What Is Anal Itching? What Is Itchy Bottom? What Causes Anal Itching?

Anal itching, also known as itchy bottom, pruritus ani or anusitis, is irritation and sometimes inflammation of the anus - located at the exit of the rectum. Itching severity varies and is usually exacerbated by such factors as type of clothing worn, whether the patient is seated or upright, moisture levels, pressure and general rubbing of the anal area. Anal itching can become so severe that some people find it intolerable, describing the sensation as one of incredible burning and soreness.

Anal itching is not a disease in itself, but rather a sign or symptom. In the majority of cases, there is an underlying cause or condition which causes the anal itching. However, sometimes the underlying cause is never found.

Regardless of the cause, virtually every type of anal itching sign or symptom can be successfully treated.

Anal itching is much more common than people realize, probably because it is not exactly something most people will reveal to others, apart from the their doctors. According to the National Health Service (NHS), UK, about 1 in every 20 British people experience "itchy bottom". It is four times more prevalent in males than in females. Although anybody can develop anal itching, people aged 40 years and more are more likely to get it, compared to younger individuals.

According to Medilexicon's medical dictionary, pruritus ani is "itching of varying intensity at the anus; may be paroxysmal or constant, associated with seborrheic candidiasis or moniliasis, with irritated and enlarged hemorrhoidal veins, or may occur independently of any cutaneous lesions in association with systemic disease."

What are the signs and symptoms of anal itching?

A symptom is something the patient feels or reports, while a sign is something that other people, including the doctor detects. A headache may be an example of a symptom, while a rash may be an example of a sign.

Most humans and other animals sometimes scratch their bottoms. For a person with pruritus ani (anal itching) the urge to scratch around the anus is very strong and persistent. Although the urge may occur at any time of day or night, it is more common after going to the toilet; especially if stools are liquidy. Some patients say the itching becomes more intense just prior to falling asleep in bed at night.

The symptoms of anal itching are self explanatory - "itching of the anus and the anal area". The patient generally experiences:

• Burning
• Intense itching
• Soreness
• Pain (sometimes)

Symptoms may be short-term or persistent. Some individuals may experience irritation that is so intense that the desire to scratch must be satisfied there and then - this can be embarrassing.

What can set off anal itching or exacerbate it?

• Anxiety
• Heat
• Mental stress
• Moisture
• Soiling (defecating or pooing in one's clothing)
• Some clothing or bedding materials, such as wool
• Having nowhere private to go into nearby

What are the causes of anal itching?

Anal itching is usually a sign or symptom of a harmless physical problem with no long-term health consequences. Unfortunately, it can also be an indication of something more serious, such as:

• Skin type - if the skin around the anal area is too dry there is a significantly greater risk of developing persistent and sometimes severe anal itching.

• Moisture levels - if moisture levels around the anal area are high, the chances of having anal itching are raised. High moisture levels can be the result of several different factors, including over-sweating, allergies, diarrhea, very wet and sticky stools, inappropriate clothing, fecal incontinence, and not having access to toilet paper or any means of cleaning oneself.

• Abrasive rubbing - cleaning your bottom with toilet paper can aggravate anal itching if the sensitive skin area is rubbed too hard, for too long, or too often.

• Over-washing the anal area - if harsh soaps affect the skin, especially if not rinsed off properly, the chances of itching in the anal area may increase.

• Some chemicals - some substances found in some soaps, douches, laundry detergents and body sprays may irritate the skin and cause anal itching.

• Type of toilet paper - the texture and substances added to toilet paper may irritate and inflame the skin in the anal area, resulting in itching.

• Some foods - some people may develop anal itching after consuming certain types of hot sauces or spices. The irritation may occur when the food is anywhere in the digestive system, even when stools are exiting through the anus.

If a stool is not smooth and does not come out with the minimum of friction, irritation may occur and then subsequent itching - some people find that their anus becomes irritated after passing stools which originated from eating tomatoes, nuts, popcorn, chocolate, and even drinking alcoholic beverages. If some foods make people have diarrhea, their risk of developing anal itching is greater (because of the diarrhea).

• Some medicines - some medications, such as antibiotics can cause diarrhea, which can cause anal itching.

• Laxative abuse - if laxatives are used inappropriately and the patient has diarrhea or very liquidy stools, the probability of anal itching occurring becomes much greater.

• Hemorrhoids - when the veins around the anus or in the rectum are swollen or inflamed the patient has hemorrhoids. Hemorrhoids can occur both inside and above the inside of the anus. They can also appear externally, under the skin of the anus. People with hemorrhoids commonly suffer from anal itching.

