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Pruritis - Symptoms & Treatment

Pruritis is a synonymous terms with Pruritus and itching . the medical term for itching. Pruritis is intense itching sensation that produces the urge to rub or scratch the skin to obtain relief. Many patients have had an itchy anus sometime or other. The skin around the anus is sensitive and difficult to keep clean. Seepage of faeces and moisture are the commonest factors that cause this condition.Constant scratching to obtain relief can damage the skin (excoriation, lichenification) and reduce its effectiveness as a major protective barrier. Hair near the anus may aggravate the problem. Pruritiscan lead to loss of sleep, anxiety, and depression. Suffering from pruritus can also mean lost sleep, which can lead in turn to irritability and slower mental functioning. 

Symptoms of Pruritis

Itch, a raw feeling and occasional bleeding (caused by scratching) are the common symptoms. Diarrhoea necessitating frequent cleaning of the anus will irritate pruritus. Pruritis differs from urticaria which is associated with wheals, flares, and reddening. Nontheless, both conditions present with itching or pruritis. Stress, a change of living circumstances or a change in diet may make the condition worse. Diarrhoea necessitating frequent cleaning of the anus will irritate pruritus. Constant scratching to obtain relief can damage the skin (excoriation, lichenification) and reduce its effectiveness as a major protective barrier.

Causes of Pruritis

Several common complaints such as allergies, diabetes and inflammatory bowel disease may involve the skin around the anus causing pruritus. Haemorrhoids with associated mucous discharge may also be associated with this problem. In children, threadworms may be the cause. There are several internal diseases that may cause itch. The most common example is kidney failure.

  • Vulvar and vaginal problems in prepubertal females can cause
  • Intrahepatic and extrahepatic biliary obstruction
  • Common skin diseases can also cause
  • 2% of pregnant women have pruritus without any obvious dermatological cause.
  • Pruritus caused by systemic disease like Diabetes, Hyperthyroidism, Hypoparathyroidism, Myxoedema, etc.

Treatment of Pruritis

The ten golden rules of treatment are:

  1. after a bowel action use only the softest toilet tissue to clean the anus. It is better to use a dabbing technique rather than rubbing across the anus as most people do. You may prefer to use small moistened cotton wool pads rather than toilet paper.
  2. to remove any small particles of motion, the area can be kept thoroughly clean by washing with warm water (e.g. After each bowel action and/or before retiring at night).
  3. avoid rubbing with soap or applying antiseptics as this may increase irritation.
  4. ensure the skin around the anus is dry by gently dabbing with soft tissues, towel or cotton wool or ? using a hair dryer.
  5. if an ointment is not being used, a drying powder or baby powder can be applied but avoid perfumed talcum powder etc.
  6. do not use ointment unless prescribed by your doctor. Note that ointments containing cortisone should be used in small amounts and not for prolonged periods.
  7. choose sensible clothing (e.g. Cotton underwear rather than nylon briefs and generally avoid tight fitting garments).
  8. keep your bowels regular with a high fibre diet or fibre supplement.
  9. improvement follows diligence. If it recurs be patient and continue with the above measures.
  10. if these measures do not solve the problem you may need to see a skin specialist after consultation with your family doctor.
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