What is Pruritus Ani?

Pruritus Ani, also known as itchy bottom, is a very common condition in men and women (but is more prevalent in men). Yet, very little medical and scientific attention is paid to it, perhaps because the medical community feels that it is not a serious condition. It can affect anyone at any age, but is more common in middle aged persons.

 

Pruritus Ani is a physical condition and affects the skin in the anal area; sometimes it is more widespread and includes the vulva or scrotum. It manifests itself as a persistent itchy feeling and causes a strong urge to scratch the area. This urge may be more pronounce after defecation and at night. The itch can be so severe as to cause sleep problems. Heat, moisture (sweat), and stress can aggravate the itch. Scratching the area can damage the skin and increase the risk of an infection.

 

Itchy bottom is a symptom, rather than a final condition. There are many possible causes, but often the exact cause is unclear and in this case one is diagnosed with idiopathic pruritus ani. Conditions which may cause itchy bottom include:

• Skin conditions, such as psoriasis, eczema and dermatitis.
• Allergic dermatitis, which is an inflammation of the skin caused by excess moisture (sweat) around the anus.
• Skin damage, caused by excess or rough cleaning of the area.
• Thrush and infections such as herpes and sexually transmitted diseases.
• Threadworms, which are very common in children (these cause particularly strong itching at night).
• Iron deficiency anemia.
• Anal fissures.
• Haemorrhoids.
• Severe diarrhoea, which irritates the anal skin.

Pruritus Ani tends to aggravate itself, because scratching (as well as excessive cleaning) of the area further irritates and damages the skin, worsening the itch. Furthermore, damaged skin is more prone to infection. It is best to see a doctor if the itch is chronic, so that treatment can be tailored to the case. For easily identifiable causes, treatment is generally very effective and symptomatic relief quick. For example, if the cause is a fungal infection, then an antifungal cream will be prescribed. Similarly, for a bacterial infection, antibiotics will be used. For idiopathic itchy bottom (unknown cause), treatment can be more tricky.

Note that if in addition to an itch, you also have other symptoms such as bleeding, discharge, or lumps in the anal region; you should see a doctor immediately.