Pruritus Ani

Treat cause The generalised disorders causing pruritus may cause pruritus ani. However, various primary skin disorders such as psoriasis, dermatitis, contact dermatitis and lichen planus may also cause it, in addition to local anal conditions, e.g. anal skin tags, Crohn disease, warts, threadworms, incontinence.

General measures

• Stop scratching

• Bathe carefully: avoid hot water, excessive scrubbing and soaps

• Use a soap substitute, bland aqueous cream, Cetaphil lotion or Neutrogena soap

• Keep area dry and cool

• Keep bowels regular and wipe with cottonwool soaked in warm water

• Wear loose-fitting clothing and cotton underwear

• Avoid local anaesthetics and antiseptics

If still problematic and a dermatosis probably involved use:

• hydrocortisone 1% cream or

• hydrocortisone 1% cream with clioquinol 0.5 to 3% or with clotrimazole 1% (most effective)

If isolated area and resistant: infiltrate 0.5 mL, triamcinolone intradermally If desperate: fractionated X-ray therapy