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Itchy Bottom Syndrome AKA Pruritis Ani or Anal Itching

Q. A year ago I read in your column about a woman who complained of anal itching. I too had this problem until a kidney specialist recommended using witch hazel. This is a simple solution for a vexing problem.

A. The woman you referred to wrote to us with the following question:

“What can I do for itching of the anus? I have had it for some time and it is driving me crazy. This biting and itching feeling is embarrassing and most of the time the drugstore hemorrhoid remedies don’t stop it.”

Dermatologists tell us that “pruritis ani,” also known as itchy bottom, can be caused by many factors. Coffee, citrus fruit and beans may aggravate this condition, as can tight clothing. Perfumed toilet paper and clothes washed in fabric softener may also contribute. People who are overweight are more likely to suffer.

The usual remedies are greasy ointments or cortisone creams. These are likely to make the problem worse because they increase moisture in the area. Although it is difficult, try to avoid scratching, as it can set up a vicious cycle that leads to more intense itching.

Good hygiene, though, is the best solution. A far better solution would be to prevent the itch in the first place. The French have it way over us with their use of the bidet. We cannot think of a better way to solve this problem.

An alternative would be to gently wipe with 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.

If the itching does not go away, a dermatologist may be able to determine the underlying cause.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.”.
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