Anal itching, also known as pruritus ani (proo-RIE-tus a-nee), is a very common problem that can cause embarrassment and discomfort. Itching in and around the anus can be relieved with good hygiene and simple treatment measures.
Irritation of the rectal area is commonly caused by scented soaps and lotions, rubbing too much or over-scrubbing the anal skin. In addition, recurring diarrhea and fecal leakage can make itching worse.
A skin condition that can cause anal itching is pruritis ani, often called “anal itchy syndrome.” The condition can be caused by many things, including contact dermatitis and systemic diseases. Itchy skin can also be a side effect of certain medications, especially some types of steroid creams. Itching is usually the first sign of a problem with anal health and can often be resolved easily at home, with over-the-counter treatments.
Intense rubbing and scratching the anal area can actually make the itching worse. Itching also irritates broken skin, which can lead to infection. If anal itching persists, see a doctor to be evaluated and treated for an underlying issue.
Anal itching can be triggered by local chemical irritation or an allergic reaction to chemicals in the anal area. Some common causes include perfumed powders or sprays used in feminine hygiene and medicated talcum powders, as well as soaps, lotions and detergents used for personal hygiene.
A doctor can help treat anal itching caused by a skin irritation or allergy by recommending avoidance of the offending substance, using over-the-counter treatments or prescription ointments with higher doses of steroids and applying a cold compress to the area. He or she may also recommend banding or surgical removal of hemorrhoids. Chronic, recurrent hemorrhoids may be the result of straining during bowel movements, constipation, pregnancy or anal intercourse.
Sometimes the same organisms that cause vaginal yeast infections, called Candida albicans, can infect the skin around the anus and produce an itchy rash. Itching is common among people with diabetes who develop Candidiasis due to a disruption of the normal ecology in the colon, and people with inflammatory bowel disease can also experience itchy anus as a side effect. Certain dietary habits and foods, such as dairy products, spicy foods and nuts, can irritate the anal area during bowel movements and lead to itching.
The skin of the anal canal is delicate and easily irritated. Scratching this area can damage it, so avoiding it is recommended. Gently cleansing the anal area when it is soiled or after each bowel movement with a shower, a bidet or a squeeze bottle and then gently patting dry, rather than rubbing, can help reduce itching. It may also help to sprinkle nonmedicated talcum powder between bowel movements, or lay a square of cloth on the anus to absorb moisture.
If anal itching continues, a doctor should be seen for an examination and treatment plan. Antifungal, antibacterial or antiparasitic treatments can be prescribed. If a hemorrhoid is the cause, banding or surgery can be used to shrink them. If a digestive disorder is the culprit, dietary changes may be necessary. In some cases, the itching will go away on its own once a proper treatment plan is in place.
There are a variety of conditions that can cause itching on the anus. These include skin problems, like psoriasis or atopic dermatitis, that can affect any area of the body, but especially around the anus. Infections and parasites, such as pinworms, scabies, or tinea cruris (ringworm), may also affect the anus area. Moisture, such as from liquid stools or diarrhea, can also make the anus itchy, as well as fecal incontinence in children and adults, and rectal fistulas or anorectal cancer.
A doctor may be able to determine what’s causing your anal itching from a physical examination and a review of your diet, personal hygiene habits, and medications you take. He or she may need to take a sample of your stool to check for a worm infection, or an internal examination, called digital rectal exam, by inserting a gloved finger through the anal canal.
At home, the best way to prevent anal itching is to keep the area clean. Use a gentle soap or unscented baby wipes to wash the area after every bowel movement, and avoid scrubbing or aggressive rubbing. Then, dry the area gently with a towel or wet washcloth, and don’t use toilet paper that contains perfumes or dyes. Avoid tight-fitting clothing, which can increase sweating and irritation of the anal area. Also, try to wear cotton underwear to reduce friction on the anus area.
A person may experience itching near the anus when he or she has hemorrhoids, either external (around the anus) or internal (in the lower rectum). Hemorrhoid symptoms can include blood in the stool, burning sensations, and pain. Itching can also be caused by a prolapsed hemorrhoid, where the swollen blood vessel has fallen through the anal opening. Hemorrhoid treatment options can include OTC hemorrhoid creams or ointments, sitz baths, and suppositories that a person inserts directly into the anal opening.
If itching is accompanied by bloody diarrhea or draining pus, a doctor’s evaluation is a good idea. He or she can recommend over-the-counter treatments to ease the itching and pain, including a warm sitz bath or other medication.
If a person has hemorrhoids, he or she can help prevent itching by wearing loose clothing, not wiping the anal area, and using a moisturizing soap that doesn’t remove natural oils from the skin. He or she should also avoid irritants such as spicy foods, coffee, tea, alcohol, and vitamin C tablets because these can trigger itching. He or she should take fiber supplements to promote regular bowel movements, and should try not to strain during a bowel movement. If the itching is severe, a doctor may suggest a medical procedure to shrink or eliminate the hemorrhoids. A doctor may also prescribe an antifungal, antibiotic, or a scabies medication to eliminate infectious organisms.