Ask The Expert
July 26, 2010
Anal itching is common and can be intense. Doctors call it pruritus ani. Usually there is no specific medical cause.
See your doctor. Hemorrhoids sometimes cause itching, but it is unusual. You may have an infection or a skin condition.
Itching arises because the anus is a very sensitive area and a dirty area. Add a little moisture (from mucous or sweat) to the normal rubbing of the buttocks (from walking, working or exercise), and you get irritation and/or itching.
There is no miracle cure, but you can improve matters greatly by keeping the area clean and dry. Try these suggestions to find what works best for you:
Take frequent sitz baths, especially after bowel movements. Sit in a tub or pan of plain warm water 2 to 4 times a day for 15 minutes each time. (Pharmacies sell plastic sitz baths, which fit onto a toilet). The water cleans the area and the warmth reduces inflammation and discomfort. "Tucks Pads," "Moist Mates," or even baby wipes can be used for cleansing. (They are not as thorough as a sitz bath, but they are more convenient.) Wiping with a moistened tissue or cotton pad after bowel movements can also help. Avoid colored or perfumed toilet paper and soaps, which may contain chemicals that irritate. After a regular bath or shower, rinse soap from the anal area completely.
Keep the area dry. Dry the area after bathing or taking a sitz bath. A blow dryer (hairdryer) is helpful. Keep the anal area dry during the day by wearing loose fitting 100% cotton underwear. Cornstarch powder can help keep the anus dry. (Stay away from talcum powder; it can irritate.) Some people tuck a cotton ball or gauze pad next to the anus between the buttocks. It absorbs moisture that can make irritation worse. This is especially helpful if you sit for long periods or are overweight.
Lotions, creams, and ointments are not very important. The chemicals they contain can make the problem worse. Cream with 1% hydrocortisone sometimes stops the itching, but do not use it for long periods. It causes the skin to become thinner and more fragile, and more susceptible to irritation. Ointments that contain local anesthetics ("Americaine," Nupercainal," Xylocaine") can temporarily deaden the sensation in the area, but they only cover up the problem. And they can cause a skin reaction in some people.
If you want to use an ointment or cream, try "A & D Ointment," "Vaseline," "Balneol," "Bag Balm," "Aquaphor" (plain), "Calmoseptine," or zinc oxide ointment. (You can get them all without a prescription.) They should be used only after thoroughly cleaning and drying the anal area.
Diet is usually not a major factor, but some people find it helpful to eliminate caffeine, cola/soda/pop, chocolate, beer, tomatoes and spicy food.
If you are overweight, lose weight.
Do not scratch! Take a sitz bath instead. Some people apply a cold pack (ice pack) for 10 to 15 minutes if they are about to scratch.