Anal itching can be just an annoyance.
It is usually made worse bywarmth, and is often most troublesome in
bed. The skin round the anus easily becomes irritated and inflamed. This
is because it is difficult to keep the area round the anus clean and
dry. the skin is crinkly and traps tiny faecal particles. It is also
sweaty and airless, and it may be moist from an anal or vaginal
discharge. When it becomes irritated, scratching is a natural reaction,
but this damages the skin further – the itch/scratch cycle.
Also called pruritus ani, anal itch has
many causes. Numerous factors may cause anal itch to be more intense -
including moisture, the abrasion caused by your clothing, and the
pressure of sitting. Anal itch is usually most noticeable and bothersome
at night or right after a bowel movement.
Anal itch is a common problem that most
people have experienced. Don't be afraid to talk with your doctor about
this condition. With proper treatment and self-care measures, most
people can achieve complete relief.
Signs and symptoms
Anal itch is associated with other similar symptoms in and around the
The itching and irritation in and around your anus may be a temporary
condition, or it may be a more persistent and bothersome problem. For
some people, the irritation is so intense that the urge to scratch is
irresistible — and a source of embarrassment.
Most cases of anal itch are caused by a harmless problem. But anal itch
can be a sign of more serious medical issues. Possible causes include:
As you age, skin in and around your anus is more prone to dryness.
Dry skin can cause a persistent, intense anal itch.
Moisture around your anus from excessive sweating or from moist,
sticky stools can be irritating. Anal itch can also be caused by
frequent diarrhea or the escape of small amounts of stool (fecal
Excessive wiping with dry, harsh toilet paper or excessive scrubbing
with harsh soaps and a washcloth can cause or aggravate anal itch.
Failure to rinse away the soap completely also may cause irritation.
Certain laundry soaps, colognes, douches and birth control products
contain chemicals that can irritate skin in and around your anus.
Scented or colored toilet paper can be irritating to people with
Anal itch may be the result of irritating chemicals in some foods,
such as those found in spices and hot sauces. Similarly, some foods
may directly or indirectly irritate your anus as they exit your
digestive system. Common culprits include chocolate, fruits,
tomatoes, nuts and popcorn. Consuming certain beverages — possibly
milk or caffeinated drinks — may cause some people to experience
diarrhea followed by anal itch.
Anal itch may be a side effect of certain medications, such as some
antibiotics, that can cause frequent diarrhea.
Excessive or improper use of laxatives can lead to chronic diarrhea
and the risk of anal irritation and itch.
Hemorrhoids are engorged veins located just under the membrane that
lines the lowest part of your rectum and anus. They often occur as a
result of straining during a bowel movement. Anal itch can be a
symptom of hemorrhoids. However, most hemorrhoids don't itch.
In children, the parasite that causes pinworms can cause persistent
anal itching. Other parasites may cause similar itching.
Common skin problems — such as psoriasis, seborrhea and eczema — can
involve and irritate the area in and around your anus.
This common infection, which usually affects women, can irritate
your genital and anal areas.
An anal abrasion is a small tear in your anus, usually caused by
forced bowel movements through a tight anus. An anal fissure is a
deeper tear. Both conditions can cause anal itch, as well as painful
bowel movements and bleeding.
Rarely, benign or cancerous tumors in or around the anus may be a
cause of anal itch.
Anal itch may be related to anxiety or stress. Sometimes, the cause
Anal itch is almost never a problem of cleanliness. But your own actions
may be partially to blame. Whatever the cause of anal itch, your natural
reaction is to scratch the area. But scratching worsens the problem by
removing superficial layers of skin. In addition, the natural tendency
in response to an irritation is to wash the area frequently with soap
and a washcloth. However, excessive washing almost always makes the
problem worse by further damaging your skin and removing protective
oils. Overmedication also can aggravate the problem.
When to seek medical advice
Most itching doesn't require medical care. However, if anal itching is
severe or prolonged or if it can't be easily explained, see your doctor.
Persistent anal itching may be related to a skin condition or other
health problem that requires medical treatment.
Screening and diagnosis
Your doctor may be able to pinpoint the cause of your itching simply by
asking you questions about your symptoms.
If the cause of your itch isn't obvious, your doctor may refer you to a
dermatologist or a doctor who specializes in treating rectal and anal
problems (proctologist) for further evaluation. A rectal exam may be all
that's required for you to get an answer — and a solution — to a very
Other tests, such as a colonoscopy to view more of the digestive tract,
are sometimes needed to identify an underlying cause of anal itch.
However, the precise cause of the itch may never be identified.
Treatment of anal itch depends on the cause of the problem. It may
include self-care measures, changes to your diet, treatment of
infections or, rarely, surgery to correct an underlying problem.
Medications also may be part of your treatment plan. An over-the-counter
(OTC) cream or ointment containing hydrocortisone (Cortaid, Preparation
H), applied sparingly to the affected area twice a day for up to two
weeks, may reduce inflammation and itching. A protective ointment that
contains zinc oxide (Desitin, Balmex) also may help. If your symptoms
are worse at night, your doctor may also prescribe an antihistamine to
reduce itching until topical treatments take effect. With proper
treatment, most people experience complete relief from anal itch.
Prevention of anal itch mainly involves washing properly and avoiding
irritants. If you already have anal itch, try these self-care measures:
Wash the area in the morning, at night and immediately after bowel
movements. But don't scrub and avoid using soap. Instead, use a wet
washcloth, wet bathroom tissue, cotton balls moistened with water,
unscented baby wipes or a small squeeze bottle of water to cleanse
After cleansing, pat the area dry with toilet paper or a towel. Or
dry thoroughly with a hair dryer. Once dry, place a dry cotton ball
or a piece of cotton gauze against the anus. Replace the cotton as
necessary. Nonmedicated talcum powder also can help keep the area
over-the-counter (OTC) treatments correctly.
Apply OTC creams sparingly. Don't use these treatments unless
directed by your doctor. For some people, creams or ointments may
cause more irritation, and they may mask a persistent problem.
Scratching further irritates your skin and leads to persistent
inflammation. If you can't tolerate the itch, apply a cold compress
to the area or take a lukewarm bath to find some immediate relief.
Keep busy to distract yourself from scratching.
The skin around your anus may be sensitive to bathroom tissue that
contains dyes or perfumes. Use unbleached, unscented tissue. You may
want to use tissue that's moistened or made extra soft for comfort.
This helps keep the area dry. Avoid wearing pantyhose, which can
trap moisture. Change your underwear daily and whenever it's soiled.
Avoid bubble baths and genital deodorants. Cut back or avoid
beverages or foods that you know irritate your anal area. Avoid
overuse of laxatives that increase diarrhea and the risk of anal
irritation and itch.