Rectal Itching

Hand scratching skin indicating rectal itching

Rectal itching, also known as pruritis ani, does occur occasionally.  However, if the itching, pain or burning sensation starts to happen consistently it is a condition that should definitely be investigated further.

Pruritis refers to itching of the skin. Ani refers to the anus and the area around the anus also called the perianal area.  Thus pruritis ani is an itching of the skin of the perianal area.

Pruritis ani is thought to affect approximately 1 to 5% of the population.  It is most common in men.  In fact, it is 4 times as likely to occur in men than in women.  The most common age of this condition is from 30 to 60 years old.

This condition can lead to serious psychosocial issues and a reduced quality of life if the symptoms are severe and unrelenting.

It can be worthwhile to visit your doctor or other medical practitioner if you are concerned about pruritis ani.  Rectal itching and pain can be a sign of a more serious health issue.

You will definitely want to involve your medical professional if your itching is accompanied by rectal bleeding and pain.

Sometimes rectal itching with bleeding can be just a minor issue such as hemorrhoids but may also be something much more serious such as rectal or anal cancer.  Therefore, do not ignore it.

There are conditions which can cause uncomfortable itching in the anal area besides hemorrhoids or anal cancer.  One of these condtions is called perianal infectious dermatitis.

Dermatitis is an inflammation of the skin.  Thus perianal infectious dermatitis (PID) refers to an inflammation of the skin of the perianal area due to an infectious agent.  In this case it is usually bacteria that are the infectious agent.

Perianal infectious dermatitis is a inflammatory infection of the upper layers of the skin in the perianal region caused by bacteria.  This is not an infection that gets into the deep layers of the skin in most cases.

One of the tell-tale signs of PID is a red, swollen area around the anus that is itchy.  This area extends in a circular pattern 2 to 4 centimeters (approximately 1 to 1 & 1/2 inches) around the anus.

PID causes rectal itching and can be a condition that is fairly relentless.  This condition requires treatment with antibiotics (usually amoxicillin) but has a high rate of recurrence.

PID is just one example of a condition that can cause rectal itching.  In fact, there have been over 100 causes of pruritis ani reported.

Fecal contamination is a major cause of pruritis ani.  Thus, it is very important to keep the perianal area clean and dry in order to prevent and reverse this condition.

Dermophytic fungi are suspected of causing up to 15% of cases of pruritis ani.

Causes of pruritis ani (rectal itching) include:

  • fecal contamination
  • bacterial infection
  • fungal infections
  • worms
  • viral infections
  • contact dermatitis/allergic reactions
  • certain foods
  • hemorrhoids
  • anal or colorectal cancer
  • continually causing anal trauma due to excessive or aggressive wiping (using flushable moist wipes vs toilet paper can help alleviate this problem)
  • skin conditions (psoriasis, Paget’s disease)
  • some oral medications
  • clothing that causes heat and sweating in the area

Treatments include removing the offending agent (e.g. eliminate foods or detergents that may cause the issue), treating the infectious agent (e.g. antibiotics, antifungals) and general measures to help the skin heal such as keeping the area cool and dry.

You may also wish to learn about hemorrhoids or you may wish to learn about anal fissures.