Main reasons
Anal itching is conventionally divided into primary (idiopathic), when there is no obvious cause, and secondary - caused by a specific disease. The skin around the anus is delicate and is constantly in contact with stool and sweat, so it is easily irritated. Often a vicious circle occurs: itching causes scratching, scratching damages the skin and increases the itching.
- Hygiene violations - both insufficient and excessive with aggressive soap
- Proctological diseases: hemorrhoids, anal fissure, fistula, anal fimbria
- Loose stools, fecal incontinence
- Parasites: pinworms (enterobiasis), especially in children
- Fungal infection (candidiasis), bacterial infections
- Contact dermatitis from wet wipes, scented paper, ointments
- Skin diseases: psoriasis, eczema, lichen sclerosus
- Diabetes mellitus, liver disease
- Condylomas acuminata
Nutrition and habits
Some foods may increase itching in sensitive people by affecting stool consistency and irritating the skin. Clothing also affects itching: synthetic underwear and tight clothing retain moisture.
- Coffee, tea, carbonated drinks, alcohol
- Hot spices, citrus fruits, tomatoes, chocolate
- Dairy products with intolerance
- Synthetic and tight underwear
- Prolonged sitting, heat and sweating
Symptoms
In addition to itching, burning, redness, weeping and cracking of the skin may occur. The nature of the accompanying symptoms suggests the cause: night itching in a child is often associated with pinworms, blood on paper is associated with hemorrhoids or a fissure, and a white coating is associated with a fungal infection.
- Itching and burning in the anus, often at night and after stool
- Redness and weeping of the skin
- Scratching, cracks, thickening of the skin over a long period of time
- Discharge, feeling of wetness
- Restless sleep, teeth grinding and irritability in children
Diagnostics
The proctologist asks about hygiene, stool, products and medications used, examines the perianal area, conducts digital examination and anoscopy. According to indications, a scraping for enterobiasis, culture or microscopy for fungi, and a blood test for glucose are prescribed. If a skin disease is suspected, a dermatologist is involved. If there is blood, changes in stool, or age over 45, a colonoscopy may be needed.
- Examination and digital examination of the rectum
- Anoscopy, sigmoidoscopy
- Scraping for enterobiasis, stool analysis for helminth eggs
- Microscopy and culture for fungi
- Blood glucose
- Consultation with a dermatologist
Treatment and care
Treatment is aimed at the cause: proctological diseases are treated by a proctologist, pinworms are treated with antihelminthics for the whole family, fungal infections are treated with antifungal ointments, dermatitis is avoided by the irritant and a short course of anti-inflammatory drugs as prescribed by the doctor. Long-term independent use of hormonal ointments is dangerous: they thin the skin and can increase itching. For primary itching, the basis of treatment is careful hygiene and dry skin.
- Wash with warm water without soap or a mild, fragrance-free product.
- Gently blot the skin rather than rubbing it
- Avoid scented wipes and paper
- Wear loose cotton underwear
- Do not scratch your skin, cut your nails short
- Normalize stool: fiber and enough water