Pruritus Ani Treatment
Pruritus Ani treatment will depend on whether the cause is known or not (the latter being classified as idiopathic). If the cause is eczema, a steroid cream will usually be prescribed for a short term. If the cause if a fungal infection or thrush, an antifungal cream will be used. For bacterial infections, antibiotics will be given. Itchiness caused by threadworms is treated by a specific medicine. For conditions such as fissures or haemorrhoids, treatment will be tailored to each case.
For pruritus ani of no particular cause, general advice on controlling or stopping the itch will be given, including:
1. Avoid Irritants
Some common irritants are scented soap, perfume, bubble bath and talcum powder. You should not use these near your anus. Plain, soft toilet paper should be used, and excessive cleaning avoided. Some foods can irritate the anal area, mainly those which are not fully digested. These include grapes, citrus, tomatoes, spices, coffee, tea and beer. Try stopping these foods for a while and see if your itch gets better. Excessive use of laxatives should also be avoided.
2. Ensure Optimal Anal Hygiene
The best way to ensure optimal anal hygiene is to wash your anus after passing faeces and before bedtime, as faecal particles will irritate the anal region. Soap can be an irritant, so ideally use water only. Special moistened tissues are also available at pharmacies. Use a clean pair of underwear daily and avoid woollen ones.
3. Keep the Area Dry
Sweat in the anus will exacerbate the itch. Make sure you dry your anus thoroughly after washing (pat rather than rub, with a towel; alternatively use a hair drier). Choose loose fitting, cotton underwear and avoid nylon materials. Do not sit for long periods and if you tend to sweat a lot, put a cotton tissue in your underwear to absorb the moisture.
4. Resist Scratching!
Scratching the area will make the itch worse, so try to resist the urge. It can also help to keep your fingernails as short as possible to avoid damage by scratching.
5. Use a Cream or Ointment
You may be prescribed a special cream or ointment to use after going to the toilet and before bedtime. Generally, these are used for a short period, especially if they contain steroids.
6. If Everything Else Fails…
For pruritus ani which does not improve, your doctor may refer you to a skin specialist or a colorectal surgeon to make sure that the cause is identified.
7. Treatments in Development
At the moment, a new treatment with capsaicin cream is being researched because it is believed that capsaicin can block the sensations of itch.