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Anal itching – causes, symptoms, treatment

Anal itching is a condition characterized by annoying anal itching, which sometimes leads to neurasthenia of the patient. Most times, it is caused by local or general lesions (symptomatic pruritus).

Local causes of anal itching. The most common:

  • Ano-rectal hemorrhoids which maintain a constant moisture in anal region, favoring macerate;
  • Warts and papillomas which disrupt the hermetic occlusion of the sphincter, allowing continuous flow of secretions;
  • Anal fistula;
  • Anal fissure hidden in an envelope;
  • Rectitis;
  • Pinworm;
  • Hypertrophic papillitis;
  • Abundant leucorrhea secretions by Trichomonas vaginalis, causing vulvo-perineal itching that may be associated with the anal itching;
  • Chronic constipation and diarrhea with acid stools;
  • Excessive topical medications to combat hemorrhoids;
  • Clothing irritating;
  • Anal skin mycosis.

General causes of anal itching, most common:

  • Diabetes;
  • Azotemia;
  • Hypochromic anemia;
  • Obesity, which cause anal alkaline sweat (normal sweat is acidic);
  • Allergic conditions (asthma, gout, eczema, hives);
  • Ovarian disorder, menopause, thyroid endocrine disorders;
  • Nervous disorders.

Symptoms. There are four aspects:

  • Pruritus (itching), just where the skin is healthy;
  • Eczema itching, anal region is the seat of a diffuse epidermitis, sometimes bleeding;
  • Lichen itching when the skin and mucosa are thickened, rough;
  • Infected lichen and eczema itching.

Anal itching evolves in flare-ups (fits especially at night) that lasts 8-30 days, sometimes suddenly disappearing.

Treatment of anal itching

Treatment may include: general measures, causal treatment, symptomatic, pathogenic, physiotherapy, surgery.

General treatment. Consists of:

1. Local hygiene (avoid excess local baths with alkaline soap and water). We recommend: local wash with wool soaked with sweet almond or olive oil and will be used liquid acid soap. It contraindicate the use of paper, which will be replaced by wool.
2. General Hygiene: calm life is recommended (vitamin B1, nicotinic acid, bromide, valerian, papaverine, atropine in intramuscular injections, changing environmental and climatic spa cure). It is contraindicated the coffee, tea, alcohol.

Causal treatment. Combats the general or local cause of itching (debridement of crypts, combat pinworms).

Symptomatic treatment. Varies by anatomical-clinical form.

1. In pure healthy skin itching. During crisis are recommended starch baths or bran baths, cold baths or hot, slightly acid, followed by sub-nitrate of bismuth powder.
2. In eczema itching. At first, apply several times per day compresses with: boric acid, sodium borate, sodium chloride, distilled water.
3. In lichen itching is recommended zinc oxide.
4. In infected itching, where eczema and lichenification lesions are covered with yellow crusts, it is recommended compresses with alibur water, continuing the treatments mentioned, after disappearance of infection. In case of fungal infections is recommended permanganate baths and then apply ointment with salicylic acid.

Pathogenic treatment aims local desensitization or anesthesia of nerve endings in the region. Is achieved by:

  • Autohaemotherapy in local injections;
  • Intradermal injection of histamine;
  • Intradermal injections of fenergan in very low doses (the dose that causes ulcers). It cites cases when itching worsen by fenergan or histamine.

Surgical treatment. Surgery is indicated only after general medical and local treatment failures. It consists of:

  • Excision of diseased skin;
  • Section of anal skin nerves;
  • The combination of these two methods.


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