Anal Itching (cont.)
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- What is anal itching?
- What causes anal itching?
- How is anal itching treated?
- Local anesthetics
- What if anal itching persists?
- Take the Hemorrhoids Quiz
- Inflammatory Bowel Disease (IBD) Slideshow Pictures
- Psoriasis Slideshow Pictures
How is anal itching treated?
Initial treatment of simple itching is directed toward relieving the burning and soreness. It is important to clean and dry the anus thoroughly and avoid leaving soap in the anal area. Cleaning efforts should include gentle showering without direct rubbing or irritation of the skin with either the washcloth or towel. After bowel movements, moist pads (such as baby wipes, flushable moist wipes, and flushable anal cleansing wipes) should be used for cleaning the anus instead of toilet paper. If there is constant moisture present in the anus or stool incontinence, it may be necessary to clean the anus with moist pads between bowel movements.
Many over-the-counter products are sold for the treatment of anal itching. These often contain the same drugs that are used for treating hemorrhoids. Products used for the treatment of anal itching are available as ointments, creams, gels, suppositories, foams, and pads.
Ointments, creams, and gels - when used around the anus - should be applied as a thin covering. When applied to the anal canal, these products should be inserted with a finger or a "pile pipe." Pile pipes are most efficient when they have holes on the sides as well as at the end. Pile pipes should be lubricated with ointment prior to insertion. Suppositories or foams do not have advantages over ointments, creams, and gels.
Most products contain more than one type of active ingredient. Almost all contain a protectant in addition to another ingredient. Only examples of brand-name products containing one ingredient in addition to the protectant are discussed below.
Local anesthetics temporarily relieve pain, burning, and itching by numbing the nerve endings. The use of these products should be limited to the perianal area and lower anal canal. Local anesthetics can cause allergic reactions with burning and itching. Therefore, the application of anesthetics should be discontinued if burning and itching increase.
Examples of local anesthetics include:
- benzocaine 5% to 20% (Americaine Hemorrhoidal, Lanacane Maximum Strength, Medicone)
- benzyl alcohol (Itch-X) 5% to 20%
- dibucaine 0.25% to 1.0% (Nupercainal)
- dyclonine 0.5% to 1.0%
- lidocaine (Xylocaine) 2% to 5%
- pramoxine 1.0% (Fleet Pain-Relief, Procto Foam Non-steroid, Tronothane Hydrochloride)
- tetracaine 0.5% to 5.0%
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