WHAT YOU NEED TO KNOW:

What do I need to know about anal itching? Itching can develop anywhere in or around your anus. You can make the itching worse if you scratch the area to relieve the itch. This condition can become serious. Your healthcare provider can help you manage and treat the discomfort.

What causes anal itching? The exact cause of your anal itching may not be known. Moisture in your anal area, certain foods and drinks, and tight clothing are common causes. The following can also cause anal itching:

• Bowel and anal conditions: Hemorrhoids, Crohn disease, and colon cancer may lead to anal itching. A small amount of bowel movement may leak and irritate your anal area. You may also have a tear in your anus. You may have an abnormal tunnel between your anus and nearby skin.
  
  
• Infections: An infection may be caused by bacteria, viruses, fungi, or parasites. An anal or bowel infection may cause your bowel to swell and itch.
  
  
• Skin conditions: Anal itching may occur if you do not clean your anal area properly. Skin allergies can cause anal itching. An autoimmune skin disorder can make your body's immune system attack its own cells.
  
  
• Medicines: Anal itching may be a side effect of some medicines used to treat gout, arthritis, or infections. Creams, ointments, or medicines used to treat other anal problems may also cause anal itching.
  
  
• Mental or emotional problems: Certain psychological conditions may increase your desire to scratch your anal area.
  
  
• Trauma: An object put inside your anus may cause skin tears and anal itching.

How is anal itching diagnosed? Your healthcare provider will ask your signs and symptoms and when they started. Tell him if you have other medical problems, infections, or allergies. Tell him if you are taking any medicines. He may also ask about any changes in your bowel movements, and how you clean your anal area. He may look for any skin problems in your anal area. He may also check your rectum by inserting a gloved finger into your anus. You may also need any of the following:

• Anoscopy: Your healthcare provider gently inserts a short plastic or metal tube inside your anus and rectum so he can see inside. He will look for any growths, fissures, or other problems that may be causing your itching.
  
  
• Lab tests: You may need blood tests to check your health. The results can also help healthcare providers check for conditions that may be causing your symptoms. Small samples of your bowel movement or a skin swab may be sent for testing. The tests may show if you have an infection.
  
  
• Patch test: Healthcare providers put patches on your skin, usually on your back. Each patch has a different item on it that commonly causes allergic reactions. The patches are worn for about 2 days. If the skin under the patch becomes red, you may be allergic to the item on that patch. Your healthcare provider will check your skin the day the patches are removed, and then again a few days later.
  
  
• Skin biopsy: Your healthcare provider removes a small piece of the skin around your anus. The skin sample will be sent to a lab for tests. A skin biopsy may be done to help diagnose certain diseases that may be causing your itching.

How is anal itching treated? Talk to your healthcare provider before you use any treatments he does not order. Some treatments may worsen your condition. Your treatment may include any of the following:

• Medicines:
  • Antibiotics: Antibiotics will treat an infection caused by bacteria.
    
    
  • Antifungal medicine: This medicine helps kill a yeast infection that may be causing your anal itching.
    
    
  • Anti-itching medicine: Healthcare providers may give you medicine to decrease your itching.
    
    
  • Steroids: Steroids help decrease inflammation in your anal area.
    
    
  • Capsaicin: This is a cream or ointment you can put on your skin.Do not use this cream or ointment on skin that is scratched or torn unless directed by your healthcare provider.
    
    
  • Methylene blue: Methylene blue may be given as a shot into the skin around your anus to decrease your itching. Numbing medicine may be added to the shot to dull your pain.
  
  
• Surgery: Certain conditions that cause anal itching may need to be treated with surgery. You may also need surgery if other treatments do not work to stop your itching.

What are the risks of anal itching?

• Capsaicin ointment may cause your skin to have a burning feeling. Steroid creams may cause your skin to shrink or thin if you use it for a long time. A shot in your anal area may cause numbness, infection, or damage in the tissue near the area. Sepsis (blood infection) may occur if the shot is given too deep into your pelvis. Your anal itching may return if the cause is not properly treated.
  
  
• You may develop redness and burning around your anus if your anal itching is not treated. The skin may become scaly and rough. The area may bleed.

How can I help treat or prevent anal itching?

• Gently clean your anal area after every bowel movement. Wash your anal area every morning and every night before bed.
  
  
• Shower after you exercise to wash any sweat away from your anal area.
  
  
• Dry your anal area with a hair dryer or soft cotton towel after you wash.
  
  
• Put petrolatum or zinc oxide ointment on your skin after you dry.
  
  
• Wear loose fitting clothing and cotton underwear that is not tight against your skin.
  
  
• Use a beaded or mesh cushion when you sit for long periods of time to decrease sweating.
  
  
• Do not use perfumed soaps, powders, or deodorants on your anal area.
  
  
• Do not use rough toilet tissue to wipe yourself after a bowel movement.
  
  
• Do not eat or drink anything that causes you to have bowel movements that irritate your skin. Examples are oranges, chocolate, tomatoes, coffee, and nuts. Keep your bowel movements regular to help stop your itching. Foods high in fiber make bowel movements easier. Eat foods such as bran and prune juice, and drink more water.

When should I contact my healthcare provider?

• You are leaking bowel movement.
  
  
• You feel a painful tightening in your anus after you have a bowel movement.
  
  
• You have a new rash, itching, or swelling after you take your medicine.
  
  
• You see blood in your bowel movements.
  
  
• Your sexual partner has the same symptoms you have.
  
  
• You have questions or concerns about your condition or care.

When should I seek immediate care or call 911?

• You have bleeding from your anus that does not stop.
  
  
• You have a bad smelling discharge coming from your anus that is not bowel movement.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.