• STDs (sexually transmitted diseases) - also known as STIs (sexually transmitted infections) cause anal as well as genital itching.

• Parasites- some parasites may cause anal itching. Parasites are more commonly a cause of anal itching in tropical countries, or tropical regions of countries.

• Skin conditions - such as eczema, seborrhea, and psoriasis, which may include itching in many parts of the body's surface, often have characteristic focal areas of irritation. People with these skin conditions commonly experience anal itching.

• Some yeast infections - this generally affects women. Yeast infections which affect the genital area, may spread to the anus, causing intense irritation.

• Forced bowel movement - if the stool is dry and large and the individual heaves and still pushes it through, there is a risk of an anal abrasion (small tear in the anus). A deeper tear is called an anal fissure, which may also cause itching.

• Tumors - a tumor in the anal region may cause anal itching. The tumor may be cancerous (malignant) or non-cancerous (benign). This is rare.

How is anal itching diagnosed?

In order for doctors to diagnose the cause of your symptoms, they will need to know your medical history. They might ask what soaps, creams or powders you use on your anus or if your symptoms worsen after the consumption of certain food types.

Your GP may also ask about when the itching is at its worst, and how long it lasts. They might also want to know if anyone else in your family has had or is suffering from anal itching. The doctors may be able to come up with a diagnosis just from these questions alone; however, if the cause is not clear you may be referred to a proctologist (doctor specializing in rectal and anal problems) or dermatologist (skin expert).

Diagnosis might be made just from a rectal exam. This will involve a GP checking the anal area for any skin that is inflamed, cracked or bleeding. An internal exam may then be required; the doctor inserts his/her finger into the patient's anus. Doing this can help determine what is causing the anal itching as well as eliminating more serious conditions, such as colorectal cancer. Sometimes a more detailed exam of the digestive system, such as a colonoscopy or a proctoscopy may be required.

What are the treatment options for anal itching?

Most of the time itchy bottom is easy to treat and responds well to treatment. However, this does not stop it from recurring in the future. The type of treatment chosen is dependent on the cause of the anal itching. The various methods of treatment may include:

• Anal cleanliness/dryness - When suffering from anal itching, keeping your anus clean and dry is very important. Each time you pass a stool and before going to bed it is advised that the skin around the anus is carefully cleaned using water and then dried thoroughly.
  
  When drying, be gentle, avoid vigorous rubbing as this could further irritate the area. Another option is using a hair dryer on low heat or patting with a dry pad.

• Be careful when washing with soap - When washing the skin around the anus avoid perfumed soap, try using one which is mild and unscented, and be sure to rinse away all the soap with water.

• When travelling - The above options may not be possible when on the move or away from home. In this case try using damp toilet tissues to clean yourself.

• If the area keeps getting moist due to sweat - Putting a cotton tissue in your underwear will absorb the sweat/moisture and reduce itching.

• Avoiding consumption of certain foods - There are a number of food types that can make the anal itching worse. If you notice the urge to itch getting worse after eating a particular kind of food, you should try to cut down on it. Below is a list of foods that are known to make anal itching worse:
• Chocolate
• Citrus fruits
• Coffee
• Dairy Products
• Nuts
• Spicy food
• Tomatoes
• Unnecessary amounts of liquids

• Things you can do yourself - There are some other ways you can keep control of your anal itching symptoms. These are as follows:
• Use colorless plain toilet paper
• Make sure you have a shower every day
• Wear underwear that is made of cotton and not too tight.
• Be sure to wear clean underwear every day.
• Trim your fingernails regularly; scratching the anal area with long fingernails can damage the skin. Ideally scratching the area should be avoided altogether, as it can make the itching worse.

• Prescription Medication - Doctors can prescribe medication to help relieve the symptoms.

• Creams - Doctors can also prescribe creams or ointments.

• Corticosteroids - Patients with anal itching where the anal area is tender and inflamed may be prescribed a short course of corticosteroids (less than 7 days). It is applied onto the skin around the anus and will relieve the itching impulse and inflammation. It is known on occasion to make the itching worse, if this is the case it you should stop taking it and contact your doctor.

• Antihistamines - This is to be taken at night and can alleviate your itching and help you sleep.

• Treating the underlying cause - If the anal itching is the result of an underlying cause, the doctor will nead to treat that first. In most cases, if that underlying cause is effectively treated, the anal itching will resolve itself.

What are the complications of anal itching?

