10 clinical pearls for managing anal itching

Itching in the pruritus ani causes discomfort with an uncontrollable desire to scratch.

Patients are often too embarrassed to talk about it, so data on prevalence and aetiology are scarce.  

However, according to the authors of a BMJarticle, about 5% of the population are affected by anal itching at some point in life. More commonly men, and mostly in middle age.

Itching may be short lived or chronic and can be caused by a range of factors, including haemorrhoids, fissures, fistulas, warts, prolapse, cancers, dermatitis, infections or systemic disease.  

But mostly it is idiopathic, in which case advise patients to:

  • Avoid scratching, excessive wiping or rubbing - especially with alcohol-based wipes;
  • Clean by washing with plain water after defection and dry by dabbing with cotton wool;
  • Wear loose cotton underpants;
  • Have short fingernails

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