Anal pruritus refers to a skin disease in which there is no primary skin damage to the skin around the anus but only pruritus. It occurs frequently in spring and is more common in young and middle-aged people between 20 and 40 years old. Some are the localized skin pruritus. Symptoms are more common in the elderly. It can be divided into primary pruritus and secondary pruritus. Primary pruritus has unknown causes and is not easy to treat; while pruritus confined to the anus is often secondary to anorectal diseases. After the cause is removed, it can often be cured.
The harm of anal pruritus
In the early stage of the disease, it is limited to the itching of the skin around the anus, sometimes severe and sometimes mild, sometimes stinging and sometimes burning, sometimes like insects and ants, sometimes like mosquito bites and grilling, sometimes itching is unbearable, and even worse at night, making people sit down Restless. Scratching makes the skin ulcerated, oozes, scabs, and does not heal for a long time, resulting in thickening around the anus, thick and rough wrinkled walls, showing radial folds, lichen change, pigmentation or depigmentation, and even spread to the perineum, scrotum, Labia or sacrococcyx. After being ill for a long time, it is easy to chap afterwards. Over time, it can cause neurasthenia, lethargy, lack of taste when eating, and sleeplessness at night.
Causes of anal pruritus
1 systemic factors
(1) Spicy food irritation: Excessive consumption of peppers, spices, and white wine can induce the disease.
(2) Allergic reactions: Certain proteins (fish, shrimp, crab, etc.), drugs, pollen, etc. can cause allergies to the human body and produce excessive histamine, which acts on the peripheral nerves and causes itching.
(3) Medical diseases: Endocrine disorders, accumulation of metabolites such as bile acid and urea in the body, malnutrition, certain blood diseases, etc.
(4) Mental factors: excessive excitement, depression or neurasthenia, etc.
(5) Drug stimulation: morphine, quinine, anesthetics, antibiotics, etc.
(6) Genetic factors
2 local factors
(1) Local friction, chemical fiber, cold and heat stimulation, etc.
(2) Abnormal secretion of sweat glands and sebum around the anus; indolin and scum in feces accumulate in the anal folds to stimulate the skin.
(3) Anorectal diseases: anal fistula, hemorrhoids, prolapse, anal sinusitis, anal papillitis, anal incontinence, etc. stimulate the anal glands, increase the secretion of glandular fluid, cause the anus to become wet, irritate the skin, and cause itching.
(4) Pinworm, Trichomonas vaginalis, vaginitis, enlarged prostate, etc.
What are the causes of anal itching:
Anal itching first find out the cause and then treat it. "Anal itching is characterized by intense itching and long duration, especially at night or in a humid environment, the itching is more serious, which seriously affects the normal life of the patient. When the itching is severe, scratches, blood scabs, pigmentation, lichen-like sclerosis and even secondary infections may appear on the local skin of the anus due to scratching.
Perianal itching is caused by damage to the nerve endings in the skin, so although the itching in the anus of the patient is unbearable, nothing can be seen with the naked eye. Patients should go to the hospital, and it is recommended to go to anorectal surgery first. Perianal itching is not difficult to treat. The key to the patient is to find out the cause, make a clear diagnosis, and treat the cause. Therefore, after discovering the condition, the patient must seek medical treatment in time, cooperate with the doctor to perform local and systemic examinations, through the doctor’s naked eye, digital anus examination, anoscopy, and if necessary, also perform parasitological examinations. Blindly use medication when you know the situation.
As far as perianal skin diseases are concerned, perianal eczema, neurodermatitis, ringworm, various warts, venereal diseases, hidradenitis and other skin diseases can cause anal itching. The most common of these is perianal eczema. Perianal eczema is mainly manifested as skin damage such as papules, blisters, and even erosions and exudates on the anal circle. It is often caused by severe itching and scratching, which causes the skin around the anus to thicken and moss, and the appearance is mostly grayish white. "The most common patient is due to intestinal mucus or a small amount of feces overflowing to the perianal skin, and it is not scrubbed in time, which stimulates the perianal skin and causes eczema." Director Shi Zhangshi said that for perianal eczema, wet cotton should be used after the stool. The ball is used to clean the perianal area and then gently wipe dry. Use non-medicated disinfectant talcum powder to prevent moisture. Loose a small cotton ball and place it on the anal edge to keep it fresh. Patients with more serious illnesses need anti-allergic treatment.
If the perianal skin is itchy caused by fungi, you need to take off the skin debris to look for fungal spores under a microscope. After the diagnosis is confirmed, topical antifungal drugs can be used. In severe cases or those with fungal infections in other parts, you can also use intravenous systemic drugs.
If you have a history of unclean sexual intercourse, you must go to the dermatology department of a regular hospital for treatment, because sexually transmitted diseases such as condyloma acuminatum and AIDS can also cause perianal and vulvar itching, so diagnosis and treatment must not be delayed.
1. Perianal eczema: Mainly manifested as skin damage such as papules, blisters, and even erosions and exudates on the anal circle. The skin around the anus is thickened and lichenified due to severe itching and scratching, and the appearance is mostly grayish white.
