Pruritus Ani

What it is

Pruritus ani is intense, persistent itching in the skin around the anus, which tends to worsen at night and after bowel movements, creating a cycle of scratching and irritation that's hard to break. It can be secondary to hemorrhoids, fissures, fistulas, fungal or parasitic infections, dermatitis, allergies to hygiene products, moisture or even excessive cleaning; in many cases, though, no specific cause is found and the problem is called idiopathic pruritus ani. At Femi Saúde, the coloproctology team calmly investigates the possible causes, examines the area with anoscopy when necessary, and proposes a plan of skin care, lifestyle adjustments and treatment of the underlying cause, without embarrassment.

Most common symptoms

• Intense itching around the anus
• Worsens at night and after bowel movements
• Burning and redness of the skin
• Thickened or cracked skin from scratching
• Moisture or minor stool leakage
• Difficulty sleeping because of the itching

Causes and risk factors

• Moisture and stool residue on the skin
• Excessive hygiene or irritating products
• Hemorrhoids, fissures or fistulas
• Fungal infections, pinworms or HPV
• Dermatitis, psoriasis and allergies
• Irritating foods and caffeine

How it is diagnosed

The visit begins with a detailed conversation about hygiene habits, products used, diet, medications and associated symptoms. The coloproctologist examines the perianal skin for signs of dermatitis, infection or lesions, and performs a digital rectal exam and anoscopy to identify hemorrhoids, fissures or fistulas that might be keeping the area moist. In selected cases, a stool test, a skin scraping for fungi, or a biopsy is requested when the skin shows persistent or atypical changes.

How we treat it at Femi Saúde

The foundation of treatment is breaking the itch cycle: cleaning with water instead of paper, patting dry without rubbing, avoiding scented soaps and wet wipes, wearing cotton underwear, and keeping stools well formed with fiber and water. Barrier creams or, for a short period, topical corticosteroids help soothe the skin. Alongside this, the coloproctology team at Femi Saúde treats the identified cause, whether an infection, a hemorrhoid or a fissure, and monitors the response, adjusting the plan until the itching is under control.

What we offer