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June 2010

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Pruritus ani

Volume 39, No.6, June 2010 Pages 366-370

Joanne MacLean

Darren Russell


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.


This article discusses the assessment and management of pruritis ani.


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.

Anal pruritus, an intense chronic itching affecting the perianal skin, is a common condition. Anal pruritus is estimated to affect up to 5% of the population, with a male to female ratio of 4:1.1–3

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