Itchy Anus/Bottom (Pruritus Ani) | Causes and Treatment

What is pruritus ani?

Pruritus ani is the medical term for a persistent (chronic) itchy feeling around the anus. The main symptom is an urge to scratch your anus, which is difficult to resist. The urge to scratch may occur at any time. However, it tends to be more common after you have been to the toilet to pass a bowel motion and at night (particularly just before falling asleep). The itch may be made worse by:

• Heat.
• Wool.
• Moisture or wetness around the anus. This may be caused by sweating, or by incomplete drying of that area after washing. It may also be caused by leaking urine (incontinence).
• Stools (faeces) being in contact with the skin around the anus. This can be due to leaking of stools out of the anus, or due to incomplete cleaning after opening your bowels.
• Stress and anxiety.

Persistent scratching of the anal skin can damage the skin and make it more likely to develop a skin infection in that area. Also, chronic itching of the anal area may lead to feelings of embarrassment. Both your mood and sleep can be affected.

Who develops an itchy bottom?

An itchy bottom (pruritus ani) is a common problem but the exact number of people who develop an itchy bottom is unknown. Some sources suggest around 1 to 5 out of every 100 people have an itchy bottom. It seems to be more common in men than in women. It most commonly affects people between the ages of 40-60. However, it can affect people of any age, including children.

What causes an itchy bottom?

An itchy bottom (pruritus ani) is a symptom, not a final diagnosis. Various conditions may cause an itchy bottom. When the cause is another condition which has been identified, this is known as secondary pruritus ani. However, in many cases the cause is not clear. This is called ‘idiopathic pruritus ani’ which means ‘itchy anus of unknown cause’.

Known causes of an itchy bottom

There are lots of possible causes. See the separate leaflets linked to each condition below for more detail. These are just some of the possible causes:

Skin conditions
There are a number of skin conditions which may affect the skin around the anus and cause itch. For example:

• Eczema.
• Psoriasis.
• Lichen sclerosus.
• Lichen planus.
• Seborrhoeic dermatitis.
• An allergic or irritant dermatitis. Dermatitis means inflammation of the skin. This may be caused by:
• Excess sweat and moisture around the anus. Young children who may not wipe themselves properly, adults with sweaty jobs and adults with a lot of hair round their anus may be especially prone to this.
• Excess cleaning of the anal area.
• Some soaps, perfumes, creams, or ointments, or the dye in some toilet tissue, may irritate (sensitise) the skin around the anus in some people. You may be ‘allergic’ to one or more of the ingredients in these products.

Skin conditions cause about half of all cases of secondary pruritus ani.

Infections

• Thrush and fungal infections are caused by germs that thrive in moist, warm, airless areas, such as around the anus. Thrush is more common in people with diabetes.
• Threadworms are a very common cause in children. Up to 4 in 10 children in the UK have threadworms at some stage. Threadworms live in the gut and lay eggs around the anus which cause itch. Children may pass them on to adults in the same home. Consider this cause particularly if there is more than one person in the home with an itchy bottom. Also, with threadworms, the itch is mainly at night.
• Other infections such as scabies, infections with germs (bacteria), herpes infection, anal warts and some other sexually transmitted infections can cause itch around the anus. You are likely to have other symptoms too such as a rash, lump or discharge.

Conditions affecting the anus
These include:

Some diseases
Generalised itch, which may seem more intense around the anus at times, may be caused by some diseases. For example:

With these conditions you are likely to be unwell with other symptoms.

Some foods
When certain foods are not fully digested, they may irritate the skin around the anus after you have gone to the toilet to pass stools. These include:

• Citrus fruits.
• Grapes.
• Tomatoes.
• Spices and chilli peppers.
• Large amounts of beer.
• Milk.
• Caffeine – in coffee, tea or cola.

Some medicines

• Some antibiotics can lead to diarrhoea. Passing lots of diarrhoea can irritate the anal skin and cause an itchy bottom.
• If you are taking steroid medication or other medicines that can weaken your immune system, you are at increased risk of developing skin infections which may affect the skin around the anus.
• Other medicines such as colchicine (for gout) and peppermint oil (for wind and bloating) may cause an itchy bottom as a side-effect.
• Medicines that are put on to the skin near the anus to treat problems such as haemorrhoids may irritate the anal skin and cause a type of dermatitis.

Unknown causes of an itchy bottom (idiopathic pruritus ani)

In many cases, the cause is not clear. In some people, it may be that something is irritating your skin. This may be an ointment that you are using, or your sweat, or the toilet tissue that you use but you cannot pinpoint the cause exactly.

In other people, it is thought to be caused by a small amount of stool leaking from the anus and irritating the nearby skin, causing itching. Also, an itchy bottom may affect some people with problems such as depression. However, the cause can sometimes remain a complete mystery.

An itchy bottom and a vicious circle

A ‘vicious circle’ (itch-scratch cycle) sometimes develops. The more you scratch, the more irritated the skin becomes and the more it itches. Various factors can keep this cycle going. For example, you may have a mild itch around your anus. You may then clean your anus with a scented soap. This may contain an ingredient which irritates your skin. You then develop a worse itch. You may think the itch means the anus needs more cleaning. Therefore, you clean it even more with the scented soap – which makes things worse and so on.

Another example of a ‘vicious circle’ is: you may buy an ointment if you have a small pile (haemorrhoid). This may contain an ingredient that your skin is sensitive to, particularly if your skin is already a little inflamed. It may sensitise the skin even more and the itch becomes worse. You may think that the haemorrhoid has become worse, so you put on more ointment. But, in fact it is the ointment itself making the itch worse and so on.

Most creams and ointments do not irritate the skin in most people. However, be aware that there are many preparations with various ingredients and you may become sensitive to one of them. 

What should I do if I have an itchy bottom?

If the itch is persistent and you are not sure of the cause, it is best to see a doctor. As there are a number of possible causes (listed above), it is best to be examined and checked out by a doctor to diagnose or rule out known causes. Treatment depends on the cause.

Pruritus ani treatment

If a cause is found

A particular treatment may be advised by a doctor or pharmacist. For example:

If there is no obvious cause (‘idiopathic pruritus ani’)

This is a common situation. The following tips often help to stop the itch:

• Avoid any potential irritants:
  • Stop using scented soaps, talcum powder, bubble bath, perfume, etc, near your anus.
  • Use plain, non-coloured toilet tissue. Wipe your anus gently after passing stools (faeces).
  • If any foods or medicines could be causing the itch, try avoiding for a while the foods and drinks listed above (such as fruits and tomatoes). If you take laxatives regularly, some of your stool may be leaking on to your anal skin.
• Pay special attention to hygiene around your anus:
  • Wash your anus after going to the toilet to pass stools. The aim is to clear any remnant of stool which may irritate the skin. Also, wash your anus at bedtime.
  • When washing around your anus, it is best to use water only. If you use soap, use bland non-scented soap.
  • When you are not at home, use a moistened cloth or a special moistened tissue to clean your anus. You can buy moistened tissues from pharmacies. Avoid scented or perfumed versions.
  • Have a bath or shower daily. If possible, wash your anus with water only. If you use soap around your anus, rinse well.
  • Change your underwear daily.
• Avoid excessive moisture around your anus:
  • After washing, dry around your anus properly by patting gently (rather than rubbing) with a soft towel. Even better, use a hairdryer, especially if your anal skin is hairy.
  • Do not put on underwear until your anus is fully dry.
  • Wear loose cotton underwear (not nylon). Avoid wearing tight-fitting trousers. If possible, do not sit for long periods and try not to get too hot. The aim is to allow air to get to your anus as much as possible and to avoid getting too sweaty.
  • If you sweat and moisture gathers around your anus, put a cotton tissue in your underwear to absorb the moisture.
• Consider the ‘itch-scratch cycle’:
  • Scratching can make the itch worse – which makes you want to scratch more, etc.
  • As much as possible, try not to scratch. This is especially difficult at night when the itch tends to be worse while you are trying to get to sleep.
  • You may also scratch in your sleep without realising. To help this:
    • Keep your fingernails short to limit any damage done to the skin by scratching.
    • Consider wearing cotton gloves at night to prevent sharp scratching with fingernails.
    • An antihistamine medicine that makes you drowsy may be worth a try at bedtime. Your doctor will advise.
• Your doctor may advise a short course of a cream or ointment:
  • A bland soothing ointment may be recommended to use after going to the toilet and at bedtime. There are many to choose from. (However, remember an ingredient of an ointment may sometimes cause sensitivity and itch around the anus.) You should not use a cream such as this for longer than two weeks unless you are advised otherwise by your doctor.
  • A short course (up to 14 days but no more) of a mild steroid cream may ease symptoms if there is inflammation of your anal skin. Steroids reduce inflammation (but should not normally be used on infected skin).

Other possible treatments

The above measures will usually stop the itch. If symptoms persist for three or four weeks after doing the above then your doctor may refer you to a specialist. This may be a skin specialist (a dermatologist) or a colorectal surgeon (who specialises in problems affecting the colon and anus). Tests may be needed to make sure a known cause has not been missed.

Other possible treatments for an itchy bottom (pruritus ani) are currently being researched. One such treatment is capsaicin cream. The theory is that capsaicin blocks a chemical in the skin that is involved in sensations of pain and itch. Another treatment involves injecting a chemical called methylthioninium chloride (methylene blue) into and beneath the skin of the anus. Further research is needed to clarify the place of these new treatments.

