What causes anal itching? Learn about the 15 possible reasons for an itchy anus and how to get relief.

Understanding Anal Itching: What Causes It?

Anal itching, also known as pruritus ani, is a common and often uncomfortable condition that affects the skin around the anus. While it can be a frustrating and embarrassing problem, understanding the potential causes can help you find relief. Here are 15 possible reasons why your anus may be itching:

1. Poor Hygiene

If you don’t wipe properly after a bowel movement, leftover fecal matter can irritate the sensitive skin around the anus, leading to itching and burning. To prevent this, gently clean the area with unscented, dye-free toilet paper, pat it dry, and avoid using harsh soaps or other irritants.

2. Diet and Lifestyle Factors

Certain foods and beverages, such as coffee, tea, cola, energy drinks, beer, chocolate, nuts, citrus fruits, tomatoes, spicy foods, and dairy products, can trigger or worsen anal itching. Additionally, tight-fitting synthetic fabrics can trap moisture and lead to irritation.

3. Hemorrhoids

Swollen veins in the rectum or anus, known as hemorrhoids, can cause burning, itching, and pain, especially during bowel movements. Soaking in a warm sitz bath, increasing fiber intake, and staying hydrated can help provide relief.

4. Anal Fissures

Tiny tears or cracks in the lining of the anus, called anal fissures, can cause pain and itching, particularly after a bowel movement. Constipation and diarrhea can both contribute to the development of fissures.

5. Anal Fistulas

An anal fistula is a small tunnel that connects the anal canal to the skin near the anus. Leakage from the fistula can irritate the surrounding skin and cause itching and discomfort. Conditions like Crohn’s disease, cancer, or trauma can increase the risk of developing an anal fistula.

6. Fungal and Bacterial Infections

Fungal infections, such as those caused by Candida (the same fungus responsible for yeast infections), and certain bacterial skin infections can lead to anal itching. Staph infections and streptococcal bacteria can also trigger an itchy rash around the anus.

7. Anal Warts

The human papillomavirus (HPV) can cause the development of anal warts, which can be itchy and may spread to the genital area. If left untreated, anal warts can increase the risk of anal cancer.

8. Pinworms

Pinworms are tiny parasitic worms that can infect the digestive system, often through contaminated food or surfaces. The female worms lay their eggs around the anus, which can cause intense itching, particularly at night.

9. Scabies

Scabies is a skin condition caused by a tiny mite that burrows into the top layers of the skin to feed. The resulting rash and itching can affect the anal area and is highly contagious, often spreading through close contact or shared personal items.

10. Eczema

Eczema, a chronic skin condition characterized by red, itchy, and inflamed patches, can also occur in the anal region, leading to discomfort and irritation.

Seeking Medical Attention

If you’re experiencing persistent or severe anal itching, it’s important to consult a healthcare professional, such as a dermatologist or gastroenterologist, to determine the underlying cause and receive appropriate treatment. Attempting to self-diagnose or treat the issue without medical guidance can sometimes lead to worsening of symptoms or the development of more serious complications.

Improving Hygiene and Lifestyle Habits

In addition to seeking medical care, there are several steps you can take to help alleviate anal itching and prevent future occurrences:

• Gently clean the area with unscented, dye-free toilet paper or a soft, damp cloth after bowel movements.
• Avoid using harsh soaps, perfumed products, and medicated powders, as these can disrupt the skin’s natural barrier.
• Wear loose, breathable, all-cotton undergarments to prevent moisture buildup.
• Stay hydrated and increase your fiber intake to maintain regular bowel movements and prevent constipation or diarrhea.
• Identify and avoid any dietary triggers that may be contributing to your anal itching.

By addressing the underlying cause and implementing lifestyle changes, many individuals can find relief from the discomfort of anal itching. However, if the condition persists or worsens, it’s essential to seek medical attention to ensure proper diagnosis and effective treatment.

Why Does My Anus Itch? 15 Causes of Anal Itching

Medically Reviewed by Nayana Ambardekar, MD on November 02, 2021

An itch around your bottom is uncomfortable and sometimes embarrassing. If you have anal itch, it may be hard to fight the urge to scratch. But scratching will only make the problem worse. Doctors can’t always find a reason for it, but some health problems or habits, or your diet, may trigger it.

