Anal itching may not be something you’re comfortable talking about, although many people experience it occasionally. Most of the time you can stay quiet and treat the problem at home. But if the itching persists and is causing you significant discomfort, don’t hesitate to ask your doctor for help, especially if you have pain and bleeding.
An itchy anus happens when the skin around the anus becomes irritated. It’s not always clear what triggers this, but there are many possible causes.
“Anal itching may be temporary or long-lasting depending on the cause. Your doctor can help, especially when itching becomes severe or persistent, or if you have anal bleeding, stool leakage or another symptom that requires treatment,” says Michael Hadley, MD, a family medicine physician at Scripps Coastal Medical Center Encinitas.
In addition to itching, symptoms may include burning, soreness, visible redness, swelling, ulcers and a rash around the anus.
Anal itching, also known as pruritus ani, is not a disease, but a symptom related to skin or internal medical issues. Moisture, pressure and sitting can increase the intensity of the itching.
Treatment involves reducing inflammation and allowing the skin to heal. “Avoid rubbing, scratching and obsessive cleansing because that can affect healing,” says Dr. Hadley.
Anal disorders, including hemorrhoids, abscesses, fissures and fistulas, can cause itching, pain and other discomfort.
Bacterial, fungal and parasitical infections and sexually transmitted infections (STIs), including gonorrhea and anal herpes, can result in anal itching. Anal warts from human papillomavirus (HPV) – the most common STI – are also culprits.
Personal habits, such as what we eat and wear, how we clean ourselves and products we use, can irritate the skin around the anus. Excessive washing, prolonged exposure to moisture from loose stools, perspiration or wearing tight clothes can exacerbate the condition.
Certain foods also can cause irritation when stool is passed, including spicy foods.
Scratching can irritate the skin and make itching worse. For relief, apply a moist, room-temperature compress to the area. Keep your nails short and wear cotton gloves while sleeping to help prevent nail scratching.
Any small amount of stool left behind can cause itching and burning. So, clean properly after a bowel movement. Cleaning and wiping should always be gentle.
When wiping, use moistened wipes or toilet paper moistened with water to prevent stool staying on the anal skin.
When washing, clean the area around the anus with plain water or mild soap and a soft washcloth. Pat dry.
Avoid foods and drinks that can irritate the skin around the anus, including coffee, cola, alcohol, citrus fruits, chocolate, spicy foods and tomatoes.
Certain chemicals in foods and medications can cause irritation or allergic reactions. Certain antibiotics, for example, can trigger anal itch.
Avoid using toilet paper with dyes and perfumes. It’s better to buy soft toilet paper.
Tight underwear or any other tight-fitting clothing that can trap moisture. It’s better to wear well-fitting cotton underwear that can help keep the area dry.
Add more fluids and fiber – which can be found in fruits and vegetables – to your diet to help maintain regular, firm bowel movements.
Fiber supplements such as psyllium (Metamucil) and methylcellulose (Citrucel) also may help.
Protect the affected skin from moisture by applying a zinc oxide ointment, such as Desitin and Balmex, or petroleum jelly, such as Vaseline. If needed, apply hydrocortisone cream, such as Cortaid or Preparation H anti-itch, to relieve symptoms.
Make an appointment with your doctor if you experience bleeding from the rectum or if your itching is getting worse even after self-care treatments.
Be ready to discuss your symptoms and medical history, including medications you may be taking, frequency of bowel movements and personal care habits.
You may also need a physical exam, which may include digital and visual rectum exams. In some cases, your doctor may recommend laboratory tests to check for an infection or diseases.