Itchy Anus

Itchy Anus Definition

Itchy anus is a result of irritation of the lower end of the rectum. It is often accompanied by a strong desire to scratch the area. Simple chemical reactions in the stool may lead to itching, but inflammatory reactions in the anus may also cause it. Moisture and scratching of the perianal area may lead to more intense itch. A severe itchiness may also feel like a burning sensation and soreness in the area. People most often experience itchy anus at night.

Itchy Anus Causes

There are many reasons for itching of the anus, which include the following:

  • Dry Skin – Dry skin causes itching and commonly seen in older people and those who use hot baths frequently.
  • Poor Perianal Hygiene – Leaving dried feces in the area causes itchiness. Sweat that accumulates over the area also contributes to such. Practice good hygiene by taking a bath every day and thoroughly wash the anus.
  • Scratching – Scratching intensifies the itch so avoid scratching the area.
  • Spicy and Irritating Foods – Spicy foods, spices, wine, beer, caffeine, nuts, and chocolates cause anal itching. Food allergies also may cause pruritus (itching) in the anal area.
  • Dermatitis – Inflammation of the skin over the anal area may happen as a result of contact with sweat or other chemicals. Dermatitis causes scaling and itchiness over the body exposed to the substance including the anus.
  • Diarrhea and Bowel Incontinence – Frequent passage of stools and frequent wiping of the area irritates the skin and cause itching. In some instances, fecal particles remain on the sphincter and cause anal itch.
  • Fungal Infections – Candida species often grow on the perineum and perianal area as a result of poor hygiene. Itchy anus caused by candida tends to occur more in moist areas so thorough drying of the area is needed. Other fungal infections such as tinea cruris may result to jock itch in the groin and extends to the anus. Treatment focuses on application of antifungal creams.
  • Hemorrhoids – Hemorrhoids are varicosities in the anal area, which may be internal (inside the anus) or external (located on the anal sphincter). Chronic constipation, prolonged sitting, pregnancy, obesity and straining causes hemorrhoids. The frequent irritation of the dilated veins causes itching. Surgical removal of the hemorrhoids is sometimes required.
  • Parasitic infections – Presence of pinworms or threadworms in the intestines causes itching because the worms usually go to the anal area to lay eggs. They may be 1-2 cm in size, but may grow up to four cm. Because of itchy anus worms, the patient scratches the anal area which spreads the eggs to the hands and enters the gastrointestinal system again by accidental ingestion. Blastocystis hominis is another intestinal parasite that can cause itching and diarrhea.
  • Bacterial Infection – Infection of the anus caused by Group A beta-hemolytic streptococcus also causes itching. Antibiotic treatment is required.
  • Sexually Transmitted Diseases – STD symptoms include burning on urination, discharges on the sex organs, fever and even anal itching when they spread to the perianal area as a result of anal sex. Itchy anus caused by STDs is relieved though antibiotic treatment of the infection. Common STDS that cause itchy anus include gonorrhea, Chlamydia trachomatis, genital herpes, genital and anal warts, moluscum contagiosum, syphilis and pubic lice (pediculosis pubis).
  • Psoriasis – Psoriasis is a skin condition where the skin cells rapidly regenerate causing drying, scaling and itchiness. It is not a contagious disease as others may think. Certain ointments are placed to relieve dryness.
  • Eczema – Eczema as a result of diaper use, unclean underwear and allergies may extend to the anal area and cause itchiness. Ointments are often prescribed.
  • Anal Skin Tags – Skin tags are small, soft skin extensions that may occur on the anus. Irritation and inflammation of the area often occurs because of constant contact with garments. They are surgically removed.
  • Folliculitis – Inflammation of the hair follicles on the anus causes redness, swelling, pain and itching.
  • Anal Fissure, Anal Abscess and Fistula – Anal fissure is a vertical crack in the anal mucosa as a result of straining on stools and constipation. The crack causes significant pain and sometimes itching. On the other hand, anal abscess is an infection of the anal area and leads to accumulation of pus. It results from chronic inflammation of the bowels that have become infected. Anal fistula is a small opening in the anal mucosa that causes feces to enter and come out into to perianal area. It causes itching and surgical intervention is required to close the fistula.
  • Anal Carcinoma – Malignancy in the anus usually occurs during old age. It is predisposed by exposure to carcinogens such as processed or broiled foods. It causes itching, pain and bleeding. Surgery, radiation and chemotherapy may be suggested.