2. Viral warts: Anal genital warts or molluscum contagiosum can also cause anal itching. The former mainly manifests anal itching. The former is mainly manifested by the appearance of cauliflower-like or cockscomb-like warty growths around the anus, which are moist and dirty and have a foul smell; the form of the latter skin damage is round or hemispherical warty growths with a "belly button" in the center In addition to the perianal and scrotum, such depressions can also spread to the skin of the whole body.
3. Anal fissure and hemorrhoids: fresh anal fissures that have just occurred are mainly anal pain, itching and bleeding. Old anal fissures are mostly associated with a special hemorrhoids-sentinel hemorrhoids, which are itchy and painful. Anal fistulas are mostly ulcers around the anus. A fistula on the skin surrounding the anus, which is connected to the rectum and outside the anus, is left behind. The stimulation of the pus from the fistula can cause anal itching.
4. Local physiological changes of the perianal skin: the secretion of sebaceous glands is reduced, the skin lacks sebum moisturization, the skin is dry, and the skin folds around the anus are increased, and feces, sweat and dirt are easy to accumulate in it, often moist and unclean. This is easy for bacteria to breed, and chronic inflammation at the junction of the perianal skin and mucous membranes is prone to cause anal itching.
5. Parasitic infection: Enterobiasis can cause anal itching in a considerable proportion. When the anus relaxes at night, pinworms often crawl out of the rectum, lay eggs around the anus and mate, and cause anal itching due to irritation of the perianal skin, which is characterized by night itching. When suffering from scabies, if skin damage in the vulva spreads to the vicinity of the anus, it can also cause anal itching. In addition, trichomoniasis vaginitis can also cause anal itching due to the stimulation of leucorrhea.
6. Neurodermatitis: Neurodermatitis occurs in the sacrum or near the anus. It often causes anal itching. It is mainly manifested by the appearance of polygonal and fused papules on the local skin. Scratching and scratching often make skin lesions thickened. Mossized like bark.
7. Fungal infections: In the hot and humid season, people with obesity and sweating are prone to skin fungal infections that can cause moss or gluteal tinea, and often cause perianal itching due to the expansion of skin lesions and spread to the vicinity of the anus. Mainly manifested as circular or semi-circular or map-like erythema with clear borders on the inner thigh or buttocks, with a layer of white phosphorous on the surface. The diagnosis can be confirmed when the phosphate scraps are scraped and examined under a microscope, if fungal hyphae and spores are found.
How to prevent anal pruritus
1. Timely treatment of local and systemic diseases that cause anal pruritus, such as internal hemorrhoids, anal fissure, anal fistula, perianal eczema, diarrhea, diabetes, parasitic diseases, etc.
2. The underwear should not be too tight or too hard. It is advisable to wear pure cotton and loose fit underwear, do not wear artificial fiber underwear, and wash and change frequently.
3. Pay attention to the combination of work and rest, keep a happy mood, prevent excessive tension and anxiety, do not scratch the anus, do not wipe the anus with hard objects.
4. Keep the anus clean and dry, and clean the anus once every night as much as possible. Warm water should be used to clean the perianal area. Generally, soap is not used, especially strong alkaline. Towels, washbasins, etc. used for cleaning must be dedicated to avoid cross-infection.
5. Prevent constipation, eat more fruits and vegetables, drink more boiled water to keep the stool smooth, which can effectively excrete wastes in the body and prevent the exudate from the rectum from irritating the anus and causing itching. Do not eat or eat less irritating foods, such as chili, strong tea, coffee, high alcohol, etc. People with allergies should eat less foods that can cause allergies, such as fish and shrimps, and avoid contact with chemicals that cause allergies.
6. If the perianal itching does not stop but the skin is not damaged, gauze or absorbent cotton can be immersed in boric acid liquid at a suitable water temperature. Take it out and twist it until it does not drip. Apply it to the perianal area to stop the itching immediately. Apply once a day in the morning and evening, about 5 minutes each time. After application, wipe dry and apply talcum powder.
8. Adjust your diet, eat more green vegetables, fruits and other fiber-rich foods, fast or eat less foods and condiments that are irritating or can induce allergic reactions, such as spicy foods, strong tea and coffee, and strong alcohol.
9. Pay attention to hygiene, wash the anus with warm water after going to the toilet to keep the skin fresh and clean.
10. Avoid inappropriate self-treatment, such as scalding with hot water, topical high-concentration corticosteroids or containing anti-irritant drugs, self-purchasing some crude home physiotherapy equipment for self-treatment, etc. These methods do more harm than good. If it temporarily suppresses itching, it will cause the disease to prolong and increase over time. Patients should be advised to stop using it.
Chinese herbal lotion to treat itching
60 grams of Sophora flavescens, 15 grams of Cnidium, 15 grams of Kochia scoparia, 15 grams of white moss peel, 15 grams of Sichuan pepper, 15 grams of cork, 15 grams of cork, 10 grams of rhubarb, 15 grams of alum. Bathing, twice a day, can relieve symptoms in about a week. For those with obvious skin thickening, it is better to combine with 10 grams of peach kernel, 6 grams of safflower, and 12 grams of red peony. If long-term treatment is ineffective, or recurrent attacks, drug injection or surgery can be used, and the effect is very good. Perianal pruritus has a long treatment cycle, and it must be cured until the local skin damage is completely normal, otherwise the chance of recurrence is high