Anal Itching
Itchy skin around the anus (pruritus ani) can have many causes, including skin disorders such as psoriasis and atopic dermatitis, diseases such as diabetes or liver disease, anal disorders such as skin tags or draining fistulas, and cancers such as Bowen's disease. Allergic reactions such as contact dermatitis caused by anesthetic preparations applied to the skin, various ointments, or chemicals used in soap are another cause. Infections with fungi, bacteria, or parasites (such as pinworms and, less commonly, scabies or lice) can produce anal itching. Or itching can be a side effect of antibiotics, especially tetracycline.
Spices, citrus fruits, coffee, beer, and cola as well as vitamin C tablets can cause irritation of the anus when they are expelled in feces, causing itching. Poor hygiene that leaves stool residue (especially in people with large external hemorrhoids) or overly meticulous hygiene with excessive rubbing and use of soap can also lead to irritation and itching. Excessive sweating because of pantyhose, tight underwear (especially non-cotton underwear), obesity, or hot weather may be a factor. Or the itching may be rooted in anxiety, leading to the anxiety-itch-anxiety cycle (in which an anxious person develops an urge to scratch, scratching causes irritation possibly followed by infection, irritation/infection leads to itching, and itching leads to more anxiety).
Treatment
After bowel movements, the anal area should be cleaned with absorbent cotton or soft, plain toilet or facial tissue, which may be moistened with warm water. Dusting with cornstarch or a small amount of talc may combat moisture. Corticosteroid creams, antifungal creams such as miconazole, or soothing suppositories may be used. Foods that can cause anal itching are avoided for a while to see if the condition improves. Clothing should be loose and bed clothing lightweight. If the condition does not improve and a doctor suspects cancer, a skin specimen may be obtained for examination.
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