• Mayo Clinic Q and A: Treating persistent anal itching

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DEAR MAYO CLINIC: I’ve had anal itching for some time. It’s an embarrassing topic that I’m reluctant to bring up with my doctor. Do you have any self-care tips?

ANSWER: Anal itching is an intense itching inside and around the opening of the anus. It’s potentially embarrassing, but bringing it up with your health care provider is recommended, especially if it has become persistent. That’s because there are a number of possible causes with specific treatments that likely will help. These causes include hemorrhoids, anal fissures, skin diseases, infections, fecal seepage and ongoing diarrhea. At the most serious end of the spectrum, cancer occasionally can cause these symptoms.

Less serious causes of anal itching, also called pruritis ani, may include dry skin, irritation from wiping too hard and too often, use of soaps or frequent cleaning of the area, and excess moisture due to sweating.

When no specific cause of anal itching is found, self-care steps successfully eliminate itching about 90% of the time. The first step is to gently clean the area with water and a mild, fragrance-free soap after each bowel movement. This may involve a quick shower, or using a soft washcloth or squeeze bottle. Avoid scrubbing, or using moist towelettes or wipes, abrasive cloths, or moist toilet paper.

Next, pat the area dry with a cloth, or dry the area with a hair dryer on the fan-only setting. Using the heat setting could further irritate this delicate area.

Wear nonconstricting cotton underwear to keep the area cool and dry. Apply zinc oxide or petroleum jelly to the anal area to provide a moisture barrier. If necessary, a cream of 1% hydrocortisone applied two to three times a day can be used for a week or two to stop itching.

Finally, avoid scratching the area as much as possible to minimize further irritation. It may even be necessary to wear cotton gloves to bed so that you don’t unknowingly scratch the area while sleeping.

Although anal itching may be a topic that’s uncomfortable to bring up to your health care provider, it is a common condition, and there are treatments that can give you some relief once the cause of the itching is determined. (adapted from Mayo Clinic Health Letter) — Dr. Stephanie Hansel, Gastroenterology, Mayo Clinic, Rochester, Minnesota