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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Astringents

Astringents cause coagulation (clumping) of proteins in the cells of the perianal skin or the lining of the anal canal. This action promotes dryness of the skin, which in turn helps relieve burning, itching, and pain.

Examples of astringents include:

  • calamine 5% to 25%
  • zinc oxide 5% to 25% (Calmol 4, Nupercainal, Tronolane)
  • witch hazel 10% to 50% (Fleet Medicated, Tucks, Witch Hazel Hemorrhoidal Pads)

Antiseptics

Antiseptics inhibit the growth of bacteria and other organisms. However, it is unclear whether antiseptics are any more effective than soap and water.

Examples of antiseptics include:

  • boric acid
  • phenol
  • benzalkonium chloride
  • cetylpyridinium chloride
  • benzethonium chloride
  • resorcinol

Keratolytics

Keratolytics are chemicals that cause the outer layers of skin or other tissues to disintegrate. The rationale for their use is that the disintegration allows medications that are applied to the anus and perianal area to penetrate into the deeper tissues.

The two approved keratolytics used are:

  • aluminum chlorhydroxy allantoinate (alcloxa) 0.2% to 2.0%
  • resorcinol 1% to 3%

Analgesics

Analgesic products, like anesthetic products, relieve pain, itching, and burning by depressing receptors on pain nerves.

Examples of analgesics include:

  • menthol 0.1% to 1.0% (greater than 1.0% is not recommended) (Calmoseptine)
  • camphor 0.1% to 3% (greater than 3% is not recommended)
  • juniper tar 1% to 5%
Medically Reviewed by a Doctor on 5/4/2016

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