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What Causes Anal Itching? Causes & Treatments

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Medically reviewed by
Certified Nurse Midwife, Takoma Park Gynecology
Last updated April 15, 2022

Anal itching quiz

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An itchy anus, also known as pruritus ani, is a common condition that has an array of causes. The most common causes for anus itching include hemorrhoids, dermatitis , or irritation from hygienic products. Read below for more information on causes, related symptoms, and treatment options for rectal itching.

6 most common causes

Yeast Infection
Hemorrhoids
Dermatofibroma
Contact Dermatitis
Illustration of a health care worker swabbing an individual.
Anal cancer
Illustration of a doctor beside a bedridden patient.
Pinworm infection

Anal itching quiz

Take a quiz to find out what's causing your itch.

Take anal itching quiz

Itchy anus? your symptoms explained

Anal itching is probably not a common topic of conversation; however, this symptom can be bothersome and impossible to ignore. Anal itching, also known as pruritus ani, can sometimes be just a normal itch. If you're experiencing itchiness on a regular basis, there could be a more serious cause to consider.

Common characteristics of anal itching

If you're experiencing anal itching, it can likely be described by:

  • Itching around the anus
  • Burning
  • Pain from traumatized skin
  • Soreness

How is anal itching diagnosed?

If your symptoms persist or you can't pinpoint a cause, you need to schedule an appointment with your physician. He or she will ask you a few questions and likely examine the area.

Your physician may order a test to determine if an infection or a parasite is present. If a cause still cannot be determined, you may need to see a dermatologist or proctologist. In some cases, the cause of anal itching is never diagnosed. Instead, different treatment plans are explored until a solution is found.

7 anal itching causes

Skin conditions

Your anal itching may be the result of a certain skin condition, such as the following.

  • Dermatitis: There are several skin conditions that can cause itchy skin anywhere on the body, including the anus. If you've already been diagnosed with dermatitis or psoriasis, this is the most probable cause of your itching.
  • Hygiene: If you wash too much, you could be drying out the skin, leading to itching. If you're not washing enough, stool buildup can also cause itching.

Infectious causes

Anal itching may be due to an infection, such as the following.

  • Parasitic: There are a variety of parasitic infections that can cause anal itching symptoms, such as pinworms, a common intestinal parasite.
  • Sexually transmitted: Certain sexually transmitted infections and diseases can lead to anal itching. Genital warts are one.

Other conditions

Certain conditions can result in anal itching.

  • Diabetes: Candidiasis is linked to diabetes, which can cause itching. Patients with diabetes can also experience anal itching without candidiasis.
  • Inflammatory bowel syndrome: The causes of inflammatory bowel syndrome and anal itching are sometimes the same.

Dietary causes

Certain dietary habits may result in anal itching.

  • Irritants: Certain foods, like dairy products, spicy foods, and nuts, can irritate skin during bowel movements. Itching may occur as the skin heals.
  • Eating habits: Poor eating habits can lead to constipation. Hemorrhoids can develop as a result of itching.

Yeast infection

A vaginal yeast infection, also called genital/vulvovaginal candidiasis, is actually caused by the fungus Candida albicans and is very common. The organism is a normal inhabitant of the mouth, gastrointestinal tract, and vagina.

Antibiotics can kill off the healthy bacteria in the vagina, allowing overgrowth of the fungus. Women who are pregnant, on the birth control pill, or diabetic are more prone to yeast infections, as are those who have weakened immune systems. It can also be transmitted through sex or through mouth-to-genital contact.

Symptoms include itching, burning, pain, and soreness inside the vagina and on the external tissues (the vulva,) and a thick, white vaginal discharge.

If not treated, the yeast infection can become "complicated," severe, and difficult to cure.

Most yeast infections are diagnosed simply through the patient's description of symptoms. Recurrent infections may be diagnosed through pelvic examination and vaginal swab.

Treatment often is just an over-the-counter cream, though oral anti-fungal medications are sometimes prescribed.

