Anal itching, medically known as pruritus ani, is a common dermatological problem affecting both men and women, although it is more common in men. It can occur at any age but seems to be most prevalent among people in the age bracket of 30 to 50 years.
Pruritus ani is characterized by an excessively discomforting and often embarrassing itching or burning sensation of the skin around the anus (rectal opening). This itch is sometimes so intense that it becomes almost impossible not to scratch.
The incessant scratching, in turn, results in further skin irritation and damage and can even escalate the problem to a chronic stage, resulting in chronically inflamed and thickened skin called lichen simplex chronicus.
Rigorous scratching, particularly at night when the patient is asleep, or abrasive vigorous scrubbing with toilet paper to relieve the itch after urination or a bowel movement can cause tiny ruptures in the affected skin.
As a result of this additional trauma to the anal skin, occasional bleeding occurs when wiping after a bowel movement. Moreover, this tearing of the affected skin can make one more susceptible to developing an infection.
What Causes Anal Itching?
Anal itching can be due to skin related problems or internal medical issues. Skin-related causes include:
- Atopic dermatitis
- Excess friction in the anal area
- Excess sweat and moisture around the anus
- Exposure to chemical-based perfumes and dyes
- Improper wiping after a bowel movement
Some of the medical causes are:
- Food allergies
- Anal fissures
- Anal tumors
- Persistent diarrhea
- Leakage due to fecal incontinence
- Parasitic, sexually transmitted, fungal, and yeast infections.
Signs and Symptoms of Anal Itching
The main symptom is itching in the anal area, which is often intense and causes a strong urge to scratch.
Other symptoms of pruritus ani are burning sensation, dryness, soreness, redness, swelling, ulcers, and a rash in and around the anal region.
The symptoms may be temporary or more persistent, depending on the cause.
Diagnosis of Anal Itching
In order to zero in on the probable cause of your anal itch, the doctor will take into account your symptoms, the duration and pattern of the itch, current dietary intake and medications, your personal care habits such as the way you routinely clean your anal area after a bowel movement, and the regularity of your bowel movement.
The doctor will also inquire about your medical history, particularly any relevant past experience with other rectal problems such as fissures, hemorrhoids, and fistulas as well as skin problems such as eczema, seborrhea, and psoriasis.
This line of questioning will be followed by a physical examination of your anal area, sometimes including a digital rectal examination.
A visual analysis of the area will help reveal the extent of damage caused by scratching as well as any signs of hemorrhoids, eczema, or anal fissures.
The doctor may then probe the anal cavity with a gloved and lubricated finger to rule out rectal tumors or bowel cancer. If you happen to have grappled with skin issues involving other parts of your body in the past, your doctor will want to examine these skin areas as well.
The doctor may rarely administer a more invasive examination using a special viewing instrument called an anoscope. This short tubular device is inserted into your anus to take a closer look inside your rectum, which can help your doctor determine whether the itch is being caused by a problem inside your rectum.
Additionally, the doctor may order the following tests:
- Stool cultures
- A biopsy in case of skin abnormalities
- Anal swabs to rule out infection
- Routine blood tests to get a holistic picture of your renal, thyroid, and liver function as well as general health markers regarding diabetes, blood count, and bodily inflammation
Treating Anal Itching
Your healthcare provider may prescribe medicines. These can relieve pain and itching to help the affected skin heal.
These medicines may include skin ointments, steroid creams, antibiotic creams, and antihistamines. You may need antibiotics if there is an infection.
Simple Ways to Treat Anal Itching at Home
You may find anal itching to be embarrassing and uncomfortable. You can treat it at home with simple lifestyle changes and easy-to-follow home remedies.
Here are 10 home remedies for anal itching.
1. Drink Apple Cider Vinegar in Water
- Mix 2 tablespoons of raw, unfiltered apple cider vinegar in 1 glass of water. Drink it twice daily.
- Another option is to add 1 cup of apple cider vinegar to a hot bath. Soak in this bathwater for 15 to 20 minutes, once daily.
Follow these remedies for several days until the anal itching and irritation subside.
2. Eat Garlic Cloves Daily
Garlic helps treat anal itching from the inside out. It helps eliminate intestinal worms, one of the main causes of this problem.
- Eat 2 to 3 cloves of raw garlic on an empty stomach daily for 1 week.
- Another option is to boil 2 crushed garlic cloves in ½ cup of milk. Drink this milk on an empty stomach for a week.
3. Include Coconut Oil in Your Diet
Coconut oil is one of the best remedies for anal itching. It soothes the skin, and its antibacterial, antifungal, and antimicrobial properties can treat any infection responsible for anal itching.
- Eat 2 to 3 tablespoons of extra-virgin coconut oil daily. You can also use this oil for cooking purposes.
