The anus is the opening where bowel movements leave the body. The skin around the anus can easily become irritated and inflamed. You may feel burning, soreness, and intense itching. This can make you want to scratch the area.
Causes of anal itching include:
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Excess moisture on the skin around the anus. This can be from sweating, or from stool remaining on the skin after a bowel movement.
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Hemorrhoids.
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Anal fissures and fistulas. These are small cracks in the skin around the anus and small tunnels between the skin and the bowel. They are usually caused by infection or an abscess.
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Infection, especially fungal or from parasites such as pinworms.
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An abscess.
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Skin disorders such as dermatitis or psoriasis.
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Inflammatory bowel disease such as Crohn's disease.
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Rectal polyps or cancer.
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Foods such as caffeine, dairy products, chocolate, spicy foods, and acidic foods (tomatoes, citrus).
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Alcohol.
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Medicines such as chemotherapy and antibiotics.
The cause is not usually poor cleaning. In fact, too much cleaning with soap, and too roughly rubbing or wiping with tissue or a washcloth, can make it worse.
How is anal itching evaluated?
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A doctor can ask you questions and do a physical exam to help figure out the cause of your anal itch.
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Lab tests and stool tests may be done.
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Sometimes the doctor needs to perform a digital rectal exam, and look into the anus or the rest of the large intestine with a scope.
Home care
Your doctor may prescribe medicines. These can relieve pain and itching and help the area heal. These medicines may include skin ointments, steroid creams, antibiotic creams, or antihistamines. You may need antibiotics if there is an infection. Follow the doctor’s instructions for using these medicines.
Here are some general care guidelines:
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Try not to scratch. This makes itching worse.
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Use unscented, soft toilet paper.
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Gently wash the anal area with an unscented baby wipe, wet cloth, or wet toilet paper. Do this each morning and night and after every bowel movement. Don't use soap. This can irritate the area.
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Don't use skin care products that may irritate the area. These include soaps, bubble baths, genital deodorants, and scented wipes.
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Shower after exercise to rinse sweat from the anal area.
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After showers or baths, pat the skin dry rather than rubbing with a towel.
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Wear loose-fitting cotton underwear. Avoid pantyhose and tight pants. Change underwear every day.
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Avoid foods or drinks that cause irritating bowel movements. These include coffee, chocolate, nuts, spicy foods, and acidic foods such as citrus and tomatoes.
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Eat more fiber.
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Don't use laxatives unless your doctor tells you to.
Follow-up care
Follow up with your doctor, or as advised.
When to get medical advice
Call your doctor right away if you have:
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A fever of 100.4°F (38°C) or higher, or as advised.
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Stool leaking from the anus.
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New or worse pain, rash, swelling, or itching after using prescribed medicine.
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A small amount of blood in stool.
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Small worms (pinworms) in the stool or around the anus.
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Foul-smelling discharge from the anus that is not stool.
Call 911
Call 911 or get medical care right away if you have:
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A large amount of blood in the stool.
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Bleeding from the anus that does not stop.