If you don’t wipe well after you poop, what’s left behind can cause itching and burning. Gently clean the area with a wet piece of dye-free, unscented toilet paper. Pat dry with a soft cloth or toilet paper. If the area is very irritated, use a hair dryer set on low to dry it. (Be sure to hold the dryer a safe distance away.)

Wiping too hard can cause itching or make it worse. Don’t use soap, hot water, medicated powders, perfumed sprays, or deodorants, either. They can destroy the oily skin barrier that protects this sensitive area.

If you drink coffee, you may be more likely to have anal itching. That cup of joe may loosen your anal muscles, and that can let stool leak out, triggering itch. Other things that may cause anal irritation or itching include:

• Tea and cola
• Energy drinks and beer
• Chocolate and nuts
• Citrus fruits and tomatoes
• Spicy foods
• Dairy

If yours are tight or made of synthetic fabrics, you might have a moisture problem down below. Switch to well-fitting all-cotton ones. They absorb better. Change them every day or anytime they get damp, like after exercise. Wash them in fragrance-free detergent.

Passing lots of watery ones and wiping often can irritate the area. You also can itch and have pain if you’re constipated. More fluids and fiber in your diet can help keep you regular. If that doesn’t work, talk with your doctor. They may suggest other diet changes or medications to get things back on track.

These are swollen veins in your rectum or anus that can burn and itch. Straining when you poop or pressure during pregnancy can cause them. Sitting in warm water (a sitz bath) for 15 minutes several times a day may help. Try one after you poop. Drink plenty of water daily and get fiber in your diet so stools are softer. Call your doctor if you notice blood or have pain during a bowel movement so they can rule out more serious conditions.

Tiny cuts or sores (fissures) can open up inside your anus and cause pain and itching. You’re more likely to get these if you’re constipated and a hard or large stool tears the lining. Other causes include long-term diarrhea and an inflammatory bowel disease called Crohn’s disease.

This is a small tunnel that connects the anal canal to an opening in the skin near the anus. Fluids can leak out and irritate the skin, which triggers pain and itch. Crohn’s disease, cancer, trauma, and radiation can raise your chances of infections and fistulas. If you think you may have one, see your doctor.

A fungus, like the one that causes most vaginal yeast infections, can also cause anal itching. And certain kinds of bacteria can, too. For example, a staph skin infection can happen almost anywhere, including the area around your anus. And the same kind of bacteria that causes strep throat can trigger a red, itchy rash around the anus. This is more common in kids than adults.

The human papillomavirus (HPV)  is a sexually transmitted disease that causes anal warts. They grow inside and around your anus and may spread to your genitals. Itching is a common symptom. If you think you have anal warts, see your doctor. Without treatment, they can grow large and more may show up. Untreated warts can make you more likely to get anal cancer, too.

You may not want to know about this one. It happens when you swallow the eggs of tiny worms. They get in your digestive system through contaminated food and things like bed linens, bathroom fixtures, toys, and sandboxes. It’s more common in children. The itching usually happens at night, when a female worm lays eggs around the anus. You may see them in your underwear or in the toilet after a bowel movement. They look like tiny pieces of white thread. If you or your child has pinworms, your whole family may be treated for them.

A tiny mite nicknamed the “human itch mite” causes this rash. The bugs burrow into the top layers of your skin to feed. People usually get scabies from skin-to-skin contact. It spreads quickly where people spend a lot of time close together, like in day-care centers, dormitories, and nursing homes. Sharing clothes, towels, and bedding can spread it, too. Like pinworms, your doctor may suggest treating the family if one member has it.

If you have this skin condition, it’s possible to get patches of it where the sun doesn’t shine. The skin around your anus may be red but not scaly. It can itch like crazy, and you may have pain during bowel movements, too. Other skin conditions, including eczema and seborrhea, can cause anal itch as well.

You may need them to treat an infection, but some can kill the “good” bacteria that live in your bowels. You need those to keep your gut in natural balance, so diarrhea can be a common side effect. You also may be more likely to get a yeast infection while taking antibiotics. Ask your doctor if eating yogurt or taking a probiotic supplement may help.

Conditions that affect your whole body can affect your rear end. These include:

• Type 2 diabetes
• Leukemia and lymphoma
• Kidney failure or liver disease
• Hyperthyroidism (overactive thyroid)
• Anemia (not enough iron in your blood)
• Anxiety and stress 

If your bottom is bothering you, and the itch doesn’t go away, see your doctor to find out what’s going on.

