From the Guidelines
For an itchy anus, the most effective treatment approach is to keep the area clean and dry, and use over-the-counter treatments such as hydrocortisone cream (0.5-1%) or zinc oxide cream, while avoiding irritants and scratching, as recommended by the most recent and highest quality study 1. The treatment of pruritus ani (itchy anus) involves a combination of lifestyle modifications and medical therapies.
- Keeping the area clean and dry with gentle washing using mild, fragrance-free soap and water, followed by thorough patting dry, is essential.
- Over-the-counter treatments include hydrocortisone cream (0.5-1%) applied sparingly to the affected area up to twice daily for no more than 1-2 weeks, or zinc oxide cream which creates a protective barrier.
- Avoiding scratching is crucial as it worsens irritation.
- Wearing loose cotton underwear and avoiding irritants like scented toilet paper, harsh soaps, and spicy foods can also help alleviate symptoms. The use of flavonoids, such as micronized, purified flavonoid fraction (MPFF), has been shown to be beneficial in reducing symptoms of hemorrhoids, including itching, as demonstrated in a study published in 2021 1. It is essential to note that if hemorrhoids are causing the itching, witch hazel pads or preparations containing pramoxine may provide relief. For persistent symptoms lasting more than 1-2 weeks, it is recommended to see a healthcare provider as the itching could be due to conditions like pinworms, fungal infections, or skin conditions requiring specific treatment, as suggested by a study published in 2004 1. Maintaining good hygiene and identifying potential triggers are key to preventing recurrence, as emphasized in a technical review published in 2004 1.
From the FDA Drug Label
temporarily relieves external anal and genital itching apply to affected area not more than 3 to 4 times daily The treatment for pruritus ani (itchy anus) is to apply hydrocortisone to the affected area not more than 3 to 4 times daily 2, 2.
- Clean the affected area with mild soap and warm water and rinse thoroughly before applying.
- Gently dry by patting or blotting with toilet tissue or a soft cloth before applying 2.
- For children under 12 years of age, ask a doctor 2.
From the Research
Treatment Options for Pruritus Ani
The treatment for pruritus ani (itchy anus) can vary depending on the underlying cause. Some possible treatment options include:
- Topical tacrolimus, which has been shown to be effective in treating persistent pruritus ani in patients with atopic dermatitis 3
- Avoiding irritants such as certain foods or soaps, and keeping the anal area clean and dry
- Using topical creams or ointments to help relieve itching and inflammation
Causes of Pruritus Ani
Pruritus ani can have multiple causes, including:
- Fecal soiling or food irritants 4
- Malignancy, infections, or systemic diseases 4, 5
- Benign anorectal diseases, such as hemorrhoids or anal fissures 4, 6
- Inflammatory conditions or allergic reactions 4, 5
Importance of Accurate Diagnosis
It is essential to determine the underlying cause of pruritus ani to provide effective treatment. A proper clinical history, examination, and investigations, such as skin biopsies or patch tests, may be necessary to arrive at an accurate diagnosis 5. If symptoms or findings are not responsive to therapy, a reassessment of the diagnosis is required 4.