What is the outlook (prognosis) for an itchy bottom?

If a cause for the itchy bottom (pruritus ani) can be identified, it is easier to treat and relieve your symptoms. Most people respond well to treatment for an itchy bottom. However, in some people it can become a persistent (chronic) problem. Also, if you have had an itchy bottom in the past, you are more likely to develop it again at some point in the future.

The following symptoms are not symptoms of a straightforward itchy bottom (pruritus ani). See a doctor if any of these symptoms develop:

• Pain.
• Bleeding from the bottom.
• Mucous discharge.
• Lumps around the anus.
• Changes in your regular bowel habit.

Itchy bottom causes & treatments – Illnesses & conditions

Treatment for itchy bottom usually involves following simple self-care measures for a few months. If necessary, medication may be prescribed to help ease the symptoms.

Self-care for itchy bottom

If you still have an itchy bottom after 2 months, or if it returns, you may need to follow this self-care advice for longer.

Keeping clean and dry

If you have an itchy bottom, you should keep your bottom as clean and dry as possible.

The best way to do this is to use water to gently clean your anus and the surrounding skin. Clean your bottom in this way after every bowel movement and before going to bed each night.

You can use soap to clean your bottom, but make sure it’s mild and unperfumed so it causes less irritation to your skin. Wash all of the soap away afterwards.

After washing, gently dry your bottom. Avoid rubbing the area vigorously, as this may irritate your skin. Instead, gently pat the skin dry using a soft towel. You can also dry your bottom using a hairdryer on a low heat setting.

When you’re away from home, you can use damp toilet paper after passing stools, before gently patting your bottom dry.

If you have a tendency to sweat, or if your bottom becomes very moist, putting a cotton tissue in your underwear will help absorb the moisture around your anal area.

Other self-care measures

As well as keeping your bottom clean and dry, there are a number of other self-care measures you can undertake. For example, you should:

• use soft toilet tissue
• bath or shower daily
• wear loose-fitting cotton underwear and change it daily
• only put underwear on when your bottom is completely dry
• avoid wearing tight clothing; women should wear stockings instead of tights
• use a light duvet at night so you don’t get too hot
• avoid using scented soaps, bubble bath, perfumes or powders around your anus
• keep your fingernails short to try to keep your skin being damaged from scratching
• wear cotton gloves while sleeping so that you cause less damage to your skin if you scratch

It may be difficult, but you should try to resist the urge to scratch your bottom, as scratching will only make the problem worse.

Diet

Some foods may make your itchy bottom worse. If the urge to scratch your bottom is greater after eating certain foods, try cutting them out of your diet completely or reducing the amount you eat.

Foods that may make your itchy bottom worse include:

• tomatoes
• spicy foods
• citrus fruits, such as oranges
• nuts
• chocolate
• dairy products
• coffee
• excessive amounts of liquids, such as milk, beer or wine 

Fibre

Your GP may recommend that you follow a diet that keeps your stools regular and well-formed. 

This means your stools won’t be loose (runny), but you won’t need to strain when you go to the toilet.

Loose stools can irritate your anus. Straining to pass hard stools may cause haemorrhoids (piles) to develop. Piles are swellings that contain enlarged and swollen blood vessels in and around your anus.

Including more fibre in your diet will make your stools softer and easier to pass. Fibre can be found in:

• grains – such as wholegrain bread
• pulses – edible seeds that grow in a pod, such as peas, beans and lentils
• oats – which are in some breakfast cereals
• fruit and vegetables

Medication

While waiting for the above self-care measures to take effect, your GP may prescribe medication to help ease your itchy bottom.

However, you shouldn’t use topical treatments (those applied directly to your skin) for more than 2 weeks, because they may start to harm your skin if used for long periods.

Soothing ointments

Your GP may prescribe an ointment or cream to soothe the skin around your anus. You’ll usually have to apply it in the morning and at night, as well as after each bowel movement.

Topical corticosteroids

If the skin around your anus is sore and inflamed due to itching, your GP may prescribe a mild topical corticosteroid (an ointment that contains steroids). Applying this directly to the affected area will help relieve the inflammation and ease the urge to scratch.

In most cases, using a topical corticosteroid will help ease the itch. However, it can sometimes make the itching worse. Speak to your GP immediately if your itchy bottom gets worse after using topical corticosteroids.

Antihistamines

If your sleep is disturbed due to itching at night, using an antihistamine may help.

Antihistamines are medicines that work by counteracting the action of histamine (a chemical released during an allergic reaction). Some antihistamines also have a sedating effect (they make you drowsy).

Your GP may prescribe chlorphenamine or hydroxyzine. These should be taken at night and shouldn’t be used for longer than 2 weeks, because after this time the sedating effect may no longer work.

You need to be aware that sedating antihistamines can affect your ability to drive or operate machinery, and the sedating effect may be stronger if you drink alcohol.

Treating an underlying cause

When diagnosing itchy bottom, your GP will try to determine an underlying cause.

If they identify the cause, such as a bacterial infection or skin condition, it will also need to be treated for your itchy bottom to be properly managed.

For example, a bacterial infection may need to be treated with antibiotics. If the underlying cause is left untreated, your itchy bottom may return.

An itchy bottom in children is often caused by worms. If treatment for worms is recommended, other family members with the same symptom should also be treated.

Further treatment

Go back to your GP if your itchy bottom doesn’t improve after following self-care measures, such as keeping your bottom clean and dry, and using medication to provide relief from the itching.

Your GP may then refer you to a dermatologist (a specialist in treating skin conditions) or a colorectal surgeon (who specialises in conditions that affect the large intestine and anus).

5 Reasons Your Butt Is Itching Like Crazy

Butt itchiness isn’t cute, but hey, it happens. And since itching your booty in public isn’t as socially acceptable as, say, scratching your arm, it’s understandable that you’d want to get your rear-end itchiness under control ASAP.

While many people will experience a scratchy booty here and there, there’s a medical name for more intense cases—pruritus ani—and according to the National Institutes of Health, up to 5 percent of the American population suffers from the condition. Pruritus ani can be caused by many different lifestyle factors and medical conditions—most of which are fairly simple to soothe (phew). 

But first, you need to know what’s causing your itchy butt so you can get it under control. Here are the biggest culprits of itching down there, plus how you can make it stop already.

You’re wiping too hard

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This is the number-one cause of skin irritation and itchiness down there, according to Sarina Elmariah, M.D., Ph. D., a dermatologist at Massachusetts General Hospital. If you tend to wipe a lot, she recommends using water to rinse off first (you can use a squirt bottle or invest in a bidet for your toilet) and then pat the area dry with toilet paper. If your TP tends to be on the scratchy side, it may be time to upgrade to something a little more plush—harsh toilet paper can actually leave micro-cuts on your tush that can get itchy.

Related: The Absolute Best Way to Wipe Your Netherbits

You’re using the wrong kind of TP

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Some people prefer to use flushable wipes, but they can actually cause irritation that leads to an itchy butt. “Many patients may be allergic to wet wipes they try to use in this area,” says Gary Goldenberg, M.D., assistant clinical professor of dermatology at the Icahn School of Medicine at Mount Sinai in New York City. The fragrances in particular are a problem, he says. If you can’t live without your wipes, try switching to hypoallergenic, scent-free variety and making sure you dry off before putting on your underwear—it should help.

(Kick-start your new, healthy routine with Women’s Health’s 12-Week Total-Body Transformation!)

You ate something spicy

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The foods you eat can impact your number two and make it more or less acidic. Coffee, tomatoes, beer, and spicy foods can tip your poo into the acidic range and irritate to your skin down there, creating an itchy feeling, says Kyle Staller, M.D., a gastroenterologist at Massachusetts General Hospital. If you find that you tend to scratch a lot after you eat spicy curry or have more coffee than usual, try scaling back and see where that gets you.

Related: 7 Common Reasons Your Vagina Is Itchy Beyond Belief

You have too much moisture down there

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Your butt can trap moisture, which can create an itchy feeling, says Goldenberg. “Dermatologists see anal itch periodically,” he says. “It’s more common to see this complaint on the hottest day of the summer—from sweating,” he says. To lower your risk of developing anal itch due to moisture, make sure you towel off thoroughly after showering and try switching to cotton underwear if you know you tend to sweat a lot down there—it’s more absorbent than silky underwear and should help keep you dry.

Watch a hot doctor explain whether you have to treat yeast infections or not:

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You have hemorrhoids

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Hemorrhoids are swollen and inflamed veins in the rectum that can make it really uncomfortable to go poo. But they can also cause a little leakage of poop that can seriously irritate your skin. “Stool tends to be more acidic than your body likes,” Staller says. “In general, your body is quite happy having stool in it but when it’s on the skin part, that’s when you start to get irritation.” And that can itch like a mother. Hemorrhoids typically go away on their own, but a high-fiber diet and stool softeners can help move the process along.

If you have an anal itch and you’re really struggling, Elmariah recommends that you stop using all wipes and start using a barrier topical cream to protect your skin, like a diaper cream with zinc oxide. After you use the bathroom, rinse with water, pat dry, and then apply the cream. If it really sticks around after a week or two, call your doctor—you could have an infection that needs treatment.

