Anal itching

See also: vaginal itching - itching in pregnancy

Anal itch: what is it?

Anal itching is a rather unpleasant and poorly tolerated sensation, which recognizes various causes of origin; it is often triggered by local or regional morbid processes, but systemic or purely psychological factors are not lacking.

By definition, anal itching is characterized by the need, more or less urgent, to scratch; in many cases, it is accompanied by other symptoms, such as erythema, serous or blood loss and pain. When it becomes particularly intense and annoying, making the urge to scratch irresistible, often itching is associated with scratching lesions, which in turn can become infected, increase discomfort and further worsen the situation.

Causes

The list of possible etiological factors - particularly conspicuous and varied - includes causes:

• ano-rectal (hemorrhoids, anal fissures, rectal prolapse, diarrhea, anal fistulas, anitis, papillitis),
• infectious (genital herpes, anorectal gonorrhea, candidiasis, oxyuriasis, trichomoniasis, syphilis)
• dermatological (dermatitis caused by drugs applied locally or taken systemically, by contact with particular clothing or contraceptive means, use of excessively aggressive detergents or too rough toilet paper, mechanical irritation caused by work or sport activities, such as cycling or horse riding), poor hygiene, excessive sweating and local stagnation of sweat).

Diagnosis

The numerous causes of origin require a particularly careful and meticulous diagnosis of anal itching.

First of all, a thorough medical history must be carried out (use of special drugs and ointments, previous illnesses, work, sports, sexual activities ...) followed by a thorough general examination, dermatological, gynecological and proctological.

The clinical examination provides the doctor with valuable clues about the nature of the itch (location, extent and characteristics of the lesions, if these are present), but it is often necessary to resort to laboratory tests on secretions, skin fragments, stool samples and / or blood samples.

Treatment

Once the cause of the anal itching has been identified, we obviously try to treat it in the most appropriate manner. Among the general indications we recall:

• regularization of the alvo, helping - in the presence of constipation - with a diet rich in fiber (cereals, wholegrain, fresh fruit and vegetables) and regular physical activity; if it is suspected that the anal itching is caused by a food allergy, an exclusion diet is carried out;
• the careful intimate hygiene, to be carried out with lukewarm water and particularly delicate detergents (alternatively better to use only the hands), drying by plugging with a soft towel and not by rubbing; toilet paper must be particularly soft, alternatively use lukewarm water;
• the control of the urge to scratch, which must be ignored or solved as much as possible by lightly pinching the skin through the clothes (scratching causes the rupture of the cells and the consequent release of substances that aggravate the anal itching);
• the choice of underwear, which must be wide and breathable (cotton).

If at the end of the various diagnostic investigations the anal itching is not due to a specific cause, and the indications just reported ineffective, it is legitimate to hypothesize the psychological nature of the disorder, which as such should be treated with an appropriate psychotherapeutic course.