Scratching the anus too often can cause damage to the skin and may tear it. This can lead to the following complications:

• Lichenification - the skin around the anal area becomes thick and leathery.
• Ulceration - the skin becomes sore and breaks.
• Excoriation - the top layer of the skin wears away.
• Infection- this complication can be easily treated if the patient has prompt treatment.

Even though these complications are unpleasant, most of them can be treated effectively if you see your doctor as soon as symptoms appear.

Sources: National Health Service (NHS), UK, The Mayo Clinic, Wikipedia, HHS (Department of Health and Human Services USA), NIH (National Institutes of Health, USA).

Written by Mike Paddock

Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

• Additional
• References
• Citations

Visit our dermatology section for the latest news on this subject.

24

Top of Form

Rate article: (Hover over the stars then click to rate)

Patient / Public: 1 2 3 4 5

or

Health Professional: 1 2 3 4 5

Bottom of Form

---

Visitor Opinions (latest shown first)

Total 66 opinions, latest 20 shown. For all opinions, click through to the full thread.

on itchy anus

posted by Bianca on 30 Apr 2013 at 11:06 am

Seems with me I have been having itching and a bit of bleeding and is more above than below and seems in same area. But am now finding to just use plain water to wash with every now and again is helping and patting dry, not rubbing etc., so will keep trying this out and if it isnt clear by friday, will ask the doctor as going that day.

| post followup | alert a moderator |

Try Low or No Gluten

posted by Pat on 28 Apr 2013 at 9:00 pm

Consuming very low amounts of gluten was the magic for me. The symptom of itch and bleeding were gone once the gluten was cut out of my diet.

| post followup | alert a moderator |

Anal Itching

posted by Steven Bolin on 28 Apr 2013 at 3:58 am

I have been having anal itching. I have been diagnosed as having internal and external hemorrhoids however was told that removal of the hemorrhoids would not reduce the itching. I do not understand this since if hemorrhoids can be a cause of itching why would not removal of such hemorrhoids to try to relieve itching unless one gets perhaps an infection from such removal?

Furthermore some people think that a hemorrhoid is a varicose vein in the anal area. I am not sure about that however it does appear to be some type of inflamed blood vessel. Is a hemorrhoid and inflamed blood vessel and if yes what type/ I thought perhaps if I could find some type of anti-inflammatory suppositories and ointment without corn starch or lanolin or witch hazel this might help. Anyone know of such?

I think that also rectal itching can be from a fungal infection and that such infection are not always visible. yeast infection such as Candida it might be. What all specific types of fungus infect this area?
I also take pills for vein circulation even if a hemorrhoid is not a vein it is connected to the other vessels so I thought this might help, correct?

Some people think hemorrhoids can be from a blood clot perhaps clearing of a blood clot would help. Tomatoes and citrus fruit are common causes of rectal itching. There is a trust for pin worms and their ova from the stool. I think that internal hemorrhoids could cause seepage of fecal manner to the external area that can cause rectal itching. I know that rectal itching can be difficult to deal with and suspect a lot of it comes from toxins in the bowel movements and. If there was some way to make us not allergic to bowel movements perhaps this would solve this for many although diet may help to some extent I doubt this is the cure for all. .

Perhaps a detoxifier would help however I doubt it would get rid of all toxins and suspect making us non allergic to all in the feces would be very difficult to solve. Plasma Lab, Inc. is drawing blood samples for a place working on a vaccine for peanut allergies. With comments and answers to my questions please reply to me directly from your email address to mine as I will not be checking for replies at this forum however you may post replies directly to me and at this forum. I live in Seattle, WA United States if you know of a doctor in my area that you think is good for this please let me know. So far for em the best thing I have found is to wet my toilet with water for cleaning the area after a bowel movement and some times to re do so in case of feces seeping. Then I use Jason Cooling Mineral Gel twice a day with Premier Value Hemorrhoid Ointment which unfortunately is fragrant so I me in need of another ointment. I would like to learn how to compound other ointments and suppositories can I get some help on compounding information from some one?

| post followup | alert a moderator |

Anal Itch Remedy

posted by R Lane on 23 Apr 2013 at 4:04 pm

I had this issue for years and my doctor prescribed a steroid cream which I honestly did not feel good about using. I found a product that you can get online (amazon I think) called Fire in the Hole Anal itch spray. OMG it works really fast and the problem has not returned. hope this helps

| post followup | alert a moderator |

I have anal itching, what drugs can I buy?

posted by jhanat hanny on 12 Apr 2013 at 12:33 pm

i need help! i have anitching problem!!!
wat drugs can i buy????

| post followup | alert a moderator |

severe itchy bottom

posted by jen on 7 Apr 2013 at 3:29 am

please help I was given creams no good, and then I was given a pill yeah relief but it's back with a vengeance.