Korin Miller
Korin Miller is a freelance writer specializing in general wellness, sexual health and relationships, and lifestyle trends, with work appearing in Men’s Health, Women’s Health, Self, Glamour, and more.

This content is created and maintained by a third party, and imported onto this page to help users provide their email addresses. You may be able to find more information about this and similar content at piano. io

The Causes of a Toddler’s Itchy Anus

If your child keeps scratching their bottom, there are a few different causes to explore. Check to make sure they are thoroughly wiping, since this is one of the most common reasons for anal itching in young children, especially those who are just learning to use the potty.

Illustration by Emily Roberts, Verywell

Causes of Itching and Irritation

Toddlers and young children may complain of an itchy anus or you may see redness or irritation in the area. Consult your child’s doctor to determine the cause and get treatment.

Pinworms

If much of the itching occurs at night and keeps your child awake, a pinworm infestation is likely the cause. If they have just started wetting the bed, that could also be due to pinworms irritating the urethra. 

Pinworms, also known as Enterobius vermicularis, very commonly cause infections in kids, especially those in daycare. You should seek pediatric care if your child may have a pinworm infection. Your doctor may recommend pyrantel pamoate treatment. The itching from pinworm can continue for a week after treatment.

Yeast Infection

A yeast infection may cause a rash in the skin folds of the groin area. It is bold red with a slightly raised border and may have satellite spots of inflamed areas. If your child has diaper rash that does not respond to treatment within two days, check with your doctor to see if a yeast infection is the problem.

Perianal Strep Infection

A perianal strep infection can cause itchy anus. This can happen if other family members have recently had strep throat. The signs are a bright red rash around the anus with sharply defined edges. Your child may also have blood-streaked stools and may have a fever. Your pediatrician will prescribe oral antibiotics and you may also be given topical medications to use as well.

Other Causes

Other possible reasons for an irritated, itchy anus in a young child include:

• Chafing from too-tight clothing
• Diarrhea
• Irritation caused by spicy foods or citrus (especially orange juice)
• Reaction to detergents

Treating Your Toddler’s Anal Itching at Home

Try these remedies to soothe your child’s bottom. Be sure to check with their pediatrician, too, since pinworms and infections won’t go away without medical treatment, and diarrhea could be a sign of infection or food allergy.

Keep the Area Clean

Make sure your child’s genitals and bottom stay clean. Those new to potty training may need some help for a while until they get the hang of wiping properly (front to back) and thoroughly. Invest in some flushable wipes if your child has hard-to-wipe bowel movements (or use baby wipes, but don’t flush them).

Trim your child’s fingernails so they don’t cause injury when scratching. Clean them daily with a soft nail brush and antibacterial soap.

After baths, make sure the area is completely dry. Moisture provides an ideal environment for yeast growth, which can cause further irritation. Be sure to change underwear frequently, especially on hot days or during potty training when even small leaks can cause enough moisture to be a problem. You can also use cornstarch on the area

Soothe Itching

Apply witch hazel with a cotton ball or pad. You can find this liquid at most drug and discount stores. It’s very mild and soothing.

Prepare a bath and let your child soak for 15 minutes or so twice daily. You can mix about 1/4 cup of baking soda in a tub of warm water, or you can make a colloidal oatmeal bath.

If all else fails, there are a variety of anti-itch creams (usually containing hydrocortisone) that can safely be used in the area.

Anti-itch creams are for external use only. Consult with your physician about proper usage and dosing, especially in children under age 2. Your doctor may be able to prescribe a special low-dose cream in this instance.

Avoid Irritants

If your child consumes a lot of spicy foods or citrus fruit or juices, try eliminating them from the diet for a couple of weeks and see if the situation improves.

Try using dye-free, perfume-free soap on your child’s undergarments. Make sure you aren’t using fabric softener, which can also cause irritation to this sensitive area. If you use scented toilet paper or wipes, try switching to plain varieties.

Make sure diapers, underwear, and other clothing fit well. If they are too tight, they can cause chafing that progresses to itching and redness.

A Word From Verywell

If your child is showing signs of anal itching, it is a good time to review potty habits and ensure your child is clean and dry, no matter what the ultimate cause. Be sure to consult your doctor and discuss any symptoms so you can get appropriate treatment.

Pruritis Ani Expanded Version | ASCRS

Pruritis ani is a common medical problem affecting both men and women. This information was composed to help patients understand pruritis ani, its symptoms, evaluation, and treatment options.  This information may also be helpful to individuals or caregivers of patients who are suffering from pruritis ani.

Pruritis ani most commonly affects adults, affecting from 1% to 5% of people in the general population. Men are more commonly affected than women with a 4:1 ratio. The condition is most common in people age 40s to 60s.  There are many causes of pruritis ani, and an accurate diagnosis is important in order to treat the specific cause.  Medical management of pruritis ani often provides patients with relief of their symptoms and improves their quality of life.

WHAT IS PRURITIS ANI?

Pruritis ani is a Latin term meaning “itchy anus” and is defined as an unpleasant sensation of the skin around the anus (i.e., rectal opening) that produces the desire to scratch. Pruritis ani is classified as primary or secondary. The primary form is the classic syndrome which may not have an identifiable cause (referred to as “idiopathic”) and the secondary form has an identifiable, and often specifically treatable, cause.

Minimal stimulation of the skin may cause itching. The subsequent scratching may cause injury to the skin which produces a larger area of irritated skin. Continued scratching causes the need to scratch more, making the problem worse.

WHAT CAUSES PRURITIS ANI?

This symptom of pruritis or itching is common to many anorectal conditions.  One must consider hemorrhoids, excessive skin tags, fecal soilage or incontinence, anal fistulae (abnormal passageways between the bowel and an organ or skin surface), anal fissures (painful clefts or grooves) and anal warts as possible causative agents.  It is not always understood what causes the long-standing history of primary pruritis ani. It is believed that an irritating secretion from the anal canal may cause the itching. The local nerve fibers in the skin may become chronically active with repetitive trauma or scratching for prolonged periods of time. There can also be itching related to disorders of nerve pathways or itching related to a central nervous system stimulus such as medications. Occasionally, itching may also be psychogenic (symptoms arise from the mind, as opposed to another organ).

Other potential causes of irritation include moisture from sweat, stool and mucus.  Studies have shown that the relief of symptoms can occur promptly after the stool has been cleansed from the perianal area, indicating that stool is likely an irritant causing of itching. In addition to difficult or inadequate hygiene, overzealous or aggressive hygiene with the use of many irritating soaps, scents, and lotions may cause pruritis ani, resulting in this condition occasionally being referred to as “polished anus syndrome.”  Overzealous cleaning, in addition to the use of topical steroids, can destroy natural skin barriers and cause trauma to the anal skin, making the problem worse.  In a way, trying to keep it “too clean” may worsen the problem.

Dietary factors may also play a role with pruritis ani, although there are not definitive studies implicating particular food items or diets.  Coffee, either caffeinated or decaffeinated, is thought to be a major contributing factor. Coffee consumption may lower the anal resting pressure (normal strength of muscle contraction at rest) and contribute to anal leakage of stool. Other dietary agents which are possible causes of pruritis ani include tea, cola, energy drinks, chocolate, citrus fruits, tomatoes, spicy foods, beer, dairy products and nuts.

Infectious processes may also result in pruritis ani. Examples include bacterial skin infections, fungal infection (although a common fungus, Candida albicans, appears to be a normal inhabitant of the perianal skin), parasitic infections with pinworms or scabies, and viral infections with anal warts.

Numerous skin conditions also cause secondary pruritis ani. Conditions that are potential causes of pruritus ani include psoriasis, seborrheic dermatitis, atopic dermatitis, contact dermatitis, lichen planus, lichen simplex, and lichen sclerosis. Local cancers such as Bowen’s disease or extra mammary Paget’s disease are also potential causes of pruritis ani.

Medical diseases that affect the entire body may also cause pruritis ani. The examples include diabetes mellitus, leukemia and lymphoma, kidney failure, liver diseases (obstructive jaundice), iron deficiency anemia, or hyperthyroidism.

While this is a wide variety of potential causes, it is important to understand that in many cases the itching has no identifiable source.

PATIENT EVALUATION

A careful medical history must be obtained from the patient focusing on the timing and duration of the pruritis ani as well as any accompanying symptoms.  Toileting behaviors must be evaluated, including the frequency and quality of stools, possible stool or mucus leakage, perianal moisture sensation, or the sensation of incomplete evacuation of stool. In addition, hygiene rituals or cleansing methods after a bowel movement must be evaluated.

Travel history and current medications, including all topical agents used, must be reviewed. A detailed diet history should be taken with close attention to known dietary agents suspected of causing pruritis ani. Often a heavy consumption of caffeine with coffee, tea, cola, or energy drinks is present. Lastly, investigation regarding possible infectious agents, such as pinworms in children, should also be considered. Adults rarely harbor pinworms.

Your doctor will perform an office physical examination to provide information regarding a possible cause of the symptoms. Examination should include a thorough inspection of the skin around the anus. The skin may appear normal or may have findings such as open wounds or cracks, redness, or possible characteristic changes of thickened skin  due to repeated scratching and irritation.

