Itchy bum is an INCREDIBLY common symptom. We have a fancy name for it in colorectal….pruritis ani. Bit of a mouthful I know. I see lots of patients who suffer with this particular symptom. Commonly patients are referred to colorectal surgeons for treatment of this symptom as the assumption is that the underlying cause is likely to be haemorrhoids.

I have spent the Xmas break researching and reading deeper into other causes and novel new treatment options.

For those with haemorrhoids…absolutely we can treat your condition. The idea is that haemorrhoids that you may not be able to see, can leak mucus, faeces and blood continually throughout the day. Only a small dribble is enough to cause itchiness in the perianal skin. A wide range of treatments is on offer in my clinic however I stick to the ‘tried and tested’ treatments with a strong evidence base. By getting the basics right, the risk of recurrent haemorrhoids that I see and treat are low (<5% of 500 patients treated).

The problem with itchy bum however, is that the symptom can persist even after the haemorrhoids are treated. This happens because your haemorrhoids may have been a long term problem and the temptation to scratch the skin can lead to permanent changes in the very sensitive perineal skin. With time the skin thickens, becomes smooth/white/shiny and can split easily with further scratching.

Scratchy bum can ruin your quality of life. A bothersome symptom that niggles during the day and potentially interfere with your sleep. Even if you sleep through it, your partner may be aware and this can be embarrassing. Ultimately there could be a knock on effect on your intimate life as you may worry that friction, heat and moisture could make a bad situation worse.

For those wanting basic advice on the starter toolkit for tackling itchy bum, more information can be found here in my video about the condition;

Dermatologists have been treating itchy skin conditions for a very long time. In a bid to enhance my expertise, I have delved into their world to understand if any of their anti-itch strategies could work for the anus. I think itchy conditions around the anus are particularly embarrassing for patients to talk about. It can be that you have suffered for a long time with this condition making it more stubborn to treat.

Novel treatments for itchy bum include immune type oral medications, creams beyond steroids and injectables. We regularly use injectables around the anus for other conditions such as anal fissure and there has been exciting new evidence emerging that this type of treatment could be applicable for itchy areas (this injection works by reducing sweat and moisture around the anal skin to ‘dry the area up’). In addition colorectal surgeons are starting to use tattooing around the anus to numb nerve endings in a bit to reduce itchy symptoms (and no….you won’t have a permanently blue anus!). All of these treatments can be easily administered in clinic under local anaesthetic.

The other important issue to discuss is the how to break the cycle of scratching the area. This is REALLY HARD! Mostly because the practice happens at night and you may not be aware enough to consciously stop scratching. It’s a good idea to start with the basics – soothe the skin with a barrier cream and consider mittens overnight.

If you want to discuss or consider any of the tried and tested or more novel treatments for itchy bum, come and see us!