Anal Itching (Pruritus Ani)

  • Medical Author:
    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    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.

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Vasoconstrictors

Vasoconstrictors are chemicals such as epinephrine, a naturally occurring chemical. Applied to the anus, vasoconstrictors make the blood vessels become smaller, which may reduce swelling. They also may reduce pain and itching due to their mild anesthetic effect.

Vasoconstrictors applied to the perianal area - unlike vasoconstrictors given by injection - have a low likelihood of causing serious side effects, such as high blood pressure, nervousness, tremor, sleeplessness, and aggravation of diabetes or hyperthyroidism.

Examples of vasoconstrictors include:

  • ephedrine sulfate 0.1% to 1.25%
  • epinephrine 0.005% to 0.01%
  • phenylephrine 0.25% (Medicone Suppository, Preparation H, Rectocaine)

Protectants

Protectants prevent irritation of the perianal area by forming a physical barrier on the skin that prevents contact of the irritated skin with aggravating liquid or stool from the rectum. This barrier reduces irritation, itching, pain, and burning. There are many products that are themselves protectants or that contain a protectant in addition to other medications.

Examples of protectants include:

  • aluminum hydroxide gel
  • cocoa butter
  • glycerin
  • kaolin
  • lanolin
  • mineral oil (Balneol)
  • white petrolatum
  • starch
  • zinc oxide (Desitin) or calamine (which contains zinc oxide) in concentrations of up to 25%
  • cod liver oil or shark liver oil if the amount of vitamin A is 10,000 USP units/day.
Medically Reviewed by a Doctor on 5/4/2016

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