Primary or idiopathic pruritis ani is classified by a staging system used at Washington Hospital Center, and is based on the physical features of the skin. Stage 0 is normal skin, stage 1 is red and inflamed skin, stage 2 has thickened skin, and stage 3 has thickened skin, coarse ridges, and often ulcerations.

In addition to inspection of the perianal region, your doctor may place a finger through the anus into the rectum (digital rectal exam).  Part of the evaluation of the anal canal may be completed with a small instrument or anoscope which is referred to as “anoscopy.” An office biopsy with a small 3 or 4 mm piece of tissue may also be obtained to help with diagnosis and decision-making regarding treatment.  Skin swabs or scrapings may also be obtained.  Physical examination may also involve inspection of other sites of involvement.

The detailed anal examination is necessary, but brief, and patients should not feel embarrassed. The examination may have some feelings of discomfort but should not be painful.

TREATMENT OF PRURITIS ANI

The goal of therapy is to restore clean, dry, and intact skin. Treatment can be challenging, as many cases have no clear identifiable cause.  It is important to use bowel medications to thicken stool and create a formed bowel movement to minimize leakage or seepage and also to allow for complete evacuation.  The goal is a soft, bulky, easy to clean stool. Most people can benefit from taking a fiber supplement (Citrucel®, Metamucil®, Fibercon®, Benefiber®, and Konsyl® are examples). This can be taken in powder or capsule/tablet form and is usually taken once or twice daily. The fiber serves to absorb the moisture from the stool, adding bulk and allowing for complete evacuation of stool during bowel movements.

If stools still remain loose, additional medications may be helpful. Imodium® is an antidiarrheal medication which can thicken or firm stool and help decrease seepage. In more difficult cases, prescription medications such as Lomotil® may be needed to thicken the stool. Your physician can help decide which medications may be best for you.

Dietary changes are often necessary for treatment.  There are several common foods which may be related to pruritis ani.  These foods and beverages include coffee, colas, tea, chocolate, tomatoes and beer.  These items may possibly decrease your sphincter tone which can cause some seepage or leakage.  Avoiding overuse of these items may improve symptoms.  It may be helpful to remove one item at a time from your diet for several weeks.  If your symptoms improve, you could try reintroduction of the item in smaller volume and see if there is a limit to which you may have that item without producing symptoms.

It will also be important to modify bowel hygiene or cleaning habits. It must be stressed that the anus does not need to be scrubbed or sterilized. Cleaning with plain water rinses is quite helpful. Soaps, perfumes, dyes in tissue or clothing, and baby wipes containing deodorants should be avoided because they can act as irritants. Alcohol and witch hazel agents should similarly be avoided. Bathing with Dove® soap is recommended, as it is free of conventional soap. Also, handheld detachable shower heads can be used to clean and wash away any remaining soap residue.  The same effect can also be created with a bidet, although they are not common in the U.S.

Balneol® is a gentle and soothing cleaning agent.  It is commercially available mineral oil-based preparation that can be used at home or taken along in a pocket or a purse for use in public facilities. Another possible cleaning agent is dilute white vinegar. One tablespoon in an 8 ounce glass of water can be kept in the bathroom and applied with a cotton ball. Burrow’s solution, diluted at 1:40 (one Domeboro® tablet in 12 ounces of water or one tablet in six ounces of water for 1:20 solution) is also a gentle and non-irritating cleanser. It can be kept in a plastic squeeze bottle in the refrigerator and used in place of soap and water.

The ultimate goal of treatment is to create dry, healthy, and intact skin. The skin can be dried after cleansing using a hair dryer on low setting. An athlete’s foot powder or Zeasorb®, a lubricating and drying agent in powder form can also be used to absorb moisture. After drying, the athlete’s foot powder or Zeasorb® can be applied, and a small piece of cotton can be placed between the buttocks and against the anus to help absorb the moisture. Tight fitting, synthetic undergarments should be avoided.

One of the most important, but often most difficult, aspects of the management of pruritis ani, is to avoid trauma to the skin. This means no scratching with hands or dry toilet paper. Behavioral modification is often very difficult to achieve, due to the intense desire to scratch. Many people also scratch during sleep and are not aware of it until they wake to find themselves scratching. It is often recommended to have patients cut their nails and wear a pair of light, soft, cotton gloves on their hands at night so they are not able to scratch.

In order to control symptoms, a short course of a steroid ointment may be tried. A weak topical steroid such as 1% hydrocortisone cream used two to three times a day for a short period of time can be effective in relieving symptoms of pruritis. A long-acting topical steroid such as betamethasone may also be effective. Strong steroids or prolonged use can lead to skin atrophy (weakness and thinning) which sometimes worsens pruritis ani. High potency steroids should not be used for more than four to eight weeks. If there is thinned or denuded skin, topical antibiotics may occasionally be helpful. It should be noted that cream forms of medication cause more thinning or atrophy than ointment forms.

A skin barrier cream such as zinc oxide may also be helpful in protecting the skin around the anus from irritants. Additional topical agents such as numbing medications, menthol, phenol, camphor, or a combination of them may be helpful. Calmoseptine® is used frequently, with a combination of zinc oxide and menthol and can be very beneficial at relieving patients’ symptoms. If there is any concern that there may be an infection, topical antibiotics (gentamicin, clindamycin, or bacitracin) or antifungals (clotrimazole, nystatin) may be added in conjunction with other therapies. They can be applied at nighttime before bed and again in the morning after bathing.

Patients coming to the doctor for evaluation of pruritis ani with moderate to severe changes of the skin, may be treated by application of Berwick’s dye (which is a combination of gentian violet and brilliant green pigment) with alcohol. It can relieve itching but will sting if there are open wounds. Your physician can dry the dye with a hair dryer and it can be sealed in place with Benzoin tincture and then again dried in place. This dye can stay in place for several days and will often give great relief while the skin is able to regenerate or re-epithelialize. This treatment is performed in an office setting, but is not used in the home setting.

You may notice that your problems will improve for some time with treatment but then recur.  For a small number of patients, pruritis ani can be quite difficult to manage, and it may be difficult to completely relieve their symptoms.  In these patients, it may be beneficial to try topical capsaicin. Capsaicin comes from Capsicum chili peppers.  It is believed to work by depressing the feelings or desensitizing certain nerves.  This medicine has been studied with a small number of patients, and up to 70% of patients had relief of their symptoms for up to almost 11 months.  The medicine is applied with a very low concentration of 0.006%. 

A very small number of patients find only minimal relief from all attempted treatment options.  These individuals may benefit from injectable therapy.  This particular therapy is saved for patients with persistent and intense pruritis ani.  Methylene blue is a dye which can be injected into the skin and may relieve symptoms by causing destruction of the nerve endings.  The methylene blue can be mixed with topical anesthetics and injected into and below the affected perianal region.  Many patients do experience a change in sensation in the injected area.  It may feel somewhat numb like a local anesthetic for a dental procedure.  It also will turn the skin in the area blue.  In very rare cases, this may be injected too close to the surface of the skin and may cause some skin breakdown or ulcerations.

QUESTIONS FOR YOUR SURGEON:

1. What is pruritis ani?
2. What are the options for medical management of pruritis ani?
3. Why does pruritis ani recur?
4. Do I need surgery?
5. What if lifestyle changes, medications, or modified bowel hygiene does not fix my pruritis ani?

WHAT IS A COLON RECTAL SURGEON?

Colon and rectal surgeons are experts in the surgical and non-surgical treatment of diseases of the colon, rectum, and anus. They have completed advanced surgical training in the treatment of these diseases, as well as full general surgical training. Board-certified colon and rectal surgeons complete residencies in general surgery and colon and rectal surgery, and pass intensive examinations conducted by the American Board of Surgery and the American Board of Colon and Rectal Surgery. They are well versed in the treatment of both benign and malignant diseases of the colon, rectum and anus and are able to perform routine screening examinations and surgically treat conditions, if indicated to do so.

DISCLAIMER

TThe American Society of Colon and Rectal Surgeons is dedicated to ensuring high-quality patient care by advancing the science, prevention and management of disorders and diseases of the colon, rectum and anus. These brochures are inclusive but not prescriptive. Their purpose is to provide information on diseases and processes, rather than dictate a specific form of treatment. They are intended for the use of all practitioners, health care workers and patients who desire information about the management of the conditions addressed. It should be recognized that these brochures should not be deemed inclusive of all proper methods of care or exclusive of methods of care reasonably directed to obtain the same results. The ultimate judgment regarding the propriety of any specific procedure must be made by the physician in light of all the circumstances presented by the individual patient. 

CITATIONS

Finne, C. O. & Fenyk, J. R. Chapter 16, “Dermatology and Pruritis Ani”. Chapter in Beck, D. E., Roberts, P. L., Saclarides, T. J., Senagore, A. J., Stamos, M. J., Wexner, S. D., Eds. ASCRS Textbook of Colon and Rectal Surgery, 2nd Edition. Springer, New York, NY; 2011.

American Society of Colon and Rectal Surgeons website, 2010 Core Subjects; Davis, B. R.;  “Pruritis Ani, Pilonidal Sinus and Hidradenitis Suppurativa”.

American Society of Colon and Rectal Surgeons, website 2006 Core Subjects; Rakinic, J.; “Fissures, Pruritis Ani”.

Markell, K. W. & Billingham, R. P.. Pruritis Ani: Etiology and Management. Surg Clin N Am 2010; 90: 125-135.

