Q. Unless you have had pruritus ani, you have no idea how it affects your whole life. Anal itching is absolutely like being tortured. You itch with an uncontrollable desire to scratch, whether on an airplane, in your office, walking down the street or wherever life takes you.
I have written you to suggest that you tell your readers that they check in depth on their medications. You have never mentioned it. Doctors haven’t a clue as to what causes it, yet have suggestions for treatment that never help. In some cases, it’s just more medication.
Honestly, would it be a surprise that a medication could cause this horrific symptom? Of course not!
Your suggestion of using a bidet and washing and blow drying sounds oh, so nice, but there would be only momentary relief at best. The itching continues on a squeaky clean or a very dirty anus. It just never stops.
In my case, the culprit was lansoprazole (Prevacid). Since Prevacid went OTC, anal itching or pruritus ani isn’t listed now in the PDR as a side effect, but from my experience, it is a definite side effect.
I determined FOR SURE my cause was Prevacid by eliminating my meds one at a time for three days. Within two days of eliminating Prevacid the itching stopped. That was at least 10 years ago. I have never taken it again and I have never had anal itching again.
Please, please, help these people who write to you. Suggest at least temporary elimination of meds, one at a time and for a short time and under a doctor’s supervision if you must, to see if it makes a difference. I was desperate and it changed my whole life!
I love your newsletters and always look forward to their arrival in my inbox. Thanks for all that you do for we mortals who need so much help.
Ann B.
A.
This is a very helpful suggestion for determining if a medication might be causing the problem. You are probably aware that anal itching or pruritis ani is not often listed as a side effect of medications. We suspect that researchers rarely inquire about itchy bottom symptoms when they conduct clinical trials.
When we searched the Physicians’ Desk Reference, we only found a few medications linked to this side effect. To our surprise, esomeprazole (Nexium), a relative of lansoprazole (Prevacid), is one of them. This certainly suggests that other drugs in this class (PPIs) might also occasionally trigger pruritis ani.
There are a number of other things that can also contribute to itchy bottom syndrome (aka pruritis any or anal itching). Some people are sensitive to certain foods such as citrus fruit, coffee or even beans. Others report that clothes washed in fabric softener cause unbearable itching. This is especially true if the clothes are tight or restrictive in the crotch area.
A drug company marketing guru once told us that people often call pruritis ani hemorrhoids because it is slightly more acceptable. He also hinted that many hemorrhoid creams are really treating the itch-scratch-itch vicious cycle of pruritis any.
We do recommend a bidet for hygiene reasons. We also encourage those afflicted to try witch hazel. Thanks to our Native American forebears, we have this wonderful herb which has been used for centuries as an astringent and cleansing agent. There are many wipes available, (including Tucks Pre-moistened Hemorrhoidal Pads and Preparation H Cleansing Pads) which contain a dose of witch hazel. While convenient, you pay a price for the ease of having pads pre-soaked in witch hazel. If you want to save some money, buy a large bottle of witch hazel. The cost is relatively low. Apply liberally to toilet tissue, gently wipe, and go about your business.
Visitors to this website have also recommended their own remedies including some very reminiscent of the person above who eliminated Prevacid and got almost immediate relief:

“On the subject of anal itching, I suffered this embarrassing problem for years and went to several doctors about it. They had no good suggestions except to eliminate many things from my diet. Nothing helped.
“I finally went to the Internet and did in-depth research on the side effects of all the prescription meds I was taking and BINGO….. the purple pill (Prilosec or omeprazole) can cause anal itching. I stopped taking Prilosec and the itching stopped immediately.
“Unfortunately most doctors don’t ever consider that prescription medications can cause problems. Good luck.”
AWB


“A treatment for anal itching that my mother told me about after I had a flare up because of an itchy inflamed hemorrhoid was a very VERY careful dab of Vicks on the area which had been cleaned well. Instant relief!”
Loretta

PEOPLE’S PHARMACY RESPONSE:

Some folks with hemorrhoids have tried the Vicks trick and have told us it felt like napalm on their behind. The burning was instant and intense. We caution anyone who considers this to be very cautious!


“I use Pampers Sensitive baby wipes to clean with, they are extra soft and scent free. I read on your site about the woman who used a wet tea bag to calm her itch. I’ve tried it and it works. I used a green tea bag, not only did it stop the itch but seemed to heal the painful spots.”
Gin


“Try cutting out all caffeine & you may see all itch disappear. Worked for me after decades of discomfort.”
G.P.