IMAGE PROVIDED BY:

1. Thinkstock Photos

SOURCES:

American Society of Colon and Rectal Surgeons: “Pruritis Ani Expanded Version,” “Hemorrhoids: Expanded Version,” “Abscess and Fistula,” “Anal Warts.”

Harvard Medical School: “Anal Itch (Pruritus Ani).”

Cleveland Clinic: “Pruritus Ani (Anal Itching),” “7 Best and Worst Home Remedies for Your Hemorrhoids,” “Anal Fistula.”

National Health Services (UK): “Itchy bottom — Causes,” “How to ease an itchy bottom yourself,” “Anal Fissure. ”

University of Michigan: “Rectal Problems, ” “Hemorrhoids.”

KidsHealth.org:  “Staph Infections,” “Pinworms.”

American Academy of Dermatology: “Scabies.”

U.S. National Library of Medicine: “Scabies.”

National Psoriasis Foundation: “Genital Psoriasis.”

DermNet New Zealand: “Perianal streptococcal dermatitis.”

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Anal Itching: Causes & Treatment

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Causes of Anal Itching

Información en español

Anal itching, also known as pruritis ani, has many different causes.  If you have anal itching, you should get a rectal exam to evaluate the cause. You may need a skin biopsy and referral to see a dermatologist. Causes of anal itching include:

• Stool and excess moisture on the skin around the anal opening.
• A diet containing foods or drinks that irritate the anus.
• Antibiotics. 
• Topical medications or creams.
• Skin allergy in the anal area.
• Hemorrhoid tissue that can leave mucus and stool on the skin after bowel movements.
• Excessive cleaning after a bowel movement, including the use of wet towelettes and soaps.

Less common causes of anal itching may also include:

• Local diseases and conditions involving lower portions of the digestive tract.
• Infections and parasites.
• Dermatologic diseases.
• Systemic diseases.

How to Stop Anal Itching

In most cases, providers treat anal itching by doing the following:
 
Thoroughly, but gently dry the anal area after every bowel movement. Use a squeeze bottle with warm water or bidet to rinse the area after bowel movements. You may also try a wet tissue or piece of cotton to clean the area. You can add soapless cleanser, such as Balneol (over-the counter), to the tissue or cotton.
 
Pat (do not rub) the area dry with toilet paper. You can use a hair dryer on a cool setting to help dry the area.
 
After the area is dry, dab witch hazel on it with cotton. You can also use medicated pads that contain witch hazel, such as Tucks Medicated Pads. These medications are available over the counter.
 
Use an over-the-counter barrier cream containing zinc oxide, such as Desitin or Boudreaux’s Butt Paste, by applying a small amount to the anal area. These creams tend to be greasy, so you may want to place a piece of gauze to prevent staining your underwear.
 
Apply a one percent hydrocortisone cream two to three times a day for no more than two weeks to relieve symptoms.
 
Drying agents such as cornstarch or baby powder may also be effective.
 
If you have hemorrhoid tissue that protrudes after a bowel movement, this needs to reduce internally in order to clean and dry the area.
 
Resist the urge to scratch, no matter how itchy the area becomes. The itch will pass, or at least decrease over a short time. The more you scratch, the longer it will take for the itching to go away.
 

Preventing Anal Itching

In many cases, you can prevent anal itching by taking the following steps:

• Practice good anal hygiene – gently cleanse the anal area after every bowel movement by using wet, unscented and dye-free toilet paper. Wipe gently or blot the area. Never rub or scrub. Do not use wet wipes that contain alcohol.
• When bathing or showering, use only water to clean the anal area, never soap.
• Avoid using medicated powders, perfumed sprays, or deodorants on the anal area.
• Eat a sensible diet that does not include many food and drinks that cause anal irritation. These include:
  • Spicy foods
  • Citrus fruits and citrus juices, such as oranges
  • Tomatoes
  • Caffeinated drinks (more than two cups of coffee per day)
  • Milk
  • Alcoholic drinks (especially beer and wine)
  • Carbonated drinks such as soda
  • Chocolate
• Wear loose clothing and underwear – use underwear made from cotton rather than nylon or other synthetic materials.
• Maintain regular, formed bowel movements. If you have a problem with loose stools or frequent bowel movements, gradually add fiber to your diet. Fiber supplements, such as Metamucil, Citrucel, and Benefiber, may help.
• If you are taking oral antibiotics, eat yogurt to help restore the normal flora to your colon.