Causes of Pruritus Ani or Itching in the Anus

Itching of the skin, also called pruritus, is a common problem experienced by many people. The itching may or may not come along with a rash, which can be limited to small areas of skin or can occur over the entire body. When a rash does occur, it can be a clue as to the cause of the itching. Itching can be a minor nuisance or can be a major disruption and severely impact a person’s quality of life. When the itching involves the area around the anus, it’s referred to pruritus ani, and can be an embarrassing problem.

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Pruritus ani can affect up to 5% of people and is more common in men between 40 to 60 years of age. There are many causes of pruritus ani, the majority of which can be linked to a certain medical problem, such as hemorrhoids or anal fissures. Other common causes include irritation from fecal material, infections, contact dermatitis, reactions to food and clothing, medication side effects, colorectal and anal cancer, dermatologic conditions, as well as other medical and psychological conditions. The treatment of pruritus ani depends on the cause of the symptoms.

Fecal Contamination

The skin coming into contact with fecal material, either in large or small amounts, is a common cause of pruritus ani. This may be as a result of direct irritation of the skin, or possibly as an allergic cause. People with frequent bowel movements, loose stools, and those consuming large amounts of coffee (which lowers the anal sphincter’s muscle tone) may be at increased risk for fecal contamination as a cause of pruritus ani. Increasing stool consistency, such as by decreasing coffee intake, increasing bulk-forming agents, and taking medications such as loperamide (to decrease diarrhea) may improve symptoms.

Infections

Infections of the peri-anal skin may also cause pruritus ani. These include pinworms (Enterobius vermicularis), fungal and yeast infections (such as with Candida albicans), and bacterial infections (such as with Streptococci and Staphylococci). Scotch tape tests are useful for diagnosing pinworm infection, and cultures are helpful for the diagnosis of fungal and bacterial infections. Treatment depends on the type of infection that is found.

Contact Dermatitis

Contact dermatitis of the anal region can also result in pruritus ani. Causes include toilet paper dye and fragrances, cleansing wipes, soaps, laundry detergents, and any topical medications placed in the region in an attempt for symptom relief. Patch testing may be useful in diagnosing contact dermatitis, and treatment with topical steroids, especially those in an ointment form, can be helpful.

Foods and Medicines

Various foods are known to cause or worsen symptoms of pruritus ani, especially when those foods increase the amount of stool frequency or result in loose stools. Examples of these foods include caffeinated beverages (especially coffee and tea), alcohol, chocolate, tomato products, and—less likely—dairy products, nuts, spices, citrus, spicy foods, prunes, and figs. Most of these reactions are not from an allergic cause, as other symptoms would be expected from food allergies, especially skin symptoms such as hives and itching over the entire body. A trial of eliminating the above foods from your diet for two weeks may be helpful to reduce symptoms of pruritus ani.

Certain medications can cause pruritus ani, including laxatives, colchicine, peppermint oil, and various antibiotics. These medications cause pruritus ani, not through an allergic cause, but more likely as a result of direct irritation or as a result of loose stool consistency and increased bowel movement frequency.

Colorectal Diseases and Dermatological Conditions

Underlying medical problems of the colorectal and anal area, such as hemorrhoids, can worsen pruritus ani. Other more serious causes of pruritus ani include anal and colorectal cancers. Various skin disorders can cause pruritus ani; these include psoriasis, lichen sclerosis, and different forms of skin cancer. These conditions are often diagnosed with the help of a skin biopsy.

Miscellaneous Causes

Some people with pruritus ani may be suffering from an internal medical condition, such as diabetes mellitus, liver disease, kidney disease, leukemia, lymphoma, iron deficiency anemia, and hyperthyroidism. Psychological factors can also cause pruritus ani, such as anxiety and stress. Treating these underlying medical and psychological problems may help your symptoms improve.

Given the wide range of causes of pruritus ani, including some that can be dangerous, it’s best to seek the advice of a healthcare professional rather than to attempt to treat this condition yourself.

Anal Itching (Pruritis Ani)

The anus is the opening where bowel movements leave the body. The skin around the anus can easily become irritated and inflamed. You may feel burning, soreness, and intense itching. This can make you want to scratch the area. Many factors lead to anal itching. Causes of anal itching include:

• Excess moisture on the skin around the anus. This can be from sweating, or from stool remaining on the outside after a bowel movement.

• Hemorrhoids

• Anal fissures and fistulas

• Infections, particularly fungal or from parasites like pinworms

• Abscesses

• Skin disorders

• Rectal polyps or cancer

• Foods such as caffeine, dairy products, chocolate, spicy foods, and acidic foods (tomatoes, citrus)

• Alcoholic beverages

The cause is not from poor cleaning, but from irritation. In fact, excessive cleaning with soap, and too roughly rubbing or wiping with tissue or a washcloth, can make it worse.

A doctor can ask you questions to help figure out the cause of your anal itch. You may be examined and lab tests may be done. Sometimes the doctor needs to perform a digital rectal exam, and look into the anus or the rest of the large intestine. Stool tests may also be done. These help the doctor decide how best to treat the problem.

Home care

Your healthcare provider may prescribe medicines. These can relieve pain and itching to help the affected skin heal. These medicines may include skin ointments, steroid creams, antibiotic creams, or antihistamines. You may need antibiotics if there is an infection. Follow the provider’s instructions for using these medicines. 

The following are general care guidelines:

• Don’t scratch—this irritates the anus and makes itching worse.

• Gently wash and dry the anal area with an unscented baby wipe, wet cloth, or wet toilet paper. Do this each morning and night and after every bowel movement. Don’t use soap. This can irritate the area.

• Use unscented, soft toilet paper.

• Avoid skin irritants in the anal area. These include soap, bubble baths, genital deodorants, and scented wipes.

• Wear loose-fitting underwear made of cotton. Avoid pantyhose and tight pants. Change underwear every day.

• Shower after exercise to rinse sweat from the anal area. Dry gently.

• Avoid foods and drinks that cause irritating bowel movements. These include coffee, acidic foods such as citrus and tomatoes, chocolate, nuts, and spicy foods.

• Eat more fiber in your diet.

• Don’t use laxatives unless your provider tells you to.

Follow-up care

Follow up with your healthcare provider, or as advised.

When to seek medical advice

Call your healthcare provider right away if any of these occur:

• Fever of 100.4°F (38°C) or higher

• Stool leaking from the anus

• Increase in pain, rash, swelling, or itching after using prescribed medicine

• Blood in stool

• Small worms (pinworms) in the stool or around the anus.

• Bleeding from the anus that doesn’t stop

• Foul-smelling discharge from the anus that is not stool

90,000 ᐈ Atypical dermatite. Treatment in children and adults. Kiev

SYMPTOMS

The course of the disease has its own differences depending on age, which are characterized by lesions and the ratio of exudative and lichenoid manifestations. A constant companion of the disease of any age period is severe itching.

Age periods:

Infant . Usually the disease appears 2-3 months after the birth of the child.During this period, erythematous spots, papules and vesicles form on the cheeks, forehead and under the hair, which are very itchy, wet and accompanied by edema. The clinical picture largely depends on nutritional factors.

Child . Atopic dermatitis in this period manifests itself in the form of rashes that are less exudative than in infants. These can be inflammatory papules of the miliary or lenticular type, papulovesicles located on the skin of the arms and legs, on the wrists, forearms, elbows, under the knees, on the feet and ankle joints.Alimentary factors at this age also play a lesser role, the seasonal nature of the disease appears when it worsens in the spring and autumn.

Teenagers and adults. Lesions at this age usually appear on the skin where the limbs are bent (elbows, popliteal folds, wrists, ankles), behind the neck, behind the ears. the disease manifests itself in the form of erythema, papules, peeling, cracks, a lot of excoriation. By the age of 30, partial remission may occur with dry skin, their high sensitivity to stimuli and with possible minor exacerbations in spring and autumn.

Morphological forms of atopic dermatitis:

Exudative. Mainly, it occurs in infancy and manifests itself in the form of symmetrical erythematous rashes of the papulovesicular form on the skin of the face and under the hair, accompanied by the formation of scaly crusts. Subsequently, the rash may appear on most of the body. There is a constant itching of different strengths.

Erythematous-squamous. Most often appears in children at the age of 1.5-3 years, there are itchy nodules, erosion, excoriation, small erythema and infiltration with the location of lesions on the trunk, arms and legs, in rare cases on the face.

The erythematous-squamous form with lichenification occurs at 3-12 years of age and in adults. The rash takes on an erythematous-squamous and papular appearance. The skin becomes very dry, a lot of excoriation and scales with small plates are formed on them.Itching is intense, regular, reaching paroxysmal.

Lichenoid. Most often occurs during adolescence. With this form of AD, there is an increased dryness of the skin with a pronounced pattern, swelling, infiltration. Often, foci of lichenification merge, forming larger lesions of the skin. There is an increased intensity of itching, it becomes persistent and pronounced.

Pruriginous. Occurs infrequently and mainly in adults.The rashes are numerous isolated papules with a dense structure and swelling, the upper part of which may be covered with small vesicles. The lesions are most often located on the skin of the hands and feet. Dermographism is expressed as persistent white spots.

Complicated form. In some cases, atopic dermatitis takes this form due to the addition of a secondary infection (of a viral, bacterial or mycotic nature).