It is driving me insane. I already have a sleeping problem but this is ridiculous.

| post followup | alert a moderator |

Keep it clean - anal itching

posted by James on 31 Mar 2013 at 2:48 pm

Until I got a toto washlet, I was never able to get myself clean enough to avoid itching. I think back on the years of swamp bottom I considered normal and will never go back.

| post followup | alert a moderator |

Anal Itching Treatment

posted by Benteu Darius on 17 Mar 2013 at 2:03 am

Most times anal itching is caused by local or general lesions (symptomatic pruritus) which gives concurrent with illness cause

| post followup | alert a moderator |

A Treatment That Really Works for anal itching

posted by Mike on 13 Mar 2013 at 4:02 pm

I had a severe case for years and tried everything but nothing worked. I guaranty that Miconazole nitrite powder 2% brand name (Zeasorb-AF) sold for athlete's foot, ringworms and jock itch will work. I also useTriamcinolone Acetonide cream 0.1% and alternate between the two but you will need a prescription for the Triamcinolone cream. The itching is caused by a fungus and once under control I just use a body powder with zink oxide and menthol such as (equate) as a daily preventive. You don't need a prescription for the Zeasorb-AF or the body powder which is readily available at drugstores and retail stores. The Zeasorb-AF is truly a miracle cure for this pesky and sometimes unbearable problem. I only wish I had discovered this treatment years earlier!!!

| post followup | alert a moderator |

Anti-Yeast correction

posted by Terri Phillips on 5 Mar 2013 at 9:54 pm

@ canned tomato sauce, BarBQue sauces, V8 and tomato juice because these can be high in vinegar and/or sugar as well.

| post followup | alert a moderator |

tAngel

posted by Terri Phillips on 4 Mar 2013 at 10:02 am

CANDIDIASIS** Also try an low yeast, anti-fungal/anti-mold diet. Yeast is a fungus. It feeds on sugar and can make you eat even more sugar. I went thru a couple days of sugar withdrawl cravings. After over a year and several Dr. visits and all suggestions above, a friend told me about Candidiasis (or Candida). It’s NOT just a female yeast infection but can be an intestinal overgrowth of yeast from diet.

AVOID: SUGARs of all kinds (even fruit & especially fruit juice which seems healthy but is a sugar dumper), yeast baked goods, yeast extract additives (couldn’t believe how many times I saw this in ingredient lists!), dairy products -- beware of cultured yogurt and cheese which uses molds and also yeast, mushrooms, peanuts (the one nut really prone to molds), any products containing malt or malted anything, beer, coffee, tea, or caffeine drinks, any fermented foods or beverages, pickled smoked or dried foods, alcohol and foods containing vinegar (most dressings and condiments, canned sauerkraut). Surprisingly canned tomato sauce, BarBQue sauces, V8 and tomato juice can be high in mold depending on tomato processing.

TAKE: A homeopathic cleanse like Candi-Gone along with Candi-zymes from a natural grocer like Vitamin Cottage or as Dr. for a strong Anti-fungal prescription.

Also try to ‘alkalinize’ your body – start each day (even before you brush teeth or drink/eat anything) by juicing of 1 small or ½ large lemon and drinking that in about 8 oz water. That will chemically switch your digestive system to more alkaline, less acid.

Look for yogurt like Mountain High that is not cultured with the wrong stuff but that has live acidophilus cultures. Eat whole grains and fresh, lightly cooked/steamed veggies. Pau D’Arco tea for cleansing and other herbal teas are just fine. Natural Almond Butter & Coconut oil are great on “Matza” crackers – curbs the carb craving without the yeast/sugar problems.. Almond Milk and Coconut milk are great substitutes for use on cereals.

| post followup | alert a moderator |

have had anal itching for 12 years

posted by tim on 25 Feb 2013 at 3:21 pm

I am so glad to hear these comments. I have had it as a runner, coffee drinker and slow BM every morning...

I was traveling India 2001, and sat on a toilet, it splashed up and nailed me in the anus, never had itching before, it started next day. I have had it off and on since. WHAT do I do?

| post followup | alert a moderator |

thread worms cause anal itching

posted by colin on 23 Feb 2013 at 3:13 am

Theres another reason for itchy anus not mentioned actually. This is thread worms...small white worms that come out and itch around the anal orifice.
Be sure you look in your motions for these..they are very common

| post followup | alert a moderator |

Petroleum Jelly mix worked wonders for anal itching

posted by Josh on 22 Feb 2013 at 2:52 pm

I mixed about a 4th a cup Petroleum Jelly (plain Vaseline) with about a 1/4 tsp cayenne pepper powder and about 8 drops of pure Tea Tree Oil together and it worked wonders.

