More than six in ten men in the UK have experienced the discomfort of anal itching, according to a new study, highlighting a surprisingly common yet rarely discussed health issue.
The research, commissioned by the healthcare brand Anusol, found that 61% of UK men have dealt with pruritus ani – the medical term for the symptom – at some point in their lives. This figure is notably higher than the prevalence indicated in wider medical literature, which suggests the condition affects 1-5% of the general population. Men are far more likely to be affected than women, at a ratio of approximately four to one, with the issue being most common in adults aged between 40 and 60.
Despite its prevalence, awareness is low. The Anusol survey revealed that just 12% of men had heard the term pruritus ani, with 43% having no idea what it meant. Even among those experiencing symptoms, only 34% correctly identified them. This gap in understanding can lead to mismanagement and embarrassment; more than a quarter (26%) of the men polled said they had avoided buying treatment due to awkwardness, and 39% admitted they usually do nothing to manage their symptoms.
Ian Budd, lead prescribing pharmacist at Chemist4U, notes that the symptom can be overlooked. “People tend to focus on the itch itself rather than the underlying cause,” he said, adding that embarrassment often delays people from seeking advice.
A symptom with many potential causes
Pruritus ani is not a condition in itself but a sign of an underlying issue. The itching can range from mild to intense, often worsening at night or after a bowel movement, and may be accompanied by soreness, redness, or irritated skin, especially if scratching occurs.
The causes are numerous and varied, falling into several broad categories. A primary cause can be hygiene-related, either through excessive or inadequate cleaning. Over-washing with harsh or perfumed soaps can strip the skin’s natural barrier, a problem sometimes called “polished anus syndrome.” Conversely, moisture from perspiration or residual stool, exacerbated by tight clothing or prolonged sitting, is also a major irritant.
Diet plays a significant role, with certain foods and drinks taking 24 to 36 hours to manifest as symptoms. Common dietary triggers include caffeine, spicy foods, alcohol, citrus fruits, tomatoes, dairy products, and nuts.
Numerous anorectal and skin conditions can also be responsible. These range from common issues like haemorrhoids, anal fissures, and skin tags to eczema, psoriasis, and contact dermatitis in the perianal area.
Infections are another key cause. These can be fungal (like Candida), parasitic (such as threadworms, which are particularly common in children), bacterial, or sexually transmitted infections including herpes, HPV, gonorrhoea, and chlamydia.
Furthermore, the symptom can be linked to certain medications like some antibiotics, or systemic diseases including diabetes, thyroid disorders, and chronic kidney disease. Psychological factors, such as anxiety and stress, can both contribute to and be worsened by a persistent itch-scratch cycle.
Managing and preventing symptoms
Prevention and management focus on addressing potential triggers and maintaining gentle care of the area. Experts advise wearing loose-fitting, breathable cotton underwear and using gentle, fragrance-free products for cleaning. After washing, patting the area dry thoroughly is crucial; some recommend using a hairdryer on a cool setting.
It is important not to over-clean, as harsh soaps or excessive washing can worsen irritation. Identifying and avoiding personal dietary triggers can help, as can maintaining regular, formed bowel movements to prevent leakage or soiling.
For those seeking relief, over-the-counter products like barrier creams or those containing zinc oxide can soothe and protect the skin. The Anusol range includes products like Anusol Natural Cream, formulated with ingredients like menthol and witch hazel. Some products, such as Anusol HC, contain the mild steroid hydrocortisone, which pharmacists like Ian Budd warn should not be used for longer than seven days without medical advice due to the risk of skin thinning.
If self-care measures fail, medical treatment is directed at the specific underlying cause. A GP may prescribe stronger topical corticosteroids, antifungal or antibiotic creams, or recommend treatment for conditions like haemorrhoids or threadworms. For persistent cases, a GP might perform a physical examination and could refer a patient to a dermatologist or colorectal surgeon.
Medical advice should be sought if itching persists for more than a few days, keeps returning, or is accompanied by pain, bleeding, discharge, or a change in bowel habits. It is also recommended to see a doctor if the symptom is significantly affecting sleep or causing anxiety.