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Itching in the anus, diagnosis and treatment

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Itching in the anus

Itching in anus is more often not a separate symptom, but a completely independent disease that has an identical name. In this case, it is considered primary and idiopathic, that is, without obvious causes. However, itching in the anus can also be secondary, that is, be a symptom of a disease. In this case, it is necessary first of all to treat the disease itself.

What causes itching in the anus? We list the main ones:

• Diseases of the rectum is a very common cause of itching in the anus. There are many diseases of this group in which this symptom is observed. These are hemorrhoids, condylomas in the anus (genital), anal fissures, various tumors in the rectum, chronic proctosigmoiditis and others.
• Gynecological diseases – naturally, this group of causes refers only to itching in the anus in women. This symptom may be evidence of vulvovaginitis or some kind of vaginal secretion disorder.
• Sexually transmitted diseases and infections of the genitourinary system – itching in the anus passage is a symptom of sexually transmitted diseases such as chlamydia and trichomoniasis. It can appear with chronic prostatitis, which affects almost half of the mature male population of the planet, as well as with urethritis.
• Skin diseases – itching in the anus often accompanies a disease such as psoriasis. But it can also appear as contact dermatitis when using powders, toilet paper, or wearing clothes that irritate the skin.

This is not a complete list of causes that may cause itching in the anus. It can be a symptom of diabetes mellitus or liver disease, various fungal infections, an allergic reaction to certain foods or alcohol, a side effect of penicillin, tetracycline, or erythromycin, and even depression or anxiety.

For whatever reason itching in the anus , it is necessary to consult a proctologist . He will conduct a visual examination of the skin of the anus and prescribe a series of tests and procedures to help establish an accurate diagnosis. This is blood for sugar, urinalysis, feces for eggs of worms and dysbacteriosis, anoscopy, colonoscopy.

Treatment of anal itching

In any treatment of anal itching, hygiene measures must be taken: do not scratch the skin in the anus, avoid hot baths and long washing in general. In this case, it is necessary to use a soap and shampoo that will not increase the itching. Always make sure that the skin near the anus is dry. To do this, it will not be superfluous to use soft gaskets, which should be changed regularly. The chair should also be regular. To alleviate the condition and speedy healing of cracks and scratches in the anus, the doctor may prescribe special suppositories and ointments.

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Anal itching – which doctor to contact

Definition of the disease. Causes of disease

Anal itching – (lat. pruritus ani) – a disease characterized by prolonged itching in the anus and perianal region. Itching in the anus is a delicate problem, often the patient is ashamed of his condition and avoids going to the doctor. Nevertheless, such manifestations can indicate serious diseases, but before you suspect any problems with your rectum, you should figure out what causes it more often.

Causes of itching in the anus

• Worm infestations . With ascariasis or infection with other types of helminths, burning and itching occur after a bowel movement. Itching in the anus at night is a symptom of pinworm infection, they lay eggs in the rectal area, which causes irritation. With giardiasis in children and adults, diarrhea often occurs, leading to inflammation of the skin. In addition, giardiasis is accompanied by a rash in the perineum, which provokes itching.
• State of dysbacteriosis . Intestinal dysbacteriosis, caused by a violation of the microflora, is accompanied by diarrhea and / or constipation, leading to unpleasant sensations of irritation and itching in the anus.
• Diseases and infections of the genitourinary system. Prostatitis and urethritis in men and gynecological pathologies in women, any sexual infections (herpes types I and II, gonorrhea, chlamydia, trichomoniasis, human papillomavirus). Often itching in women is a sign of candidiasis (thrush). The most common dermatitis at my appointment is genital herpes. In some cases, anal itching is one of the manifestations of a common sexually transmitted disease – syphilis!
• Skin diseases. Psoriasis, dermatitis of various nature, seborrheic eczema, lichen planus.
• Hygiene violations . Itching in the anal area can be provoked by the use of coarse toilet paper with the addition of various dyes and flavors, insufficient hygiene of the perineum, the inability to take a shower for several days; in women – the use of pads (including daily), tampons. Skin irritation can be caused by tight synthetic underwear with rough seams or the wrong size underwear. Itching leads to scratching of the affected area and the formation of microcracks, through which pathogenic bacteria enter the body, which can cause serious infections and dermatitis.
• Diabetes mellitus, pathology of internal organs. One of the symptoms of diabetes can be persistent itching in the anal area. The same discomfort can occur with lesions of the liver, pancreas, biliary dyskinesia, gastritis, gout, beriberi, infectious hepatitis, intoxication, oncological pathology.
• Obesity . Patients who are overweight often suffer from excessive sweating, resulting in diaper rash and irritation in the perineal area, leading to itching.
• Allergic manifestations . Allergic reactions can occur to food, alcohol, medicines, hygiene products, fabrics, flowers, etc. A side effect of allergies is often itching in the anus.
• Pathologies of the rectum. Internal or external hemorrhoids, genital warts, anal fissures. If the appearance of itching is accompanied by pain and spotting, the cause of this is most often rectal fissures, anorectal fistulas and poips. The most serious factors that provoke itching are chronic proctosigmoiditis and malignant tumors of the rectum.
• Neurogenic disorders, obsessive-compulsive disorder , the so-called “psychosomatics”. Stress, anxiety and depression lead to a weakening of the body, the skin becomes overly sensitive. Mental illness can manifest itself in an obsessive desire for cleanliness, constant cleaning of the anus with soap and water, which leads to overdrying and irritation of the skin and deprives the mucous membranes of a natural protective film. Neurogenic (nervous) nature of itching is often found in patients with exudative diathesis and neurodermatitis. In this case, the itching is so strong that the patient combs the anus to the blood, which is accompanied by burning and redness of the skin.