I had been suffering for weeks and in about 24 hours it was gone, took a soak bath in Epsom salt and put a little of the mix on when I got out for yesterday and then again this morning, and WOW had almost forgot what it was like to be itch free...

It heats up a little at first but doesn't burn.

| post followup | alert a moderator |

Itching Pubic Area

posted by manz on 8 Feb 2013 at 2:25 pm

i'm suffering from itching in my pubic area. i'm sure the cause is not pubic louse/scabies. would pleased if any one kindly let me know the name of a simple cream for the treatment.

| post followup | alert a moderator |

Thank u

posted by munib on 4 Feb 2013 at 6:55 am

this is happens to me the same problem and now i am fine to apply water and your mathod.... thank u so much sir... i use cheap toilet paper.

| post followup | alert a moderator |

Home remedy treatment... anal itching

posted by Brad Reyburne on 2 Feb 2013 at 2:19 pm

I too have suffered from this for many years. I am in my early 40's and trips to the doctor have been unsuccessful.

About a year ago I read something about a product called Zostrix which has an active ingredient called capsaicin, which is found in the chili plant. Zostrix is a white cream which can be applied to the anus. However, IT MUST BE MIXED WITH A PARABIN, such as Desitin. At first I would suggest 8 parts Desitin to 1 part Zostrix, but you can experiment to find a mixture that works best for you. After application it will slowly begin to heat up and pleasantly take away the itch. Try mixing the ingredients in an old pill bottle that has a cap. As I said, it is a treatment and not a cure, but I find that I don't need more than one application every few days.

| post followup | alert a moderator |

thank you! Article on anal itching

posted by mfm on 25 Jan 2013 at 9:11 pm

I've had this issue for over a week now and cause-wise I'm still unsure about, but at least now I have somewhere to start! I'm 15 and I was REALLY not wanting to ask my school nurse or my doctor about it... so thank you again!

| post followup | alert a moderator |

Itch lessened, bleeding stopped with...

posted by george on 24 Jan 2013 at 12:31 pm

I've suffered with all of the above for over 25 years - chronic is the best way to describe it. After reading all of these posts, I decided to really change the diet and I eliminated: Alcohol, Coffee and Dairy products for seven full days. Simultaneously, I began to drink half my body weight (175 lbs) in Oz. of water (80-90 oz./day) and added a morning dose of Metamucil. Finally, i began testing a new hemorrhoid cream "Nelson's H+Care" ($6.00 at Whole Foods!). I use the cream after each BM and before bed...or at anytime I feel that "tingling/itch" coming on.

In conclusion, the removal of beer/wine, caffiene, dairy - in fact ALL of my food test proved negative. THEY DID NOTHING TO STOP THE ITCH. The water, metamucil and cream however were a HOME RUN. The additional water and fiber fundamentally changed my bowel habits and literally the consistency of the stool. There simply is LESS straining (the PRIMARY CAUSE). I wipe more gently as a result - always baby wipes and never paper. I quickly apply the H+Care H -cream and voila...two weeks later - THERE IS NO MORE BLEEDING. The itch is a fraction of what it once was. In my case (which was CHRONIC) it appears to be about hydration added fiber and constant lubrication to keep irritants to a minimum. I have shrinking of external hemmorhoids and i'm hoping to be cured in the next 30 days. We all have DIFFERENT triggers but this was the magic combo to BEGIN the healing for me. I wanted to share because I had a good result without giving up so many of the things I love. Water, Fiber, H-Cream. :)

| post followup | alert a moderator |

Cheap Toilet Papers - anal itching

posted by Jenny on 4 Jan 2013 at 5:47 pm

I had this problem of an itchy bottom that drove me insane for months. Sometimes i bled from rubbing to try get rid of the itch, tried different creams that gave me some relief for a couple of hours then it would start again. Sitting thinking about it i remember my mum never used cheap toilet paper so i thought i would try sorbent toilet paper as she always used it and my itching has completely gone. I am sure there are chemicals used that iritate this area and i have also realised my husband cannot use condoms as i start itching below after he uses them. Try changing it may be all you need to do but give it a week or so.

| post followup | alert a moderator |