Pruritus ani

Abstract

Background: Anal pruritus affects up to 5% of the population. It is often persistent and the constant urge to scratch the area can cause great distress. Although usually caused by a combination of irritants, particularly faecal soiling and dietary factors, it can be a symptom of serious dermatosis, skin or generalised malignancy or systemic illness.

Objective: This article discusses the assessment and management of pruritus ani.

Discussion: It is important not to trivialise the symptom of anal pruritus and to enquire about patient concerns regarding diagnosis. Once serious pathology has been excluded, management involves education about the condition; elimination of irritants contributing to the itch-scratch cycle including faecal soiling, dietary factors, soaps and other causes of contact dermatitis; and use of emollients and topical corticosteroid ointments. Compounded 0.006% capsaicin appears to be a safe and valid option for pruritus not responding despite adherence to these conservative measures.