Anal itch, also known as pruritus ani, is an irritating, itchy sensation around the anus (the opening where stool passes). Anal itch is a symptom, not an illness, and it can have many different causes. In most cases, a person with anal itch has no underlying disease of the anus or rectum. Instead, the itchy sensation is merely a sign that one or more of the following has irritated the anal skin:
* Stool on the skin around the anal opening — If the anal area isn't cleaned properly after a bowel movement, a small amount of stool may be left behind on the skin, triggering anal itch. Less often, watery stools may leak out of the anal opening and cause anal itching. This leakage sometimes happens in otherwise healthy people whose diets include very large amounts of liquids.
* A diet containing foods or beverages that irritate the anus — Potential dietary irritants include spices and spicy foods, coffee (both caffeinated and decaffeinated), tea, cola, milk, alcoholic beverages (especially beer and wine), chocolate, citrus fruits, vitamin C tablets and tomatoes. Once a person eats or drinks something that can irritate the anus, it usually takes 24 to 36 hours — the time food needs to travel through the digestive tract — before anal itching begins.
* Treatment with antibiotics — Tetracyclines, erythromycin and other broad-spectrum antibiotics (powerful antibiotics that work against many different bacterial species) can trigger anal itch by disturbing the normal ecology of the intestines.
* A local chemical irritation or skin allergy in the anal area — In sensitive individuals, chemicals and medications that are applied to the anal area can cause local irritation or allergic reactions. Some major culprits include dyes and perfumes used in toilet paper (especially scented toilet paper), feminine-hygiene sprays and other deodorants for the area around the anus or genitals, medicated talcum powders, and medicated skin cleansers and soaps, especially perfumed soaps. Anal itch also can be triggered by over-the-counter medications (suppositories, creams, ointments) intended to treat anal problems.
* Intense cleaning after a bowel movement — Although the anal area should be cleaned after every bowel movement, this cleaning must be gentle. Aggressive rubbing and scrubbing, especially with soaps or other skin cleansers, can irritate the skin and trigger anal itch.