Q: What's the best treatment to relieve anal itching?
A: Anal itching is common and can be intense. Doctors call it pruritus ani. Usually there is no specific medical cause.
Itching arises because the anus is a very sensitive area and a dirty area. Add a little moisture (from mucus or sweat) to the normal rubbing of the buttocks (from walking, working or exercise), and you get irritation and/or itching.
There's no miracle cure, but you can improve matters greatly by keeping the area clean and dry. Try these suggestions to find what works best for you:
Take frequent sitz baths, especially after bowel movements. Sit in a tub or pan of plain warm water 2 to 4 times a day for 15 minutes each time. (Pharmacies sell plastic sitz baths, which fit onto a toilet.) The water cleans the area and the warmth reduces inflammation and discomfort. Wiping with a moistened tissue or baby wipe after bowel movements will also help. Avoid colored or perfumed toilet paper and soaps, which may contain chemicals that irritate. After a regular bath or shower, rinse soap from the anal area completely.
Keep the area dry. Dry the area after bathing or taking a sitz bath. A blow dryer (hair dryer) is helpful. Keep the anal area dry during the day by wearing loose-fitting 100 percent cotton underwear. Cornstarch powder can help keep the anus dry. (Stay away from talcum powder; it can irritate.) Some people tuck a cotton ball or gauze pad next to the anus between the buttocks. It absorbs moisture that can make irritation worse. This is especially helpful if you sit for long periods or are overweight.
Lotions, creams, and ointments are not very important. Many of them contain chemicals that can make the problem worse. Cream with 1 percent hydrocortisone sometimes stops the itching, but don't use it for long periods. If you want to use an ointment or cream, try "A & D Ointment," "Vaseline," "Balneol," "Bag Balm," "Aquaphor" (plain), "Calmoseptine," or zinc oxide ointment. You can get them all without a prescription. They should be used only after thoroughly cleaning and drying the anal area.
Diet is usually not a major factor, but some people find it helpful to eliminate caffeine, cola/soda/pop, chocolate, beer, tomatoes and spicy food.
If you are overweight, losing weight will probably help.
Do not scratch! Take a sitz bath instead. Some people apply a cold pack (ice pack) for 10 to 15 minutes if they're about to scratch.
Paul C. Shellito, M.D., is an assistant professor of surgery at Harvard Medical School and an associate surgeon at Massachusetts General Hospital. He specializes in colon and rectal surgery.
For additional consumer health information, please visit www.health.harvard.edu.Copyright © 2015, The Baltimore Sun