Hello, am sure this sounds funny but this is a real embarrassing problem that no one really wants to get to talk about. A friend has been talking to me about this problem for a while and it seems to be a stubborn problem because of the privacy concerns talking about it. I decided to research about this and realised that it affects about 1-5 percent of individuals at some time in their life and it affects men fours times than women. Let's get into it.

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Pruritis Ani (Italian for 'itchy anus') is defined as an unpleasant sensation of the skin around the anus (i.e., rectal opening) that produces the desire to scratch

What Causes Pruritus Ani

According to Dr. Sameer Islam, this problem might be due to one or more of the following

1. UNCLEAN ANUS
2. OVER-CLEAN ANUS
3. A SEXUALLY TRANSMITTED DISEASE
4. ECZEMA
5. A FUNGAL INFECTION
6. CONTACT DERMATITIS
7. TIGHT CLOTHES
8. HEMORROIDS

The above causes are more of an informal outline to help drive the message home easily. However, in medicine there are two main types of pruritus ani—primary and secondary.

Primary (idiopathic) pruritus ani—This condition has no identifiable underlying cause. This is the most common type of pruritus ani.
Secondary pruritus ani—This condition may be due to many different underlying causes.

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UNDERLYING CONDITIONS

Local/Surgical Conditions

• Hemorrhoids
• Anal fissure
• Anal fistula
• Rectal Prolapse
• Rectal Polyps
• Per-rectal Abscess
• Solitary Rectal Ulcer
• Anal Papilloma
• Crohn’s Disease
• Cancer

Peri-anal Infection

• Candida albicans
• Threadworms
• B-Hemolytic streptococci
• Tinea Cruris
• Staphylococcus aureus
• Herpes Simlex Virus
• Human Papillomavirus
• Scabes
• STD’s ; Gonorhoea, Syphilis

Dermatological conditions

• Psoriasis
• Lichen sclerosis
• Bowen’s disease
• Paget’s disease
• Lichen planus
• Seborrheic dermatitis
• Neurodermatitis
• Atrophic dermatitis

Systemic Disease

• Diabetes mellitus
• Liver disease
• Leukaemia
• Lymphoma
• Renal failure
• Iron deficiency anaemia
• Hyperthyroidism
• Anxiety , stress

Medications

• Topical steroids
• Colchicine
• Quinidine
• Laxatives
• Colpermin
• Peppermint oil
• Some antibiotics

Allergic Contact Dermatitis

• Creams, soaps wet wipes, deodorants or perfumes
• Alcohol based anal wipes
• Glyceryl trinitrate
• Toilet paper dye
• Fabric softener intolerance

Foods

• Caffeinated drinks
• Alcohol
• Milk products
• Peanuts
• Spices
• Citrus
• Grapes
• Tomato
• Chocolate and milk products
• Beer

The above causes are used to obtain a focused history by your doctor and arrive at a specific aetiology and eventually the treatment. So the treatment of an itchy anus depends on the cause.

TREATMENT

Treatment includes self care and pharmacological therapy. We will be looking at just some tips you can apply to ease the symptoms.

Some tips for self-care
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• Resist the urge to scratch. This is very difficult as some persons unconsciously scratch during sleep as itching is worse at night. It is advisable to wear cotton gloves as to prevent injury and infection of the anal region.

• Keep the perianal area clean and dry. Use clear water instead of soap or moistened tissue paper to clean the perianal region after a bowel movement.

• Apply a small amount of cornstarch or piece of cotton to the area to keep it dry during the day. A small cotton gauze pad can be used instead.

• Do not use soap when cleansing the anal area or scrub vigorously with toilet paper or a washcloth.

• Avoid using perfumed creams, lotions, bubble baths, powders, or other products that may cause irritation to the area. Thus you need to be sensitive to note what creams or lotions you might be allergic to.

• Eat foods high in fiber. A healthy diet can help prevent diarrhea or constipation and ensure regular bowel movements. Avoid any foods that might promote itching, such spicy or acidic foods or caffeinated beverages.

• Avoid wearing tight or constricting underwear. Cotton underwear can help to absorb moisture better than synthetic fabrics. Make sure underwear fits properly and change it frequently. Wash clothing with fragrance-free detergents.

If these tips prove unhelpful , then you might need to see a doctor. You will undergo some tests to exclude the secondary causes.

REFERENCES

1. American Society Of Colon and Rectal Surgeons;Pruritus Ani Expanded Version Article source
2. Cleveland Clinic : Pruritus Ani Article source
3. Doctor Sameer Islam:8 Reasons For Itchy Butt | How to FIX It |Video source
4. Raymond G Buick; Pruritus AniSlide source

Thanks @steemcurator01 and @steemcurator07 for your continuous support

Written by @hokulor - a Medical doctor in Nigeria.
All images used are copyright free
Vancouver Style was used for References.