Anus itch

Dr. rer. nat. Daniela Oesterle is a molecular biologist, human geneticist and trained medical editor. As a freelance journalist, she writes texts on health topics for experts and laypeople and edits specialist scientific articles by doctors in German and English. She is responsible for the publication of certified advanced training courses for medical professionals for a renowned publishing house.

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Itching of the anus (medical: pruritus ani) is a very unpleasant symptom, which means a high level of suffering for many sufferers. For some, the urge to scratch becomes unbearable at night. There can be many causes behind the itchy anus. Short-term itching in the anus does not necessarily require treatment. However, if the itching persists, you should consult a doctor.

Anal itching: description

Itching of the anus is characterized by intense itching in the anus and around the anus and can be the main symptom of numerous - sometimes serious - diseases.

Short-term, mild itching of the anus does not necessarily require medical treatment. Mostly allergic reactions to food and skin irritations are behind the itching of the anus.

However, if the anus itch persists longer and becomes excruciating and painful, you should consult a doctor. The right people to talk to are proctologists and dermatologists. An itching of the anus can hide a (possibly serious) disease. On the other hand, the quality of life drops enormously, also because restless nights lead to exhaustion. The causes of anus itch range from physical illnesses (e.g. diabetes mellitus) and mental illnesses to tumors.

Excruciating itching

For many people, itching in the anus is a physical, but also a mental problem. Those who suffer report an almost compulsive urge to scratch, which can become stronger at night.

Itching of the anus can be so uncomfortable that people use scratching tools (such as toothbrushes) to get rid of the itchiness. Those who suffer from itching of the anus often find it extremely agonizing and stressful and more excruciating in character than pain. Scratching relieves itching only for a short moment, which is why scratching is almost permanent. Patients feel exhausted and feel personal humiliation. At a certain point, those affected can no longer distinguish itching from pain.

frequency

Itching of the anus is one of the most common symptoms that leads sufferers into prokotlogical practice. There are no exact figures about annual new cases, as the majority of patients do not see a doctor if the anus itching is less severe.

• It is believed that around one to five percent of the population suffers from itching of the anus.
• Men of all ages are two to four times more likely than women to suffer from itching of the anus, with most of those affected being between 40 and 50 years old. Children are also affected.
• The majority of patients complain of symptoms lasting more than twelve months.

Side effects

Patients who go to the practice because of anal complaints report other anal symptoms in addition to itching of the anus. There is seldom a single cause of anus itching. Common side effects of anal itching are:

• Burn,
• Urge to defecate,
• Oozing,
• Discharge,
• Pain,
• Foreign body sensation and
• abnormal bowel movements

Itchy anus: causes and possible diseases

Itching of the anus can be the symptom of various anal / anorectal or dermatological diseases, but also internal diseases. Food, incorrect hygiene products and insufficient or excessive anal hygiene trigger a slightly milder itchiness. In addition, infections or medication lead to itching in the anus. Itchy anus is often caused by more than one underlying disease. The anus itching is only relieved after all causes have been treated.

External causes

Food is a harmless cause of anus itching. It is believed that food and drink consumed in large quantities can be potential triggers for itching of the anus. Beverages containing caffeine (e.g. coffee, tea, cola) and alcoholic beverages (e.g. beer) are suspected of being responsible for anus itching. Spicy foods, especially foods that are too spicy, but also salty foods, nuts, chocolate, dairy products or citrus fruits are possible causes of food-related itching of the anus.

Intolerance reactions to chemicals (for example fragrances, soaps, damp toilet tissues) and medication (for example local anesthetics, antihistamines, antibiotics) can lead to irritation of the skin and thus to itching in the anal region.

Another cause of anus pain can be poor hygiene after a bowel movement. But be careful: If you already suffer from anal itching, you should avoid excessive hygiene. Increased hygiene with wet wipes and soaps damages the anal skin and can become infected by bacteria. This increases the itching of the anus.