90,000 main causes and what to do

Itchy scalp is a problem that one in two faces.An unpleasant sensation that causes a lot of inconvenience and discomfort is quite treatable. It remains only to find out the reason.

The most common causes of itchy scalp are: poor hair care and cosmetics, stress, unhealthy diet, scalp tension, parasites, weather, hormonal changes, atheroma, viruses and fungal infections.

Consider the 7 most common reasons more

Dandruff

Dandruff is scales, obsolete epithelial cells of the scalp, which die off as a result of natural aging.But if the fungus actively multiplies on the skin, it speeds up the process to such an extent that the cells exfoliate much faster. This problem leads to both itching and dandruff, seborrhea, so it cannot be ignored.

Cosmetics and Hygiene

Hair cosmetics are a common cause of itchy scalp. The wrong shampoo can cause allergies or dry scalp. Excessive use of hairspray creates a dense coating that interferes with normal water-lipid metabolism and oxygen delivery to the cells.Because of this, the skin dries out.

Wrong diet

An improper diet leads to metabolic disorders in the body, insufficient intake and poor vitamins – this leads to weight loss, as a result of which the nutrition of epidermal cells deteriorates, which becomes another cause of MCH.

Muscle tension

Few people know that excessive muscle tension often causes an itchy scalp. The head itches from the tension of the muscles of the shoulders, back and occiput.It is also worth remembering that the head also has muscles that can strain. But how can this process lead to GCS? The answer is simple: at this moment there is a violation of the microcirculation of the vessels of the scalp, as well as the appearance of microtraumas of tissues, therefore, the process of inflammation begins with a frequent unbearable sensation of itching. With such sensations, a person begins to scratch his head strongly, which leads to damage to the skin and increased itching.

Parasites

The most unpleasant and one of the most common causes of itching are insects: lice, which provoke head lice.Even with proper hygiene, regular medical examination, good nutrition and clean clothes, this problem occurs quite often and no one is immune from infection.

Stress and nervous tension

During stress, itching of the scalp may occur, as a person is in a state of nervous excitement, and this provokes excessive activity of the autonomic nervous system.

Another common cause of this itching is hormonal changes during puberty, pregnancy or menopause.

If you cannot find the cause at home, and when you change shampoo or eliminate stress, itching of the scalp continues and is accompanied by hair loss or dandruff, then you should contact a specialist.

Causes, treatment of itching in the lower legs

Everyone at least once in their life experienced itching in the lower extremities. Quite often, this condition is provoked by external factors, so it should not cause concern.But, in some cases, people have strong and often itchy legs below the knees, the reasons for which lie in the development of serious diseases. In no case on your own should you try to fix the problem using medicines and folk recipes. The only right solution for prolonged itching will be to go to a hospital for an appointment with a dermatologist, endocrinologist, neuropathologist, or the doctor on duty.

Main reasons

The following factors can provoke the appearance of itching in the lower part of the legs:

• Dehydration has occurred, for example, the person is not drinking enough fluids.
• With the onset of cold weather, the skin may itch, as they receive appropriate signals from the brain.
• The use of cosmetics can lead to flaking, redness and itching of the skin. If such problems arise, you should immediately contact a hospital facility. The dermatologist will prescribe a course of therapy, and the disease will not become more severe.
• An insufficient amount of vitamins and minerals in the body may cause this problem.
• Skin diseases are usually accompanied by severe itching. Patients in most cases scratch the lesions and aggravate the situation. Treatment of dermatitis always requires a lot of time, the use of medications for internal and external use.
• Itching on the skin may indicate the patient is developing psoriasis. Also, this symptom should be considered as a manifestation of an allergic reaction to a product, pollen or any other substance.
• Itching in the lower part of the legs can accompany problems with blood vessels, diabetes, kidney and liver disease, mental disorders.

What to do?

If severe itching occurs, a person should go to a hospital to determine the exact cause. If the discomfort is provoked by the disease, then the doctor should prescribe a course of drug therapy. For dry skin, moisturizers should be used, and it is also recommended to normalize the drinking regime. But, regardless of the cause of the itching, people should not comb these places, since a secondary infection can join the already existing problem.

90,000 Why does a dog have an itchy back at the tail: causes, treatment of the root cause, remedies

Causes of itching

Most often, itching in the tail in a dog occurs for the following reasons:

• Ectoparasites. For example – fleas. Flea saliva allergy causes dermatitis and severe itching . Even if no parasites are visible on the dog, this does not mean that they are not there;
• Allergy. Each organism is individual, so you can get an allergy to anything – food, new bedding, shampoo, food from the table … There are many options and each must be dealt with separately;
• Inflammation of the paraanal glands.Normally, they are cleared when the dog goes to the toilet “in a big way”, but with errors in nutrition they can become inflamed.
• Stress.

Any of these causes can cause irritation and itching of the back in your dog. Very often, our four-footed friends begin to itch after visiting a groomer. This could be due to inappropriate shampoo / conditioner, aggressive hot air drying, or stress.

Important! If you wash your dog at home, then you only need to do this with special shampoos for animals.Shampoo is a concentrate and must be diluted with water and whipped into a lather. Wash your dog with this foam.

And if the wool comes out?

Bald patches are the consequences of itching. Above the tail and on the sides, they can be caused by the same causes as itching in general. Bald patches appear due to excessive licking of the itchy area by the dog itself. The most common cause of this itching is fleas. But why does the dog itch near the tail, what should I do?

Usually the dog scratches the back close to the tail due to inflammation of the paraanal glands.The itching of the dog at the base of the tail gives it discomfort, and the dog begins to actively gnaw the fur in this place and around the anus, and bald patches appear. Also, the dog can ride on the carpet, sitting low. A visit to the veterinarian and cleaning of the paraanal glands will solve this problem. Once the problem causing the itching is corrected, new hair will grow in place of the receding hairline.

Age, pregnancy and lactation

Aging, pregnancy and lactation are natural processes. They cannot be the reason that the dog scratches his back.The occurrence of local itching in an old, pregnant, or lactating dog is nothing more than a coincidence. Yes, older animals lose their hair more abundantly than younger ones. And lactating and pregnant dogs can shed heavily due to lack of vitamins. But the condition itself can in no way be associated with itching and be considered the cause.

Diagnosis of itching

The veterinarian will begin the diagnosis by collecting information about the dog’s lifestyle. It is important for the doctor to know what the dog usually eats, inaccuracies in nutrition (food “off the table”, treats), as well as the treatment of the dog from parasites.Typically, the diagnostic plan is as follows:

1. Taking anamnesis.
2. Examination of the dog.
3. Local inspection of combs.
4. Biochemical and clinical blood tests.
5. Taking a scraping from an itchy area.

The diagnosis and treatment plan can be changed at the discretion of the doctor. Sometimes the solution to the problem lies on the surface, and the veterinarian can immediately answer why the dog’s back itches at the tail, and what to do about it.Your task is to strictly follow the appointments and listen to the recommendations of the attending physician.

Help pet

It so happens that the diagnosis takes a long time, and the debilitating itching and continuous self-combing only aggravate the condition of the dog. Apoquel will help alleviate symptoms during this time. It successfully relieves itching, and at the same time does not harm the body in any way. A huge plus of Apoquel is that it can be used for a long time without any harm to the dog. This drug has no analogues.Apoquel is an absolute innovation in the world of veterinary dermatology. It relieves itching at the cellular level, starting to act within 4 hours after giving the pill. Apoquel is suitable both for allergies to flea saliva and will provide a comfortable life for an animal with atopic dermatitis.

Consult your veterinarian before use.

Causes and treatment

Based on the results of the examinations, the doctor will prescribe treatment. It always depends on the cause of the itching.

• Ectoparasites. The main treatment for flea infestation is drops or pills for parasites. For example, Stronhold or Simparica. In combination with them, you can wash your dog with a special anti-flea shampoo and put on a collar that protects against ectoparasites. Remember that fleas do not live on the dog, they only feed. The habitats of parasites are cracks in the floor, bedding, carpets, toys. Therefore, when treating a dog, do not forget to treat the apartment and household items of the dog with special means.The use of Apoquel during the treatment of flea dermatitis eliminates constant scratching of the skin, which contributes to the speedy healing of the affected areas.
• Allergy. Allergy treatment is always tailored individually. When all allergens have been eliminated and the dog has been treated for parasites, you can think of atopic dermatitis – one of the manifestations of allergy. Apoquel is the best option for maintaining a comfortable life in animals with atopic dermatitis.
• Paraanal glands.When the paraanal glands are inflamed, the animal experiences discomfort: the dog gnaws at the back near the tail and under the tail, and also “rides” on the carpet. Treatment in this case is complex – finding out the cause of itching, timely cleaning of the paraanal glands, anti-inflammatory and antibacterial therapy.
• Stress. Particularly susceptible animals are prone to itching after experienced stress. The departure of a loved one, fireworks, a new family member – all this can provoke idiopathic dermatitis.To avoid exacerbations, consult a dog handler for behavior correction or ask your doctor to prescribe sedatives to your dog in combination with Apoquel.

Remember, prevention is the best treatment. At the first manifestations of itching, immediately contact the veterinary clinic.

90,000 Itchy scalp | Alliance

Itching of the head can bring a lot of inconvenience to a person. Over time, the skin becomes thinner, cracks and sores appear on it.To prevent this, it is necessary to start treatment on time.