Itchy Anus Symptoms

Symptoms of itchy anus are described as:

  • Itchiness of the area around the anal sphincter that may extend inside the rectum
  • Intense desire to scratch the area
  • Burning and tingling sensation in the anus
  • Mild itchy anus bleeding episodes as a result of scratching

Itchy Anus Treatment

The primary treatment of anal itching is to resolve the underlying cause. Anal itching is not a disease which means it only needs palliative management. The main cause is treated to relieve the itching. The following treatments can be used to stop the itching:

  • Topical moisturizing creams, gels, and foams – These contain small amount of corticosteroids and protectant to relieve inflammation and itch. A thin layer should be applied using the fingers up to two cm inside the anal sphincter. Caution should be exercised because steroids damage the skin.
  • Local anesthetics – These provide local relief of pain, itching and burning. It should be applied with caution as this may cause allergies that may intensify the itch. Available local anesthetics include lidocaine, dibucaine, benzocaine, tetracaine and benzyl alcohol.
  • Analgesics – Menthol, camphor and juniper tar have local analgesic effect and relieves itchiness.
  • Local Vasoconstrictors – When vasoconstrictors are applied, they narrow the blood vessels to reduce swelling and pain. They also have a mild anesthetic effect to relieve itching. Vasoconstrictors cause increased blood pressure so they are contraindicated to hypertensive patients. Available vasoconstrictors are ephedrine sulfate, phenylephrine and epinephrine
  • Astringents – Astringents promote clumping of proteins around the perianal skin which relieves burning, pain and itching. They include calamine, zinc oxide and witch hazel.
  • Protectants – Protectants form a barrier between the skin and other harsh substances such as stool and urine. They prevent further irritation of the perianal skin. Some of the available protectants are cocoa butter, glycerin, aluminum hydroxide gel, lanolin, kaolin, mineral oil, starch, and white petrolatum.
  • Antiseptics – Antiseptics are sometimes used in cases of bacterial infection to reduce the microorganism in the area. Soap and water can be used as an alternative. Examples of these are benzalkonium choride, resorcinol, benzethonium chloride, phenol, boric acid, and hydrastis.
  • Keratolytics – Keratolytics are substances that remove the outer layers of the skin. It is used to allow other topical medications to be absorbed faster.

Itchy Anus Home Remedies

Aside from the above treatments, home remedies and prevention may be done to relieve the symptoms.

Suggestions for itchy anus relief:

  • Clean and dry the anal area thoroughly with mild soap and water after elimination.
  • Use moist pads in cleaning the anal area instead of tissue paper.
  • Wash the area with lukewarm water

Measures for itchy anus prevention:

  • Never scratch the anus to prevent more intense itching. This also prevents possible infection from dirty fingers.
  • Do not place perfumes or powders in the anal area. This may leave chemicals and cause itching.
  • Avoid straining and constipation. Irritation of the anus as a result of hard stools leads to anal itching.
  • Avoid leaving soap in the area. Wash thoroughly with water.
  • Do not rub the perianal area to prevent irritation.

Itchy Anus Complications

Complications of itchy anus depend on the causative factor. The most common complications are a result of scratching and prolonged itching. These include:

  • Infection
  • Ulcerations

ulceration of anus image

Ulceration of a complication of itchy anus

  • Itchy anus bleeding

If anal itching is persistent, medical consultation should be done to assess and correct underlying cause.

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