Causes and risk factors
Usually the condition results from oozing from hemorrhoids. It can also cause due to overactivity of sweat glands. Poor hygiene may be responsible for pruritus in perianal region. Secondary causes include threadworm [Enterobius vermicularis] infestation, fungal infections, [e.g., candidiasis], infection with E. coli, pinworms. Underlying diseases like perianal eczema, contact dermatitis, atopic dermatitis, psoriasis, scabies, lichen sclerosus, lichen simplex, lichen planus, or diabetes can also cause pruritus ani.
Clinical presentation
There is intense itching in the anal and perianal areas. Patient has an irresistible desire to scratch which can give relief. The condition can be acute or chronic. Perianal excoriation results from scratching.
Investigation
Medical history by the patient and clinical examination by the doctor helps in diagnosis. CBC may be done.
Treatment
No specific treatment is required. Systemic cause must be treated. Treatment consists of salt baths, keeping the area dry with anti-allergic or medicated talcum powder. Use of all topical creams should be avoided. Personal hygiene and sanitation should be maintained. Underlying cause, if any, must be treated.
Other Modes of treatment
The other modes of treatment can also be effective in treating pruritus ani. Homoeopathy is a science which deals with individualization and considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly, the Ayurvedic system of medicine which uses herbal medicines and synthetic derivates is also found to be effective in treating pruritus ani.