- Rub some warm coconut oil in and around the affected area several times a day to relieve itching and burning sensations.
4. Apply Aloe Vera Gel to the Affected Area
Aloe vera has soothing and calming properties that can relieve anal itching, soreness, and inflammation. Aloe vera also helps reduce the irritation of hemorrhoids or anal fissure, one of the main causes of anal itching.
- Slice away the thorny edges of a fresh aloe vera leaf and then cut it open.
- Extract the gel and rub it in and around the anus for 5 minutes.
- Reapply the gel every few hours to get rid of the itching and soreness.
5. Take an Oatmeal Bath
- Mix 1 to 2 cups of colloidal oatmeal or unprocessed oat flour in a bathtub filled with lukewarm water.
- Soak in this water for about 15 to 20 minutes.
- You can take an oatmeal bath 1 or 2 times a day.
6. A Dose of Probiotic Yogurt can Help
To treat a yeast infection, which may cause anal itching, you can use yogurt. Not all types of yogurt are beneficial.
You must use probiotic yogurt with live active cultures (good bacteria). These bacteria can help control the growth of the infection. Use plain, unsweetened probiotic yogurt only.
- Rub some plain yogurt on the affected skin. Let it sit for at least 20 to 30 minutes, preferably overnight. Then, rinse it off with warm water and dry the area thoroughly.
- Also, eat 2 to 3 cups of plain yogurt daily.
7. Warm Epsom Salt Bath can Provide Relief
An Epsom salt bath is great for skin disorders such as eczema and psoriasis, two key causes of anal itching.
It helps relieve the itching and burning sensations.
- Mix 1 to 2 cups of Epsom salt in a bathtub filled with warm water.
- Soak in it for 15 to 20 minutes.
- Finally, pat your skin dry thoroughly.
- Enjoy this soothing bath two or three times a week.
8. Drink a Mixture of Licorice and Honey
According to Ayurveda, licorice can also help treat anal itching.
- Slightly roast a mixture of equal amounts of licorice, rind of chebulic myrobalan (also called haritaki), and cardamom.
- Grind them into a fine powder.
- Mix ¼ teaspoon of this powder and 1 teaspoon of honey in a glass of water.
- Drink this mixture once daily until you get relief.
You can also apply an over-the-counter licorice cream on the affected area a few times daily.
9. Increase Your Fiber Intake
A common cause of anal itching is constipation. When the constipation is treated, anal itching will automatically resolve.
To treat constipation, the best option is to increase fiber intake. Fiber promotes healthy digestion and can soften the stool and increase its bulk.
- Eat high-fiber foods such as beans, potatoes, carrots, brown rice, quinoa, prunes, buckwheat, fresh fruits, green leafy vegetables, nuts, pumpkin seeds, sunflower seeds, broccoli, and peas.
- You can also opt for fiber supplements after consulting your doctor.
10. Avoid Food Allergens
Certain foods can cause irritation during a bowel movement, leading to anal itching. Moreover, there are certain foods that can increase itchiness and inflammation.
So, it is best to choose foods wisely and avoid food allergens for some time.
- Foods that can increase rectal itching are coffee, tea, soda, alcoholic beverages, and chocolate.
- Avoid spicy foods such as peppers and jalapenos.
- Avoid citrus fruits such as grapes, lemons, and oranges.
Avoid these foods for at least 2 weeks, and then reintroduce them into your diet gradually.
Precautionary Measures for Anal Itching
Anal itching or irritation may be prevented or treated if you take some precautionary measures, including the following:
- Avoid scratching as this will only exacerbate the condition. To get temporary relief from itching, apply a cold compress.
- To prevent unconscious scratching while sleeping, wear cotton gloves at night until the symptoms subside.
- Use damp toilet paper to clean yourself thoroughly after a bowel movement. Then, give a final wipe with dry paper to soak up any excess moisture.
- Avoid using scented or colored toilet paper, as these may aggravate the condition. Always use white, unscented toilet paper.
- Always make sure that you dry your bottom well after using the bathroom.
- For anal itching caused by excessive sweating, apply talcum powder on the affected area to absorb moisture.
- Do not sit in the same position for hours, as it may lead to a buildup of moisture or sweat in the anal area, causing more itching.
- Avoid using scented soaps on the affected area, as these may cause irritation.
- Avoid wearing tight-fitting underwear. Choose underwear made of cotton, rather than synthetic fabrics.
- Never use cornstarch on the affected area, as it may worsen the skin infection.
- Manage stress. This will help overcome anal itching.
When to See a Doctor
Generally, anal itching is not a serious problem and usually does not require medical attention.
However, seek medical advice if the itching becomes unbearable or persistent or if there is blood in the stool or stool leakage.
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