- Itching, often intense, that may be persistent or may occur only after a bowel movement
- Redness, irritation, soreness and burning in the skin around the anus
What Causes Anal Itching?
The majority of cases are caused by skin irritation from fecal soilage. In older people, or in anybody with diarrhea, seepage of fecal matter may occur. Also, as people grow older, anal skin becomes more irregular and harder to clean. People with hemorrhoids (which may trap small fecal particles) are more prone to itching.
At any age, not taking the time to wipe thoroughly may contribute to poor hygiene, which causes itching and irritation. Then, too, being overzealously hygienic, such as rubbing energetically with dry toilet paper, can injure the skin. Another precipitating factor may be the hard stools of constipation, which can irritate the anal area.
Once the itch starts, many factors can exacerbate it. Hot weather and sweating, tight clothes that compress the buttocks, and nonabsorbent nylon panty hose and underwear may make matters worse, as can activities such as walking, sitting—particularly prolonged sitting on a plastic seat, which hampers the evaporation of any sweat—and bike riding. Some experts think stress may also be a factor in anal itching.
What If You Do Nothing?
Until the cause of anal itching is eliminated, the condition may persist indefinitely.
Home Remedies for Anal Itching
- Clean carefully. Meticulous, gentle cleaning provides relief. One option is to regularly use pre-moistened wipes. You can also wash the anal area gently—in a shower or bath or over the toilet—with soap and water. Take care to rinse thoroughly, then gently pat the area dry with a towel or cotton ball.
- Control the itch. Corticoid lotions or creams can be effective if used for a short time. Avoid the “-caine” creams sold for topical relief, since they can further inflame sensitive skin.
- Don’t scratch. It only causes additional irritation and invites infection.
- Consider changing your toilet tissue. Use plain, unscented, non-colored tissues.
- Eat foods high in fiber, such as cereals, fruits and vegetables. Consume prunes, spicy food, orange juice, figs, coffee and beer only in moderation.
- Be prepared. When away from home, carry a few pre-moistened, individually packaged wipes—the kind you use for a baby.
- Manage leakage. If you are bothered by leakage, wear a small cotton pad against the anal opening and change it frequently. Underwear should have a cotton crotch. Avoid tight clothing.
- Don’t schedule long bike rides—at least until the problem is resolved. Also, avoid other activities that may cause excessive perspiration.
An anal fissure is an elongated ulcer—or crack—in the skin lining the anal canal. Fissures usually result from constipation and the passage of hard stool, stool that is inadequately emptied, or in association with hemorrhoids. Subsequent bowel movements can irritate the fissure and cause spasms of the sphincter muscle—which can be extremely painful—and sometimes bleeding.
The best way to treat anal fissures is to avoid constipation by eating a diet high in fiber along with drinking plenty of fluids.
If you experience pain during bowel movements, or notice any bleeding, don’t simply assume it’s an anal fissure. Contact your physician to rule out potentially more serious problems. If your doctor diagnoses anal fissure, avoiding constipation can help make it less likely to cause pain. Warm baths can help ease the pain of spasms. Your doctor may prescribe stool softeners. Cleaning the anal area after each bowel movement is also important: use moistened cotton (and soap if necessary), then pat dry with dry cotton. A fissure will usually heal within two to three weeks.
- Bathe regularly. Wash your anal area with soap and water and dry thoroughly.
- Make use of moistened tissue. After a bowel movement, cleanse carefully with tissues moistened with vegetable or mineral oil. Several brands of pre-moistened varieties are now available in stores. You can also use toilet tissue that you’ve moistened and lightly soaped, then rinse with plain wet tissue and dry the area.
- Avoid tight underclothing. Choose roomy, breathable underwear made of cotton rather than synthetics. This will keep the anal area ventilated and relatively dry.
Beyond Home Remedies: When To Call Your Doctor
Contact your physician immediately if anal itching occurs along with bleeding or any unusual pain. Very rarely, persistent anal or rectal itching may be a sign of serious infection, so if it does not respond to simple treatments or the passage of time, contact your physician. Scabies and pinworms are possible causes that require a doctor’s advice.
What Your Doctor Will Do
Your doctor will make a careful physical examination that may include a close inspection of the anal area using a plastic device known as an anoscope. You may also be examined for pinworm eggs or scabies.
The Complete Home Wellness Handbook
John Edward Swartzberg, M.D., F.A.C.P., Sheldon Margen, M.D., and the editors of the UC Berkeley Wellness Letter
Updated by Remedy Health Media