Itching

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Most people experience some soreness or itching around their anus (bottom) at some time. Fortunately for most of us this is only a temporary problem. But for some sufferers it can be a great ordeal. In most patients, Pruritus is due to inflammation (dermatitis of the sensitive skin just around the anus). The skin in this area is one of the most sensitive parts of the body. It is particularly prone to inflammation. This is not surprising because the area is frequently smeared with motion and is soggy due to perspiration.

Itching that occurs all over the body may indicate a medical condition such as diabetes mellitus, liver disease, kidney failure, jaundice, thyroid disorders (and rarely, cancer). Blood disorders such as leukemia, and lymphatic conditions such as Hodgkin's disease may sometimes cause itching as well. Some people may develop an itch without a rash when they take certain drugs (such as aspirin, codeine, cocaine); others may develop an itchy red "drug rash" or hives because of an allergy to a specific drug. Itching also may be caused when any of the family of hookworm larvae penetrate the skin. This includes swimmer's itch and creeping eruption caused by cat or dog hookworm, and ground itch caused by the "true" hookworm.

Specific itchy areas may occur if a person comes in contact with soap, detergents, and wool or other rough-textured, scratchy material. Adults who have hemorrhoids, anal fissure, or persistent diarrhea may notice itching around the anus (called "pruritus ani"). In children, itching in this area is most likely due to worms. Intense itching in the external genitalia in women ("pruritus vulvae") may be due to candidiasis, hormonal changes, or the use of certain spermicides or vaginal suppositories, ointments, or deodorants. It's also common for older people to suffer from dry, itchy skin (especially on the back) for no obvious reason. Younger people also may notice dry, itchy skin in cold weather. Itching is also a common complaint during pregnancy.

Itching is one of the easiest symptoms to detect in a child over three months of age, which is about when babies have the hand coordination they need to scratch. Children will rub, claw and pick at itchy areas until they are raw and bleeding. In many cases, they feel the itch and begin to scratch before any rash is visible. In eczema, for example, the rash typically appears after the child scrapes away at the itchy, dry skin. Itching is not a disorder in itself, but a symptom of another problem. Itching can develop as a small patch in a specific area or allover the body. Scratching will produce redness, bumps and even bleeding if the injury breaks the skin. Scratching can lead to infection.

If a skin rash or irritation goes with it, then itching is usually the result of a fungal, parasitic or scabies infection. It can also be part of an internal process such as chickenpox or measles; or a skin disorder, like eczema, psoriasis or dandruff. Allergies cause the skin to itch, even before an eruption appears. Excess toxins are eliminated through the skin, as it is the final detoxifying organ in the digestive process. Insect bites, especially from mosquitoes, or dry skin can be the problem due to a lack of essential fatty acids in the body, particularly in the elderly. In some cases, itchy skin can also be a sign of a more serious illness, like diabetes, leukemia or kidney failure, when other symptoms exist.

Itching can be a side-effect of prescription and over-the-counter drugs. Jaundice from the back-up of bile will cause the skin to itch and turn yellow. If confined to the anal area, the cause is constipation, fissures, hemorrhoids or worms, and if situated in the genital area, it is often the result of a vaginal yeast infection, although a sexually transmitted disease like trichomoniasis should be ruled out. Itching is an early symptom of shingles (herpes zoster), a condition more common in people over the age of sixty. Another cause of itching is a deficiency in B vitamins (especially biotin), vitamin A, iron, selenium, silicon, zinc, essential fatty acids and vitamin E. It is not uncommon to find itching the result of psychological causes related to stress, drug abuse, alcohol or tobacco excesses.

There are treatments available to reduce itching. Antihistamine medications such as hydroxyzine and diphenhydramine can be helpful. Another type of medication is topical corticosteroids such as hydrocortisone cream. Occasionally, oral corticosteroids such as prednisone are used for severe rashes. Other remedies such as calamine lotion are also available.

Treatment of the cause is also important, when possible. For example, antibiotics can be used to treat scabies. A thyroid hormone imbalance can often be corrected with medications. Surgery, chemotherapy, or radiation therapy may be needed to treat a tumor or cancer. Treatment of anal itching depends upon what is causing the problem. Gently wipe your anus well with toilet paper after having a BM. Use soap and water to wash between your legs each day. Dry this area well after washing. Wear cotton underwear and loose-fitting clothes. Do not use soaps or perfumes in the anal area that may bother your skin.

Antihistamines such as diphenhydramine (Benadryl) can help relieve itching caused by hives, but won't affect itching from other causes. Most antihistamines also make people sleepy, which can help patients sleep who would otherwise be awake from the itch.

Specific treatment of itching depends on the underlying condition that causes it. In general, itchy skin should be treated very gently. While scratching may temporarily ease the itch, in the long run scratching just makes it worse. In addition, scratching can lead to an endless cycle of itch--scratch--more itching. To avoid the urge to scratch, a person can apply a cooling or soothing lotion or cold compress when the urge to scratch occurs. Soaps are often irritating to the skin, and can make an itch worse; they should be avoided, or used only when necessary. Creams or ointments containing cortisone may help control the itch from insect bites, contact dermatitis or eczema. Cortisone cream should not be applied to the face unless a doctor prescribes it.