What is Pruritus Ani (proo-rí-tus a-ní)?
Itching around the anal area is called pruritus ani. This condition results in a compelling urge to scratch.

What causes this to happen?
Several factors may be at fault. A common cause is excessive moisture in the anal area. Moisture may be due to perspiration or a small amount of residual stool around the anal area. Pruritis ani may be a symptom of other common anal conditions such as hemorrhoids and anal fissures. The initial condition can be made worse by scratching, vigorous cleansing of the area or overuse of topical treatments.

In some individuals pruritus ani may be caused by eating certain foods, smoking and drinking alcoholic beverages, especially beer and wine. Food items that have been associated with pruritus ani include:

• Coffee, Tea
• Carbonated beverages
• Milk products
• Tomatoes and tomato products such as Ketchup
• Cheese
• Chocolate
• Nuts

Does Pruritus Ani result from lack of cleanliness?
Cleanliness is almost never a factor. However, the natural tendency once a person develops this itching is to wash the area vigorously and frequently with soap and a washcloth. This almost always makes the problem worse by damaging the skin and washing away protective natural oils.

What can be done to make this itching go away?
A careful examination by a colon and rectal surgeon or other physician may identify a definite cause for the itching. Your physician can recommend treatment to eliminate the specific problem. Treatment of pruritus ani may include these three points.

1. AVOID MOISTURE in the anal area:

• Apply either a few wisps of cotton, a 4 x 4 gauze or some cornstarch powder to keep the area dry.
   
• Avoid all medicated, perfumed and deodorant powders

2. AVOID FURTHER TRAUMA to the affected area:

• Do not use soap of any kind on the anal area.
   
• Do not scrub the anal area with anything – even toilet paper.
   
• For hygiene, it is best to rinse with warm water and pat the area dry. Use wet toilet paper, baby wipes or a wet washcloth to blot the area clean. Never rub.
   
• Try not to scratch the itchy area. Scratching produces more damage, which in turn makes the itching worse. For individuals that experience irresistible itching at night, wearing socks on the hands may be helpful.

3. USE ONLY MEDICATIONS AS DIRECTED BY YOUR PHYSICIAN. Apply prescription medications sparingly to the skin around the anal area and avoid rubbing. Prolonged use of prescribed or over the counter topical medications may result in irritation or skin dryness that can make the condition worse.

How long does this treatment usually take?
Most people experience some relief from itching within a week. If symptoms do not resolve after 6 weeks, a follow-up appointment with your colon and rectal surgeon may be needed.