Proctological causes

Much more serious are diseases such as hemorrhoids or fecal incontinence. A constantly moist environment irritates the skin and itching occurs. Gastrointestinal diseases such as ulcerative colitis and Crohn's disease can lead to long-lasting diarrhea. The increased contact with stool and frequent wiping after using the toilet promotes itching of the anus. Diarrhea, constipation, injuries in the anal skin (anal fissures), fistulas or anal or rectal prolapse also cause skin irritation and thus anus itching.

New formation of body tissue (neoplasia) such as polyps, Bowen / Paget's disease, colorectal / anal carcinoma are also among the proctological causes of anal itching.

Dermatological causes

Dermatological or infectious causes are found in around half of all patients with anus itching. Perianal eczema is an inflammatory reaction of the skin that is usually associated with itching of the anus. Therefore, like anal itching, perianal eczema is not a cause, but also a symptom. When diagnosing perianal eczema, it is therefore necessary to continue searching for the underlying disease. Anal eczema can be triggered by scratching, rubbing, a damp environment, chemicals and medication.

Other skin diseases such as psoriasis inversa, lichen planus, lichen sclerosus et atrophicus, acne inversa or autoimmune bullous dermatoses also cause itching in the anus.

Internal causes

The common metabolic disease diabetes mellitus is the first internal cause of anal itching. Rare internal causes can be:

• A disturbed immune system (e.g. due to HIV); often associated with this are infections from staphylococci and streptococci, herpes zoster, fungal infections or sexually transmitted infections.
• Liver, blood and thyroid diseases are some of the possible causes of anus itching.

Anal itching in children
Itching of the anus, but also itching in the vaginal area (pruritus vulvae) is a common problem in girls. A common reason: the anatomical proximity of the anus and vagina often leads to contamination of the vagina with stool debris. The vaginal and anal skin are still thin and vulnerable in childhood. In addition, the vaginal flora is pH-neutral, which promotes bacterial infections first in the vagina, then also in the anus.

Anus itch: when do you need to see a doctor?

If the anus is itchy for a short time, harmless triggers such as food or contact allergies to chemicals (washing lotion, toilet tissues, etc.) could be the cause. In this case, you do not necessarily need to see a doctor. If the itching lasts longer and becomes excruciating, it is advisable to go to the doctor quickly. The right specialists are proctologists or dermatologists. Itching of the anus can also be caused by serious diseases such as diabetes mellitus or a tumor.

Anus itch: what does the doctor do?

The doctor will first want to find out in a conversation what symptoms you have (itching, burning, oozing, etc.). It will also ask you how long the itching has been going on, when it occurs and how severe it is. Irregular stool and pre-existing intestinal diseases provide further clues as to the cause. He will then proceed with the clinical examination of the anal region (palpation of the anal region and endoscopic proctoscopy). He also examines the skin and mucous membranes to identify or rule out dermatological or infectious diseases. If the diagnosis is suspected, further examinations will be carried out accordingly.

Itchy anus: You can do it yourself

If you experience an uncomfortable itch of the anus, take care of your anus carefully. Unfortunately, the symptoms cannot be averted immediately, so be patient with your body. The following tips will help you get rid of the symptoms:

• After a bowel movement, during your menstrual period and before and after sexual intercourse, you should clean the genital area with clear water and then pat dry with very soft toilet paper.
• Use soap-free washing lotion.
• Avoid wet toilet towels because of allergic reactions to chemical additives in the towels.
• You should avoid using creams. If it is difficult for you, you can use Vaseline without additives (read the package insert!).
• Wear cotton underwear (no synthetic underwear) so that it does not get too warm and damp in the genital area.
• Sitz baths and anti-inflammatory creams should only be used for a short time and in consultation with the attending physician.
• Avoid spicy foods, salty foods, nuts, chocolate, dairy products or citrus fruits, as well as beverages containing caffeine and alcohol.

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