18 March 2019 It may be more intense during the night or after defecation . It also tends to get worse: In hot and humid conditions; With friction caused by clothing; With pressure associated by being in the seated position; In situations of stress and anxiety. The discomfort it causes can be difficult to withstand . It can also make defecation difficult , if there are lesions in the anal region as a result of scratching, and it can also interfere with sleep. Anal itching is relatively common in both adults and children. It affects about 5% of people and is more common in men than in women. What are the causes of anal itching? The are several possible causes for anal itching. Anal itching often occurs as an isolated symptom and has no major health causes or consequences. However, occasionally it can be associated with local or systemic diseases of varying severity. The causes of anal itching include skin problems that cause significant inflammatory processes of the skin of the anal area that lead to itchiness , such as: High moisture content in the anal region due to excessive sweating; The presence of faecal residue due to poor hygiene; Frequent episodes of diarrhoea; Faecal incontinence. Some skin diseases, such as psoriasis and seborrheic dermatitis , may affect the anal area and cause itchiness. Contact with certain substances may cause local irritation with subsequent anal itching . Where a person suffers with allergic or sensitive skin, irritation of the skin near the anus resulting from contact with compounds contained in laundry detergent, soap, creams, perfumes or toilet paper can lead to anal itching. Anal itching can also be the result of eating certain foods , particularly when: They are not completely digested and cause irritation of the skin in the anal area after defecation; They are digestive irritants and increase the frequency of defecation or the amount of mucus present in the faeces. These include: Alcohol; Hot pepper sauce; Citrus fruit; Grapes; Tomatoes; Chocolate; Nuts; Some spices. Excessive consumption of beer, milk, tea or coffee can have a similar effect. Anal itching is also one of the side effects of some drugs used to increase the frequency of evacuation. Misuse of laxatives can lead to chronic diarrhoea , with risk of irritation and anal itching. Some microorganisms (bacteria and fungi) find temperature and humidity conditions in the anal region that are favourable to their development, and this leads to local infection accompanied by itching. Some systemic infections may also cause anal itching, such as: Scabies; Herpes; Some sexually transmitted diseases; Some parasitic infections (particularly in children). Other local diseases may also be associated with anal itching, including: Anal fistula; Anal fissure; Haemorrhoids. More rarely, benign or malignant anal tumours can cause anal itching. There are also systemic diseases, such as kidney failure and hyperthyroidism , which cause generalised itching ; this is sometimes more pronounced in the anal region. Poor hygiene can result in anal itching when faecal residue is left in the anal area, leading to local inflammation. However, individuals with anal itching tend to have exaggerated hygiene care routines , in terms of both frequency and aggressiveness. This exacerbates the problem , not just because of the trauma it causes to the skin, but also because it eliminates natural protective barriers. Excessively tight clothes can also contribute to the development of anal itching, as a result of the friction and irritation they can cause. What are the symptoms of anal itching? In addition to itching, the skin of the perianal region may be reddish, thickened and damaged due to the constant scratching, which will make it sensitive and possibly painful. How is anal itching diagnosed? Diagnosis is made on the basis of: Clinical history; Symptoms; Examination of the patient. When the cause of pruritus is not obvious, some additional examinations may be necessary , such as: Tests for parasites in faeces; Skin scraping assessment; Biopsy of lesions; Anoscopy; Colonoscopy; Assessment by a doctor specialised in treating diseases of the colon, rectum and anus, especially when the possibility of underlying diseases are suspected. In spite of everything, the cause of anal itching often remains unidentified. In these cases, the problem is known as idiopathic anal itching. Is there any treatment for anal itching? When no obvious cause for anal itching can be identified, treatment focuses on the alleviation of symptoms. When the cause is known , in addition to alleviating the symptoms, treatment is aimed at overcoming the cause. In any case, the success of the treatment prescribed by the doctor usually depends on a commitment to good personal care of various types and avoiding any predisposing factors. A number of measures need to be taken, such as: Avoiding trauma to the affected area; Maintaining adequate hygiene in the area; Ensuring that the anal region doesn’t remain wet; Avoiding potentially irritating foods or drinks; Avoiding scratching the area (the application of cold swabs and seat baths can help to achieve immediate relief). In general, dietary changes with increased fibre content can have a beneficial effect as this can help reduce straining during defecation, which can in turn cause trauma to the already irritated and sensitive skin around the anus. By complying with the proposed treatment plan in each case, symptoms are generally alleviated within a few days . The condition should resolve itself within 3 to 4 weeks. How can you prevent anal itching? Various measures can be taken to prevent the occurrence (or recurrence) of anal itching. Hygiene measures After defecation, the anal region should ideally be cleaned with water; Alternatively, wet wipes or soft, white, non-perfumed toilet paper may be used; The anal region should be kept clean and dry. Strong-smelling soaps or gels should be avoided, as should rough towels; To avoid moisture in the anal area, a piece of cotton or a dressing may be applied to the anus, this should be replaced when necessary; Talcum powder can also help to keep the anal region dry. Diet Avoid consuming food and drink with the potential to irritate or which has caused anal itching in the past; Increase fibre intake; Increase water intake. Drugs Only use drugs that have been prescribed by your doctor. Clothing Wherever possible, wear loose-fitting cotton underwear; Change your clothes every day and every time you get dirty. Colorectal surgery is carried out by gastroenterologists and general surgeons. This article was written with the support of general surgeons from the Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
