DEAR DOCTOR K:

I'm tormented by anal itching. What's causing it? And how can I make it stop?

DEAR READER:

Anal itching occurs when something has irritated the skin around the anus. For example, if the anal area isn't cleaned properly after a bowel movement, a small amount of stool may be left behind on the skin. This would cause the area to itch.

Certain foods or beverages can also cause anal itching. These include spicy foods, coffee, tea, cola, milk, alcohol, chocolate, citrus fruits and tomatoes.

Conditions that affect the anus can also lead to itching. These include hemorrhoids (particularly when they prolapse, or stick out through the anus), anal fissures and anal warts.

Some chemicals and medications that make contact with the anal area may also be to blame. Major culprits include dyes and perfumes used in toilet paper, feminine hygiene sprays, and medicated talcum powders, skin soaps and cleansers. Suppositories and anal ointments can also irritate the skin.

Finally, aggressive scrubbing can trigger anal itch. Cleaning after a bowel movement should be gentle.

You can treat most cases of anal itching by:

-- Thoroughly but gently drying the anal area after every bowel movement. Use unscented toilet paper or a clean cloth towel.

-- Dusting the anal area with non-medicated talcum powder.

-- Resisting the urge to scratch. The more you scratch, the longer it will take for the itching to go away.

-- Applying topical remedies such as zinc oxide or hydrocortisone ointment (1 percent).

If the area remains irritated after a month, call your doctor. Sometimes anal itch is a symptom of an infection. Perhaps the most common is a yeast infection, the same kind people often get in their groin or under their breasts. A less common infection in adults is caused by little worms called pinworms (this condition is more common in children).

Prevent future episodes of anal itching by:

-- Using only water (never soap) to clean the anal area.

-- Gently cleaning the anal area with wet toilet paper (unscented and dye-free) or a wet washcloth after every bowel movement. Wipe gently or blot the area.

-- Avoiding medicated powders, perfumed sprays or deodorants in the anal area.

-- Limiting foods and beverages that cause anal irritation.

-- Wearing cotton underwear that is not too tight.

-- Eating yogurt if you are taking antibiotics, to restore bacterial balance.

Anal itching is one of life's annoying little problems. Fortunately, it usually has a simple solution.

(Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.)

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