“Good day to all… I have been suffering with this problem for almost 2 years. I tried everything over the counter, under the counter, homes remedies. I decided to look at other possible causes to this. I did a search for Anal yeast infections and it turned out to be my problem.
“I had a yeast infection which was causing anal fissures. It also cause the tireless itch and constant burning. I had hemorrhoids at first and I used medications for that and the internal pain went away, but the pain and itching and burning on the outside didn’t.
“So I asked my doctor if it was possible and that I had a yeast infection there and she said that it was not talked about a lot among men but it is quite common. She gave me medication to treat the yeast infection and it went away.
“The fissures healed up and the itching and burning are gone. I wanted to wait to be sure before I posted anything about this, so I can assure you that I am cured. Yeast infections are caused by a fungus just like Athlete’s Foot, and we all know what athlete’s foot feels like right? I hope this can bring relief to some if not all of you. Good luck”
A.C.


“I had this all my life and discovered the solution with a Hand Bidet Sprayer = it allows you to get clean (cleaner!) than using toilet paper and without irritation the sensitive skin with all the rubbing plus helps keep the natural oils in your skin that you need to keep it from drying out and itching!”
David

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  1. Jillery
    Reply

    Thank you thank you thank you. I had what I called ‘cranky crotch’. It was always easy to get a yeast or vag infection or I would develop what I would call ‘hot spots’ (those of you with dogs can laugh now). Outside my labia closer to the bend in my leg I would get itchy spots that I could swear I could feel crack. The skin was always compromised.
    When I read this about baby wipes I stopped using them (At times I could get itchy around my anus too). Well it’s been over a week and a half and no itchy problems anywhere. I gone to the gyno with this problem on and off for a number of years too. She’d take scrapings and after the results would shrug her shoulders. She was thrilled when I told her about the baby wipe issues. She WILL share with other patients too. Thanks!!

  2. KBC
    Reply

    Last night I tried the dab of Vicks trick based on one writer’s suggestion, and so far the itching has decreased a bit. This condition is agonizing. I wish there was a real fix to end it forever.

  3. Martha
    Reply

    My husband was prescribed Decadron and starting having pruritus ani. He had battled athlete’s foot several times, and itching/rash in his armpits once or twice (tight, synthetic material shirts made it worse)…I’m sure all of these symptoms are fungal in nature. If I had known then what I know now, I would have suggested he take anti-fungal pills and colloidal silver, and not eat sugar and yeast (breads), which feeds the fungal/yeast infections. I want to share this with others, in his memory, so that it will be helpful.

  4. kem
    Reply

    Update from yesterday: On recommendation from buyer of natural and homeopathic remedies at my local grocery, am using the following routine: cleanse the area with witch hazel, spray with colloidal silver, apply calendula ointment. Making a great difference. Relief! Symptoms not perfectly gone, but very much reduced and intermittent. Slept for 3 hrs last night, got up, reapplied the sequence of remedies, then slept peacefully again for another 4 hours. Am hopeful that this will continue to provide relief and ultimate healing.

  5. kem
    Reply

    Thank you for all this information. I have been experiencing this challenge for about 2 months. My primary care doc doesn’t seem to be interested beyond lotions that do not really have any lasting effect beyond the first 5-10 minutes. In desperation I have turned to my memory of past skin issues and have been sponging the area with a dilute solution of Bragg’s apple cider vinegar (which someone else has suggested also). First full night’s sleep without waking up due to burning itching in about 2 months! I recommend it.
    Also have thought I would love to have the opportunity to try a bidet. I think that might help.

  6. KSF
    Reply

    I have suspected Prilosec, Zegerid, and Prevacid have been the cause of the anal discomfort I have been experiencing. Unfortunately nothing else controls the reflux. I play the game of alternating between taking the pills for a few days, dealing with the itching and leaving them alone and trying to get by with just Tums or baking soda. I am glad to see others have come to the same conclusion. I thought I was crazy since the doctors I had spoken to didn’t seem to think it was likely.

  7. SH
    Reply

    I’ve had the same issue on occasion and thought it might be a yeast infection as I have a tendency to get vaginal yeast infections. Every time it has gone within a day after using athlete’s foot cream. Vaginal anti-fungals did not work at all. If you have anal itching, definitely try this first. The itching is so uncomfortable and it gets rid of it so quickly.

