Anal Itching

WHEN TO SEE YOUR DOCTOR

* You feel a lump in the rectal area.

* You have diabetes.

* You are taking steroids.

* Your children complain of anal itching.

What Your Symptom Is Telling You

Of all the places to get an itch, your anus is probably one of the most embarrassing. Face it, it's nearly impossible to look dignified while scratching your rump. Yet no matter how solemn or romantic the moment, it's hard to ignore the urgent pleas for immediate attention.

An itchy bottom usually is a signal that fecal material or body secretions are irritating nerve endings in the anus. However, the causes are numerous, and finding a specific reason for it can be elusive, doctors say.

More than likely, hemorrhoids, pinworms, fissures (cracks in the skin surrounding the anus), anal warts or allergic reactions to toilet paper or foods are responsible for your dilemma. Anal itching also can be caused by a fungal infection, which is particularly common among people with diabetes and can be one of the first signs of the disease. In rare cases, anal itching is a sign of an abscess, polyp or sexually transmitted disease.

Symptom Relief

I would be wary of using over-the-counter creams and ointments to deal with anal itching. They may do more harm than good, and frankly, there are easier ways of dealing with it," says Bruce Orkin, M.D., an assistant professor specializing in colon and rectal surgery at the George Washington University School of Medicine and Health Sciences in Washington, D.C. Here are a few suggestions on how to banish that tormenting itch from your life.

Nix citrus fruits and spicy foods. Doctors aren't sure why, but citrus fruits, such as oranges, grapefruits and tangerines, and spicy foods, like curry and hot peppers, can cause some people to develop irritating secretions at the anus, says Juan Nogueras, M.D., a colon and rectal surgeon at the Cleveland Clinic-Florida in Fort Lauderdale. Simply eliminating these foods from your diet may solve the problem, he says.

Slash your coffee drinking. Coffee beans contain oils that you can't digest. The oils irritate the skin surrounding the anus when they are excreted from the body. Simply limiting yourself to one or two six-ounce cups of coffee daily may be enough to prevent or relieve anal itching, says Scott Goldstein, M.D., a colon and rectal surgeon at Thomas Jefferson University Hospital in Philadelphia.

Tame a rebel with a gauze. Place a thin strip of gauze or cotton up against the anal opening to absorb excessive sweat and mucus and to prevent rashes and itching, says Dr. Orkin.

Make like a boxer. Loose cotton underwear is a better choice than clinging nylon or polyester because it absorbs moisture better and allows more air to pass through, keeping your bottom dry, says Dr. Orkin.

Sock it to pinworms. Pinworms generally infect young children, but other family members can attract the unwanted attention of these pests, which come out at night and cause infernal anal itching. Your doctor can prescribe an oral antiparasitic medication to relieve the problem, but you also should thoroughly wash all bedding in hot water to prevent a recurrence.

Check your medications. Some drugs can cause anal itching. Antibiotics, for example, often destroy harmless bacteria in the anus that fight off itchy yeast infections. Ask your doctor if your medications may be causing your problem.

Blow your itch away. Using a hair dryer set on low for 20 to 30 seconds after bathing or swimming is a good way to gently but thoroughly dry your bottom and prevent itching. One precaution: If you feel your skin burning, either the dryer is set too high or it is too close.

Bare your bottom to the sun. "The sun's ultraviolet light can help prevent and relieve itching and other irritations in the anal area and dry the skin. Nude sunbathing is a great way to get some of that sunlight into areas of your backside that are usually left in the dark," says Eric G. Anderson, M.D., a family practice physician in La Jolla, California. As with more modest forms of sun worshipping, you should always apply a sunscreen to exposed skin and build up your time in the sun gradually.

Don't worry. Believe it or not, if you feel anxious or are under a lot of stress, you may develop an itchy anus. Relieving your stress through yoga, progressive relaxation or exercise might end your scratching.

Wash, don't wipe. Good hygiene is crucial to preventing anal itching. If possible, after each bowel movement wash your anus with a soft cloth dipped in warm water and mild soap. Rinse and pat dry; don't rub.

Go for the plain paper. "You should stick to plain, two-ply soft toilet paper and avoid fancy stuff," Dr. Goldstein says. "You don't want anything like perfumes in those papers that may irritate the skin."