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Anal tattooing can be considered in patients with pruritus ani who have failed other treatment measures, become steroid-dependent, or in whom symptoms severely impact on quality of life. I am presently one of the few specialists in the UK able to offer this treatment option. This procedure is performed on a day-stay basis under general anaesthesia and involves several injections of diluted methylene blue a dye mixed with a local anaesthetic agent and a steroid in and around the anus. The whole procedure takes about 30 minutes. The tattoo itself lasts only a matter of weeks and the skin looks no different in the long term.

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