Background
Anal pruritus affects up to 5% of the population. It is
often persistent and the constant urge to scratch the area
can cause great distress. Although usually caused by a
combination of irritants, particularly faecal soiling and
dietary factors, it can be a symptom of serious dermatosis,
skin or generalised malignancy or systemic illness.
Objective
This article discusses the assessment and management of
pruritis ani.
Discussion
It is important not to trivialise the symptom of anal
pruritis and to enquire about patient concerns regarding
diagnosis. Once serious pathology has been excluded,
management involves education about the condition;
elimination of irritants contributing to the itch-scratch
cycle including faecal soiling, dietary factors, soaps and
other causes of contact dermatitis; and use of emollients
and topical corticosteroid ointments. Compounded 0.006%
capsaicin appears to be a safe and valid option for pruritis
not responding despite adherence to these conservative
measures.
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