Risk factors

• Risk factors include spicy, salty foods, condiments and alcohol. It is undesirable to use hygienic alcohol-containing wipes, which greatly dry the skin in the perianal area.
• Pruritus ani can result from work in hot and dusty environments, accompanied by harmful exposure to mercury vapor, tobacco dust, lead, sulfur or other chemicals.
• Itching in the anus can be caused by diseases of the stomach and intestinal tract: ulcers, hypo- and hyperacid gastritis, polyposis, dysbacteriosis, colitis, dyskinesia.
• Itching in the anus can lead to pharmacological agents – preparations for hemorrhoids (suppositories, ointments and gels) and vaginal suppositories for contraception.
• Sometimes itching appears in women during menopause, when there is a natural decrease in the synthesis of sex hormones – estrogens. Hormonal imbalance leads to a violation of the microbiocenosis of the vagina and excessive dryness.
• Important! In women, anogenital itching of unexplained origin is sometimes found. A distinctive feature of this symptom is the absence of lesions of the skin and mucous membranes.

Symptoms of disease

Itching in the anus is usually the only complaint of the patient. It can occur during the day, in the evening, at night and contribute to insomnia. With a long course of the disease, the skin around the anus becomes covered with scratches and abrasions, turns red, coarsens or thins over time and becomes easily damaged. Deep, pronounced scratching can become infected – at this time, white patches may appear (which indicates the addition of a fungal infection) or multiple ulcers with discharge up to purulent (bacterial infection). Long-standing anal itching leads to severe scratching and may contribute to eczema, ulceration, and bleeding.

I carried out statistics for 1.5 years of admission of patients to LLC “MMC “URO-PRO” – taken in 2017 and 2018 – a total of 40 people complained of itching, of which: genital herpes – 27 people, perianal dermatitis – 7 patients, anal fissures – 4 patients, chronic hemorrhoids (with perianal dermatitis) – 2 patients.

Total: out of 40 patients, 6 patients needed treatment by a proctologist, 36 patients were referred for consultation and further treatment to a dermatologist. This statistic suggests that if you have a symptom – itching – you do not need to immediately panic and urgently make an appointment with a proctologist, first you need to calm down and analyze your complaints.

So if:

• You only have itching and nothing else bothers you, itching occurs during the day, regardless of the stool, then you need to see a dermatologist. If the dermatologist deems it necessary, he will send you for further examination to specialists, including a proctologist.
• If you have itching, rashes (pimples, papules, redness), dampness, moisture outside around the anus, in the perineum and / or between the buttocks – you should also see a dermatologist – these are clear signs of dermatitis.
• If you have itching, growths of “warts”, dampness (may not be) – you should see a proctologist, most likely, it may be genital warts.
• If you have itching, bleeding, pain in the anus – then yes, you need to urgently make an appointment with a proctologist, as these are signs of an anal fissure or hemorrhoids. Treatment directly depends on the factors and / or underlying disease that caused anal itching.
• If itching is accompanied by stool disorder, flatulence, abdominal pain, it is better to consult a gastroenterologist to rule out intestinal diseases.