Why does the head itch? Causes of itching

Irritation of the epidermis can be triggered by various factors. In some cases, scalp therapy is carried out at home. If folk remedies do not help, then consult a doctor (dermatologist, allergist or trichologist).

Factors causing itchy scalp can be as follows:

• Mechanical damage;
• Sometimes a burning sensation on the skin occurs after receiving any scratches or cuts.The head itches due to the healing of wounds. You should not comb them, you can only delay the healing process. In this case, no specific treatment is required. But you can use a variety of soothing oils and ointments.
• Devices for drying and laying

Frequent use of a hair dryer, straightening irons and curling hair negatively affects the condition of the epidermis. They dry it greatly, cause various unpleasant symptoms. Also, these devices worsen the condition of hair in women.Try to use them no more than three times a week, and completely abandon them during treatment.

Parasites

If you are concerned about severe itching of the scalp, then you need to check it for parasites (you can use a magnifying glass). Most often, the following parasitic organisms are found on the scalp: lice, ticks, etc. They can be picked up in public places, by contact with an infected person, or after visiting a forest. Also, parasites appear on the skin due to non-compliance with the rules of personal hygiene.

Lice most often lay their eggs in the region of the back of the head and ears. They are attached to the hair roots and have a white or light yellow tint.

Seborrhea can cause severe itching in the area of ​​hair growth. Seborrheic dermatitis occurs due to a malfunction in the production of the sebaceous glands. This disease is characterized by the presence of dandruff, acne and increased burning of the dermis (dry appearance). With the oily type of seborrhea, excess sebum and small scales form on the scalp. It occurs due to problems with the human digestive or immune system.

Psoriasis is a non-communicable disease. Its main symptom is the formation of pink plaques covered with white scales. If left untreated, the disease will spread to the skin of the neck and ears.

Eczema and atopic dermatitis have similar symptoms. If you do not consult a doctor in time, then these diseases can provoke active hair loss.

All of the above skin diseases require medical attention. Do not stay idle or self-medicate, as this will only worsen the condition of the scalp.

Xerosis

This disease occurs due to insufficient secretion of the sebaceous glands. As a result, the scalp dries up, and small cracks may appear on its surface. The patient is worried about a burning sensation, he develops peeling of the epidermis.

Itching and itching of the scalp with xerosis for two reasons:

• Use of aggressive detergents, frequent shampooing.
• Hormonal disruption in the body.

In the first case, it is recommended to replace the shampoo with a more “gentle” one. It is advisable to use a hypoallergenic detergent. If you have a hormonal disorder, you need to see a doctor. He will conduct an examination and prescribe the most appropriate medications.

Dermatomycosis (trichophytosis)

Itching of the scalp occurs due to contact with the epidermis of fungal microorganisms. The patient develops several serious symptoms at once: skin irritation and hair loss.Trichophytosis causes profuse scaling, itching and redness of small areas of the epidermis. Also, due to illness, the hair loses its former strength, easily breaks and falls out strongly when combing.

It is impossible to detect parasitic microorganisms of the fungus on your own. Only a doctor can make an accurate diagnosis, having previously taken a scraping.

Dermatophytosis (ringworm)

This fungal disease is most often diagnosed in children. Ringworm occurs through contact with infected people or animals.The main symptoms are the appearance of itchy plaques on the epidermis. They swell over time, fester and become covered with a thick crust. If left untreated, the head itch will spread to the skin of the auricles (itching behind the ear), neck, chest and back.

Diabetes mellitus

Increased blood sugar provokes disruptions in the production of the sebaceous glands, causing dehydration. Severe dryness, flaking and itchy skin spreads not only to the scalp, but to the entire body.
In order to make an accurate diagnosis, you must contact a qualified specialist. He will prescribe a special diet and medications for you. You will first need to donate blood for the sugar level.

Neurodermatitis

This serious neurological disease can cause itching and other changes in the skin. Exacerbations occur due to stressful situations. The unpleasant symptoms are most pronounced in the evening.

Neurological disorders

Scientists have proven that stressful situations (stressful environment at home or at work, depression, severe shock) can cause itching of the scalp (often itching of the top of the head, back of the head).Stress triggers the body to produce cortisol, adrenaline, and norepinephrine. To remove them, it is necessary to engage in physical activity, otherwise they will accumulate in the blood. This, in turn, causes severe itching.

Avitaminosis

Itching of the scalp and neck skin appears due to the lack of macro- and microelements in the body. Lack of some vitamins affects the skin as follows:

• With a deficiency of vitamin B2 in the body, there is an excessive production of the sebaceous glands.This can lead to the development of seborrhea (oily type).
• Lack of vitamins A and C leads to profuse hair loss.
• Insufficient vitamin D intake causes premature aging of the skin. The epidermis becomes dry, peeling and itching appears.
• Deficiency of vitamins E and B6 impair the regeneration of skin cells.
• Distinctive symptoms of vitamin deficiency: lack of performance, frequent colds, weakness. Also, the patient may have a deterioration in the appearance of the nail plates and hair.

Allergic reaction

If, after using new cosmetics for care: shampoo, conditioner, rinse or hair mask, your scalp itches badly, then this is a sure sign of allergy.

To avoid unpleasant symptoms, study the composition of the new product. The most common irritant is sodium lauryl sulfate.

Special diet

If the causes of itching of the scalp are vitamin deficiency, diabetes mellitus or allergies, then a diet is used to eliminate unpleasant symptoms.

Proper nutrition will help get rid of itchy head

The condition of the scalp and hair depends on our nutrition. Due to the frequent use of harmful products, the condition of the epidermis worsens, peeling, dryness and itching appear. To restore the normal functioning of the sebaceous glands and improve the condition of the hair, follow these nutritional guidelines:

• Be sure to include dairy products in your diet (low-fat cottage cheese and cheese, kefir, fermented baked milk, natural yogurt, etc.)etc.).
• Drink plenty of fluids (1.5-2 liters). You can add lemon juice, ginger and a little honey to plain water. This will improve your metabolism.
• Avoid sweets, salty and fatty foods.
• Eat nuts daily (no more than 50 grams per day), eggs, liver, boiled poultry and lean fish (steam or simmer).
• Add more fiber to your diet. It can be taken in powder form (available from a pharmacy). Also, fiber is found in large quantities in buckwheat and oatmeal, pistachios, beets, cabbage and other vegetables.
• In addition to food, it is recommended to take vitamins A, E, B, C, iodine and calcium. They can be purchased at any pharmacy.

If your scalp itches due to parasites, skin diseases or fungal microorganisms, proper nutrition will help speed up the healing process.

How to get rid of itchy scalp?

First you need to be examined by a dermatologist or trichologist. Depending on the cause of the itching, he or she will prescribe a medication.In some cases, in order to make an accurate diagnosis, you will need to be tested.

Why your head itches and how to get rid of itching

1. Reaction to hair care products

You may have simply not rinsed off the ^{shampoo badly and caused skin irritation.}

Perhaps itching and rash on the head are signs of allergic contact dermatitis. It is common among people who dye their hair.

You may also be allergic to shampoo, conditioner or any other hair product.To check for suspicions, simply apply the substance to the crook of your elbow. If a rash appears there, then your fears are not in vain.

What to do

It is better to rinse your hair so that no shampoo remains on it. If it’s an allergy, find and stop using the agent that causes it.

If this does not help, go to the doctor. He will investigate the causes and possibly prescribe an antihistamine to relieve the itching.

2. Hairstyle

A casual ponytail or bun can also cause itching.

Natalya Koporeva

dermatovenerologist, trichologist of the medical center “Intermed”, work experience – 21 years

Too tight hairstyles damage the hair follicles and can cause itching of the scalp and hair loss.

What to do

Stop pulling your hair as hard as you can.

3. Dry skin

If the skin lacks moisture ^{, it may itch and flake off.You may be drinking too little water, washing your hair too often, or using harsh shampoos.}

What to do

Drink more. Use mild shampoos with hyaluronic acid or natural oils. After washing, additionally moisturize your skin with glycerin or aloe toner. Do a head massage at least once a week. And do not forget about a hat: in winter you need to protect your skin from the cold, in summer from the heat.

4. Poor hygiene

During the day, dust, germs, sweat, sebum collect on the scalp and hair.If you don’t clean your scalp regularly, itching may occur.

What to do

Wash your ^{head as it gets dirty, that is, about once every three days.}

5. Hives

Hives usually go away after a few hours or days, but may reappear / dermline.ru

These red itchy bumps can appear ^{anywhere. Hives can be caused by allergies to food, drugs, insect bites, pollen, animal dander, latex, and other materials.But it can also be chronic – its causes are unknown.}

What to do

Hives often go away without treatment. But if it periodically appears and disappears for six weeks, it’s time to go to the doctor. He will prescribe medications that will reduce the symptoms.

6. Dandruff or seborrheic dermatitis

Dandruff is the result of too much work of the sebaceous glands. It does not harm in any way, but it can be accompanied by ^{itching. Seborrheic dermatitis, a chronic skin inflammation 90 390, has the same symptoms, but whitish scales can appear not only in the hair, but also on the nose, eyebrows, ears, eyelids and chest.}

What to do

If you just have dandruff, most likely shampoo will help, which will contain one of these components:

• zinc pyrithione;
• salicylic acid;
• selenium sulfide;
• ketoconazole;
• coal tar.

