Pruritus Ani – Anal Itching

All people experience Pruritus Ani at one time or another. Over-the-counter creams and ointment usually control this short-lived symptom. An evaluation by a specialist is recommended when anal itching fails to respond to these medications. Although gastroenterologists and dermatologists commonly treat Pruritus Ani with topical steroids, long term anal itching treatment is best provided under the care of an experienced proctologist. We perform an office based evaluation for the underlying cause of Pruritus Ani. This allows us to offer “anal itching treatment options” that are effective when medications fail.

We perform a physical evaluation for treatable, organic, causes of anal itching. These include anal warts, internal hemorrhoids, anal skin tags, chronic anal fissures, and anal fistula. We also look for allergens, psoriasis and abnormal growths such as cancer. Irritants such as fecal soiling associated with decreased strength of the sphincter muscles can cause severe Pruritus Ani. Evaluation for anorectal sexually transmitted disease is an important part of this work up as they are implicated in Pruritus Ani and can occur in all sexually active patients, whether or not they partake in anal-receptive intercourse. Pinwork evaluation and treatment is essential when the anal itching is mainly a nighttime problem. The entire evaluation takes less than 30 minutes and allows us to provide our patients with relief of the symptoms and with peace of mind.

Our “anal itching treatment options” address the underlying disorder to resolve the symptom. If no underlying cause is identified, the idiopathic symptoms are then managed with effective non-steroid based medications to control the symptoms while availing the bad side effects of long term steroid use. Importantly, many o these cases, we make recommendations for prevention of anal itching symptoms and discuss treatment options if the symptoms or the underlying disease processes return in the future.