Pruritus Ani

What is Pruritus Ani?

Pruritus ani is a common condition causing itching or irritation around the anus (back passage). It has many possible causes, including haemorrhoids and certain skin conditions. Excessive sweating is another cause. However, the most common cause is a minor leakage from the anus. If small amounts of stool (bowel motion) or liquid mucus (slime) leak from the anus, this can irritate the delicate skin around the anus.

What can you do to help yourself?

Pruritus is often difficult to treat, and it may take many months of gentle care to improve things. There are some things that you can do to help.

Personal Hygiene

  • Pay special attention to hygiene. Be very careful to keep the area as clean as possible, ideally by careful washing and gentle drying at least once a day and after each bowel motion.
  • You may find that sitting on the edge of the bath and using a shower head (if available) makes washing easier. If you are out or at work, take a small plastic bottle of water into the toilet with you to wash with after a bowel motion.
  • Some people find that cold water is more soothing than warm.
  • Wash without soap as soap can sting. It is best to use water on you hand rather than on a flannel. Never use soaps with a strong perfume or any antiseptics on your bottom.
  • Use very soft white toilet tissue or baby wipes. You may even find damp cotton wool the most comfortable.
  • If you have a problem with leakage from the anus, a small amount of damp cotton wool on your finger tip may be used to gently clean into the anus to make sure there is no residue left behind.
  • If your leakage continues after wiping, a small plug of cotton wool in the anus may stop the stool from coming out to irritate the skin.
  • Dry the area by gentle patting with a soft towel or tissue. Avoid rubbing. If you are very sore, you may find that a hairdryer on a low setting is the most comfortable way of drying the area.
  • Try to avoid scratching the area, however tempting this may be. If you find that you are scratching in your sleep at night, get some cotton mittens (available from your chemist).
  • Never use anything on your bottom except the treatment suggested by your specialist. This includes all cream, deodorants, talcum powder and antiseptics.
  • Never put anything in your bath water. In particular, avoid all antiseptics, bath salts, bath oil and bubble bath.
  • Wear loose cotton underwear and change daily. Avoid all man-made fabrics coming into contact with your bottom. Women should wear stockings or open-crotch tights, rather than regular tights, which can cause sweating. You should also avoid tight trousers or jeans, and avoid sitting on plastic chairs for long periods.
  • Wash your underwear in non-biological washing powder, and make sure that all traces of detergent are rinsed out.
  • Try to establish a regular bowel habit.
  • A diet high in fibre makes the stools softer and more likely to cause leakage. You can try to make your stools firmer and therefore less likely to leak by cutting down the amount of fibre in your diet. This means avoiding foods like bran cereals, muesli, beans, peas, pulses and nuts. Moderate your intake of fruit and vegetables, particularly those with skins.
  • Avoid lagers and flat beers (i.e. those with high yeast content) as these can make the problem worse.
  • Avoid coffee, chocolate and fruit juices high in citric acid for the same reason.