These shampoos should be used strictly according to the instructions.

If the case is in seborrheic dermatitis, you will have to take ^{medications, which the doctor will select.}

7. Sunburn

Prolonged exposure to sunlight or UV radiation in tanning beds causes burns ^{and dries the skin.}

What to do

Take a cool shower or apply a cold compress (not ice). Lubricate skin with ^{with aloe juice or moisturizing lotion. In the future, try to protect yourself from the sun.}

8. Use of medicines

Components of some medicines cause ^{itching even without rash or irritation. Among them are allopurinol, amiodarone, amiloride, hydrochlorothiazide, estrogen, sivmastin, hydroxyethyl cellulose.}

What to do

Discard the drugs that you have prescribed yourself, and ask your therapist to find new ones for you. If your doctor has prescribed medications for you, tell him about the problem. He will change the dosage or suggest an equivalent.

9. Lice

In fact, lice are small and almost transparent, so it is not easy to notice them among the hair / yachist.ru

They run on the head ^{, bite and cause itching. At the same time, anyone can become infected, because parasites are easily transmitted by touching the hair or through personal belongings.So, just in case, have someone examine your head.}

What to do

Wash your hair with a shampoo containing pyrethrin or permethrin. Just read the instructions carefully and follow the directions, otherwise you can get skin irritation. Comb the nits with a fine comb. Be sure to wash clothes and bed linen in hot water (at least 54 ° C) and then iron.

If home treatment does not work, you will need the help of a dermatologist. He will examine you and write out stronger funds.

10. Scabies

If this is it, not only the head will itch, but the whole body. Moreover, it is so strong that it will be impossible to sleep. Also, a rash or crusting will appear.

What to do

Scabies does not go away on its own, it must be treated without fail ^{. First, go to a dermatologist, he will tell you what to do and prescribe medication.}

Permethrin, lindane, benzyl benzoate, crotamiton or sulfur cream or lotion is usually prescribed to kill scabies mites.And for itching, antihistamines and cool compresses are prescribed.

11. Folliculitis

This is the name of the inflammation of the hair follicles. It looks like red bumps or pimples with a white head around the hair.

What to do

You can cure ^{a mild form of folliculitis at home:}

• Apply gauze moistened with warm water or saline solution to your head (1 teaspoon of salt for 2 glasses of water).
• Wash skin with antibacterial soap twice a day.
• Use an over-the-counter antibiotic cream or gel to fight infection.

Your condition should improve in a few days. If the bumps and itching persist, it’s time to leave home treatment and go to the hospital.

12. Psoriasis

Plaques can be found not only under the hair / aad.org

Psoriasis makes itself felt ^{dry red spots raised above the skin and covered with white scales. Itching can be mild or severe.}

What to do

The treatment plan should be drawn up by a dermatologist.Therefore, with the signs of psoriasis, you need to immediately go to it.

For mild scalp psoriasis, try ^{salicylic acid or coal tar shampoos. They will reduce itching and make plaque invisible.}

13. Eczema or atopic dermatitis

Most often 90 390 children suffer from this. The skin turns red, scales appear on it. Some people feel like their head is on fire with ^.

What to do

Go to a dermatologist.He will diagnose and prescribe treatment.

14. Lichen

Severe itching usually causes ringworm, but there is also a more rare form – red ^{flat. In any case, the skin is covered with scales and turns red.}

What to do

And again you need to see a dermatologist. At home, you can only rinse your hair with warm water and use an over-the-counter emollient cream or anti-itch lotion, but this is not a substitute for medication.

15. Alopecia areata

In another way – baldness, which is often accompanied by itching.

What to do

Go to the doctor at the first sign of baldness. It is impossible to expect complete hair loss: long-term alopecia ^{is very difficult to treat.}

16. Skin cancer

Any unusual moles, nodules or dark spots may be a sign of it. Sometimes they itch or burn.

What to do

A suspected skin lesion should be examined by an oncologist. He will already decide whether it is dangerous or not. If it is dangerous, then the neoplasm will have to be removed ^.

17. Lymphoma

Usually lymphoma occurs in people over 50 / marickautosales.com

Lymphoma appears on the skin ^{as red or purple pimples or flat plaques. The affected area is usually itchy and scaly.}

What to do

Consult a dermatologist or oncologist and, if necessary, take blood tests, biopsy, computed tomography.

18. Mental state

Depression, anxiety, psychosis, obsessive-compulsive disorder can cause phantom itching ^{, although there is no rash or other manifestations on the skin.The maximum is damage from scratches.}

What to do

Contact a psychotherapist to confirm that the cause of the itching is in a psychological state.

Behavioral therapy or antidepressants can be prescribed as treatment. When the problem is resolved, the itching will also disappear.

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Why does a dog scratch, lick or gnaw itself?

April 3, 2020

Does your dog constantly scratch his ears, lick his paws, or gnaw his tail?
If this gives you discomfort, then imagine how your four-legged friend is feeling.

The obsessive urge to scratch, gnaw and lick oneself is quite common in dogs and has various reasons. One of the first signs that your pet is having problems may be the appearance of a “hotspot” – a red, weeping, irritated area. Although hotspot or weeping eczema can occur anywhere, it is most commonly found on the scalp, armpits, groin, or abdomen. Eczema causes great discomfort in dogs, so they continuously brush and lick the inflamed areas, which can cause hot spots to grow in size rather quickly and cause unbearable pain and itching.

Reasons why dogs itch compulsively, lick or gnaw themselves

Dogs itch, lick or bite the body, paws, tail for a variety of reasons, from boredom to serious illness:

• Parasites . Fleas and ticks are among the most common causes of itching in dogs. Although ticks are usually visible to the naked eye, fleas often go unnoticed until a severe infestation occurs.Therefore, do not think that the ponytail does not suffer from parasites just because you cannot see them.
• Allergies . Unbearable itching in a dog can be the result of food allergies or environmental influences, including mold and pollen. Dogs can also develop a skin irritation called contact dermatitis when exposed to substances such as pesticides or soap.
• Boredom or anxiety. Just as people with anxiety may bite their nails or pull their hair, dogs can also develop physical reactions to a psychological disorder.This condition is similar to human obsessive-compulsive disorder. It manifests itself in constant gnawing and licking, which can cause serious damage.
• Dry skin. Various factors, including winter and a deficiency of fatty acids, often cause dry skin in dogs. Your pet may react to discomfort by brushing or licking its skin or fur.
• Hormonal imbalance. If your dog’s body does not make enough thyroid hormones or secretes too much of the hormone cortisol, your dog may develop superficial skin infections.You may notice baldness, and your pet will act as if he is worried about allergies.
• Pain. When you are trying to determine why your dog is licking and chewing excessively, be sure to think about the fact that something is causing him physical discomfort. For example, if a dog constantly bites its paw, it may have a thorn or a sharp stone in its paw. Compulsive paw licking can also be a response to orthopedic problems, including arthritis and hip dysplasia.

Treatment of compulsive licking, combing and gnawing of hair in dogs

Since there are many reasons dogs gnaw or scratch themselves, be sure to check with your veterinarian as soon as you notice a problem. Your veterinarian can help you figure out the cause of the behavior and determine the best treatment plan. Depending on what is causing your quadruple compulsive behavior, treatment may include:

• Elimination of parasites. Flea and tick preparations for dogs will help get rid of existing parasites and prevent their further appearance. The variety of antiparasitic agents will allow you to choose a convenient format and type of protection. Also, if itching and biting is caused by fleas, be sure to wash your pet’s bed and regularly clean carpet and upholstered furniture to reduce the chances of re-infestation. You should also do the same for other pets.
• Change of feed or hygiene products. If food allergies are the cause of your dog’s itching, trigger foods (such as beef, chicken, or wheat) should be identified and eliminated from the diet. Your veterinarian will help you choose a special diet that suits your pet.
  In case of contact allergies, shampoos and conditioners are selected specially for sensitive skin.
• Use of vitamin and mineral complexes. Adding fatty acids and other trace minerals to your pet’s diet will solve dry skin and hair loss.
• Drug use. The veterinarian will prescribe medication for the underlying problems that contribute to permanent scratching, depending on the disease:
  – hormones
  – chondroprotectors
  – NSAID
  – antibiotics
• Solving the problem of anxiety or boredom. In some cases, compulsive licking and gnawing of fur develops in response to stress. To reduce this likelihood, make sure your four-legged friend is getting enough exercise, attention, and love.It will also be helpful to teach your pet to chew toys or bones to relieve nervous tension.
  If this is not enough, then you need to use sedatives for dogs.

How can I help my dog ​​with itching and wet dermatitis before starting the main treatment?

Since compulsive behavior can cause serious harm and affect your pet’s quality of life, it is important to do everything possible to prevent it from scratching, chewing, or licking itself too much:

• Use bitter spray .Applying a bitter spray to the inflamed area will prevent it from licking.

• Put on a bandage with bitter impregnation. Weeping dermatitis can be protected from licking and combing with a special bandage:
  – bitter impregnation will prevent you from removing it
  – moisture resistance will allow you to walk with your pet even in rainy weather
  – breathable structure ensures no greenhouse effect

• Put on a special collar.