  8. jb
    Reply

    Hi Betty….read your Yeast solution post from August….are you cured? My affliction is recent, and I’m pretty confused about all the solutions…and non-solutions I’m reading online. thanks…..

  9. Mo
    Reply

    Aloe Vera gel straight from the plant works for me. Only get the itching when I’ve had too much caffeine from drinking black tea. That is the one plant everyone should have in their home!

  10. Betty France
    Reply

    Yeast infection! Yeast infection! I used stuff intended for athletes’ foot, and got rid of it for good. It has plagued me for ten years prior. Yeast infection, or fungus. But it is gone!

  11. Jj
    Reply

    I could kiss you!
    My wet wipes just went in the trash!
    I called Kimberly Clark and ripped them a new one! (No pun intended)
    Thanks for the info!
    That picture on the link cinched it for me! That’s me!

  12. T.R.
    Reply

    Wet Wipes Were The Culprit!!! There’s a known allergen in many brands of wet wipes called Methylchloroisothiazolinone/Methylisothiazolinone. It’s a preservative. It’s also known as MCI/MI, so you can google search on “MCI Allergy.” My anal itching worsened for many months in spite of everything I tried in an attempt to make it better. I modified my diet (lost 15 pounds,) tried numerous creams and ointments, natural remedies, sitz baths, etc. I’ve always cleaned thoroughly and gently. I thought using wet wipes had to be a good thing, and I never even considered they might be the cause of my itching. My itch was deep in the tissue around the rectum and so bad that several times I could not resist the urge to scratch the skin open.
    At its worst it looked like I’d sat on flaming charcoal! It was waking me during the night and keeping me up. I was a walking zombie at my new job, and I almost dozed off while driving! I started sleeping on ice packs, which greatly helped so long as the anus was nearly frozen – anything to stop that horrible itch and burning. Last week at 3am I fell to my knees and cried to God for an answer. When I stood back up, I refined my Google search and this is the link I found immediately following that desperate prayer:
    JAMA Dermatology
    The Hazards of Moist Toilet Paper
    Allergy to the Preservative Methylchloroisothiazolinone/Methylisothiazolinone
    http://archderm.jamanetwork.com/article.aspx?articleid=210124
    The article also said that many wet wipes contain the allergen, and that there are other allergens in wet wipes. It’s been 10 days since I stopped using Huggies wet wipes for sensitive skin, and I am about 95% better. My skin is healing so fast I can hardly believe it. I’m furious to find out this known allergen is one of the chemicals in these wipes, and they market this stuff for babies!!!

  13. RBL
    Reply

    Since I developed this issue a few years ago I have tried everything to stop the excruciating itching down there day and night. My doctor gave me some hygiene tips and prescribed a steroid cream that helped but I didn’t continue using (because I don’t really like to use steroids on my body). I recommend avoiding powders because they tend to dry out the area-they did for me anyway.
    Like many people on this thread there is no single road map to fix this issue because it has so many causes. I did find a natural spray that made a difference. It has mostly kept the problem away since I started using it a month ago. I am also seeing an allergist

  14. J.L.
    Reply

    Anal itching can be helped if not cured by the diaper rash ointment which contains Vitamins A and D plus Zinc Oxide.

  15. DS
    Reply

    I will use this forum to air my pet peeve about hotels. Does it bother anyone else that maids feel they must fold the toilet paper end to a point? I always discard several sheets since that paper is going to touch an intimate part of my anatomy. It doesn’t make the room cleaner–it makes it dirtier! Likewise with the tissue boxes. They fold it down rather than leave a nice clean tissue popped up. I cringe every time I see this. Do the hotel managers TELL them to put their hands all over my paper products? I’d rather they disinfect phones and TV remotes and faucets and doorknobs.
    I mentioned it here since someone mentioned throwing away the first several sheets due to the cornstarch on them.

  16. Liz H
    Reply

    I’m not surprised that Prevacid and yeast infections are both implicated here. The acid in the stomach is necessary to start the digestion process. When poorly digested food hits the colon, it’s a feast for the yeast that normally resides there.
    Often our acid indigestion is caused by a lack of stomach acid causing the food to remain too long in the stomach. I took prescription prilosec and then prevacid for years, until a nutritionist recommended that I swallow a betaine (HCL) capsule when I ate protein. Within a few days my esophagus and stomach felt better than I had with all the years on the purple pills.

