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Pruritus Ani: the Condition and Treatment

Pruritus Ani is continual itching of the skin surrounding the anus. The perirectal area is exposed to irritants from the stool. Once the area becomes inflamed, daily use of toilet tissue and bowel movements prevents the rash from healing and the problem becomes chronic. In most cases, Pruritus Ani is primary, as it is not a symptom of any other condition. However, there are several instances where Pruritus Ani is secondary (a result of another condition).

  1. Cleanliness

    • While residual stool is a factor in some cases, over-cleansing the area to compensate for that often exacerbates the situation. The initial itch as a result of the soiled area leads to scrubbing and scratching, thus resulting in more irritation and a washing away of protective oils. Once the area is irritated, being at least used daily (in most cases), the simple act of keeping the area clean can make Pruritus Ani flare up, and difficult to cure.

    Causes of Primary Pruritus Ani

    • Excessive moisture or residual stool in the anal area may be the initial cause of pruritus ani. Anal itching may also be a symptom of the common conditions hemorrhoids and anal fissures.

    Causes of Secondary Pruritus Ani

    • Pruritus Ani can occur as a result of bacterial infection, dematologic disorders (like atopic dermatitis, psoriasis, and skin tags), fungal infections, local diseases (Bowen's disease, cryptitis, draining fistulas, Extramammary Paget's disease), parasitic infections (pinworms and scabies), systemic diseases (diabetes and liver disorders), and antibiotics. These conditions will cause the itch, and scratching the itch, even with toilet tissue, makes the problem worse.

    Foods to Avoid

    • Certain foods may irritate the anus or cause multiple stools and mucus that may disrupt the area. Such foods should be considered as possible irritants and include coffee, tea, beer, wine, carbonated beverages, milk products, tomatoes, tomato related products, cheese, chocolate and nuts.

    Treatment

    • The first step in treating Pruritus Ani is keeping the area dry. Also avoid continual trauma by avoiding the urge to over-scrub, over-clean, or use soap of any kind in the area. Do not scratch the area and rinse with warm water, pat the area dry, and use wet toilet paper, baby wipes, or a wet wash cloth to clean the area. Certain medications have proven to heal the area and relieve symptoms. Apply Lotrimin cream mixed with hydrocortisone 1% cream daily. Other treatments include mild alpha hydroxy acid and plain Vaseline applied daily.

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