Itching around the anus can be very uncomfortable, often interfering with daily activities, and making it difficult to get a good night’s sleep.
The basic aim of treatment is to keep the anal area clean, dry, and to avoid injury to the skin from excessive wiping or abrasion. Items in the diet that produce gas, indigestion or loose bowel should be avoided. Foods associated with irritation of the bowels, producing mucus or aggravating drainage, include tomatoes (including ketchup), citrus fruits and juices, coffee and tea (including "decaf" in excess of two cups a day), beer and alcoholic beverages, colas, nuts and popcorn, milk, chocolate, spices (especially peppers). Some people have anal itching only after certain foods (coffee, tea, cola, beer, chocolate, and tomatoes) beginning 24 to 48 hours after eating them and clearing up in a few days provided the more isn't eaten.
No matter what the cause, certain rules apply. Wear cotton (dermal) gloves during the night to prevent from scratching. Antihistamine pills may be given for itch that disturbs sleep (both prescription and over the counter).
When showering or bathing avoid the use of perfumed soap. Especially avoid rubbing the bar on the anal area or rubbing the itching area with a washcloth.
Soap is highly alkaline and the residues collecting in the folds of the skin cause irritation and alter the normal acidity of the skin. Avoiding soap completely is preferable. Use Cetaphil lotion for the shower.
After bowel movements, wash the anal area with water or use wet cotton or tissue. Tucks Pads, hypoallergenic unscented baby wipes or absorbent cotton impregnated with Prax lotion can be used for cleaning. Pat the area dry with non-scented toilet paper and avoid rubbing with the toilet tissue.
During the day wear a thin cotton strip drawn off the side of a roll of absorbent cotton (Red Cross Cotton/Johnson & Johnson). The cotton strip should be thin enough so that one is not conscious of its presence. Do not use a cotton ball. Change the cotton strip frequently. It is important to apply the cotton strip directly to the anus. A sanity napkin is not a substitute. Wear cotton underwear.
Take a tub or Sitz bath morning and/or night in lukewarm water. Apply the prescribed lotion, cream or ointment as directed by a physician following a cleaning and drying routine.
This management program may be reduced or adjusted depending upon the control of symptoms. The cotton strip should be the last measure abandoned and the first measure to be resumed in the control of the problem.
Recurrences are common and to be expected. See a dermatologist if the itching continues or if the situation worsens in spite of these measures. A proctologist can sometimes help if this is due to some anal disease.
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