  17. MF
    Reply

    I use Braggs Apple Cider Vinegar. Excellent for all skin problems.

  18. spayneuteryourpets
    Reply

    Yeast infection. Vinegar

  19. cg
    Reply

    I lived in Paris and/or just kilometers west and although I had a car – did a LOT of walking and my hemorrhoids disappeared – but I never learned to use a bidet and we had several in our apartment (VERY unusual unless things have changed enormously) but maybe it had been used with several couples living together
    I really tried to figure it out and I’m not stupid nor brilliant (IQ148)
    oh yes, some ways, but water running down my legs very unappealing.

  20. DS
    Reply

    Coconut oil.

  21. JBR
    Reply

    I have to take Prilosec, otherwise it hurts when food enters my stomach.
    Along with taking it I get anal itching, and use a steroid cream (prescription) intermittently to keep comfortable. My belief is that pills beget more pills to treat the side effects, so stay off medication if you can!

  22. S.J.
    Reply

    Herpes can cause it too. Even without a breakout I found that while on suppressive therapy (taking Valtrex daily regardless of symptoms)eliminated two problems. Leakage and pruritus. Seems to be a low level (sub-clinical) inflammation caused by the HSV virus…

  23. Donnie
    Reply

    I have severe corn and sulfite allergies, and the cornstarch on most bathroom tissue packaging will trigger serious itching and even a rash. I have to throw away the first several sheets of paper that was in contact with the plastic package, and the last several sheets because of the glue on the cardboard tube. Bathroom tissues with fragrance, dyes or lotions can also cause the itching. Laundry products used on underwear are often the culprit, especially anything with fragrance chemicals. And so are soaps that people use to wash their bodies. Fragrance and chemical free soaps and laundry products are much safer and less likely to cause itching. Food allergens are notorious for causing the itching, too. And so is nickel allergy. There are many other causes, so keep looking for the culprit.

  24. Mary C
    Reply

    I had anal itching for YEARS. Later I developed itching all over my body – especially behind my ears. I , and many doctors, suspected food allergies. Zyrtec helped some, but I wanted to find out what CAUSED my itching. It took me about 5 years and 10 doctors to finally figure out what I was allergic to (beef, lamb, all dairy products and cane sugar). The doctor who helped me in the end also discovered that my body does not make betaine hcl. I avoided all my problem foods and started taking betaine hcl and probiotics daily. My symptoms were reduced by about 95% – the anal itching was completely gone!
    I happily discovered that I now do just fine eating citrus fruits & peanuts – those WERE foods that aggravated my anal itching. Now with betaine pills and occasional probiotics, it feels like my body can digest all food much better. I’m not an itchy person any more! Do follow directions on the betaine bottle – take with meals, don’t take with very light meals or snacks, such as a salad.

  25. B.T.
    Reply

    I occasionally get exterior anal itching. The remedy that works for me is to clean the area well with soap and water, then apply ordinary hemorrhoidal ointment. One application usually eliminates the itch and pain discomfort. This doesn’t address the cause, but some of the ingredients get rid of the pain.

  26. TK
    Reply

    I get an anal itching when I take any drugs containing sulfa. Apparently, I am allergic to sulfa.

  27. Betty F.
    Reply

    I had such an itch for several years and no home remedies worked. It got worse when I went on a long trip and wore mini pads and rode in a car all day. One night in desperation I used my athlete’s food cream and thought I had been hit by a blow torch. I jumped and screamed and hopped and finally washed it as best I could. BUT BUT the itch was gone! No more itch.! Was it a fungus or a yeast? Why not! It had all the right conditions. If I feel it trying to return, I repeat the treatment, but a little more carefully.

  28. SJ
    Reply

    Here’s another cause of anal itching: low thyroid,which causes dryness. I suffered with this and many other symptoms for years before the cause was identified. This was in the 1980’s, before thyroid testing was as common as it is today.

  29. PK
    Reply

    I read People’s Pharmacy all the time and find their cures amazingly affective. What can be done to shrink or remove hemmoroids?

  30. Rem
    Reply

    If you’re going to use Tucks or other pads, avoid flushing them down the toilet. They ultimately do degrade, supposedly, but not rapidly, and they can collect in the pipe system and cause serious backups. It can take many months before the clog finally is obvious, so it’s easy to think that flushing them is o.k. and not making a problem. But the plumber that cleaned out our pipes says he encounters problems with pads regularly.

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