Patient Information
Pruritis Ani
(Anal Irritation)
What is pruritis ani?
This is a common issue and pertains to anal skin irritation. It presents similarly to a nappy rash in babies when they are left in wet or dirty nappies for a few hours. The normal resistance of the skin is affected by moisture or small particles of faeces that may stick in small creases of skin around the anus. Scratching of the irritated anal skin may lead to a break in the skin surface. Bacteria may enter under the damaged skin and worsen the symptoms.
Causes
Pruritis ani may be caused by prolapsing haemorrhoids, mucosal rectal prolapse or something higher up in the rectum. If there appears to be no other cause of the irritation, then there are some tips available to help prevent the issue.
Treatment
- Avoid creams and ointments: Steroid creams are helpful for a short period of time. However, the use of such creams more than ten days may thin and damage your skin and perhaps lead to a fungal infection.
- Avoid soaps Do not use soaps or antiseptics around the anal canal. A bath or shower at night is important if you itch at night.
- Dry well After washing, pat dry only. A hair dryer on a cool setting also works well.
- Wear cotton Avoid synthetic underwear, especially in hot weather as well as G- strings. Cotton is best.
- Use soft but strong toilet paper
- Wet Wipes You may avoid using toilet paper by using a baby wipe (e.g. Wet wipes) or a bidet if available. Dry the area thoroughly by patting it with absorbent soft paper
- Diet
A number of foods have been associated with anal irritation, even though they may only be consumed in moderate amounts. These include
coffee (caffeinated and decaffeinated) and coffee-containing products
- Chocolate
- Acidic Foods, such as citrus and tomato
- Spicy Foods
- Tea
- Beer
- Milk and foods high in milk content
- Avoid foods that encourage flatulence/wind
- Sweating problem If there is moisture, use Corn-starch Powder (from Johnson’s Baby Powder range). Do not use powders that contain talc, as this is abrasive.
- Avoid scratching Pain and itch sensations share the same nerve endings. Pinching the skin from outside the underwear may help relieve the desire to scratch. If you are itchy at night, wearing cotton gloves can reduce the damage done to the skin if you tend to scratch in your sleep. Your doctor may prescribe an antihistamine tablet to reduce the itchiness.
Surgical Treatment:
Your surgeon will assess your symptoms and perform a clinical examination to identify the cause of the anal irritation, and may recomment surgical treatment depending on the cause of the symptoms and its severity.