Pinworm infection

Pinworm infection, also known as Enterobiasis, is the most common worm infection in the United States. It can be passed from one person to another if contaminated fecal matter is ingested. The most common symptom of this infection is itching around the anus, especially at night.

While this infection is not particularly dangerous, it can be transmitted easily - particularly between people in the same household. Prescription medication is extremely effective, but in most cases the entire household must be treated at the same time to completely eliminate the infection. A primary care physician will be able to prescribe this medication; specialists or urgent care is not needed.

Rarity: Rare

Top Symptoms: anal itching, constant but weak urination stream

Symptoms that never occur with pinworm infection: constant but weak urination stream

Urgency: Primary care doctor

Anal itching quiz

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Hemorrhoids

Hemorrhoids, or "piles," are swollen veins in the anus or rectum. They may be located inside the rectum (internal) or outside the body at the anus (external.)

The condition is caused by straining during bowel movements and/or from increased pressure during pregnancy and childbirth.

Hemorrhoids are a common occurrence, especially in older people. Pregnant women are susceptible, as is anyone who has chronic constipation or is obese.

Symptoms include discomfort, pain, pressure, and itching. There may be small amounts of bleeding during bowel movements, though some hemorrhoids cause no symptoms at all.

Severe pain can indicate a thrombosed hemorrhoid, meaning a clot has formed within it. This is not serious but the pain can be debilitating and requires treatment right away. Also, rectal bleeding can also be a sign of more serious diseases such as diverticulitis or cancer and should always be diagnosed by a medical provider.

Diagnosis is made through physical examination and sometimes through colonoscopy.

Treatment begins with good hygiene, cold compresses, and over-the-counter pain relievers. Surgery may be done for some cases.

Dermatofibroma

A dermatofibroma is a fairly common skin growth that usually appears on the lower legs, but may appear anywhere on the body. These mole-like growths are benign (noncancerous.)

The cause is not known, though a dermatofibroma may appear after a minor injury. The growths are not contagious.

Dermatofibromas are most common in adults and are rarely found in children.

Symptoms include a hard, raised growth that is red, pink, or brown and less than half an inch across. They are usually painless but may be tender or itchy, and may appear alone or in groups.

Any new growth on the skin should be seen by a medical provider, especially if the growth is very dark in color or changes its shape or appearance quickly.

Diagnosis is made through physical examination and sometimes biopsy.

A dermatofibroma does not require treatment unless it is interfering with clothing or is unsightly. They can be surgically removed, though this will leave a scar and the growth may eventually return.

Anal cancer

Anal cancer is a neoplasm, or tumor, growing in the tissues of the anus. The tumor may be malignant (cancerous) or benign (non-cancerous.)

Most anal cancers are linked to the human papilloma virus, or HPV. However, many people carry HPV and have no symptoms or illness of any kind.

Most susceptible are men who have sexual contact with men; women who have had cervical cancer; and anyone who has engaged in anal intercourse, had anal warts, or is HIV positive. Smoking and lowered immunity are also factors.

Symptoms include minor anal bleeding and itching, which may be attributed to hemorrhoids; pain or fullness in the anal region; and abnormal anal discharge.

It is important to see a medical provider about these symptoms so that if needed, treatment can begin as soon as possible.

Diagnosis is made through patient history; physical examination; anal swab; and biopsy. CT scan, ultrasound, or endoscopy of the anus may also be done.

Treatment involves some combination of surgery, radiation therapy, and chemotherapy depending on the needs of each individual patient.

Allergic contact dermatitis of the butt

Allergic contact dermatitis means the skin has touched something that provoked an allergic reaction, causing inflammation and irritation.

"Contact" means the allergic reaction came from touching something, not from consuming something. The first exposure to the substance sensitizes the immune system, and then the second exposure actually causes the symptoms.

The most common causes of allergic contact dermatitis are:

  • Nickel, a metal often used in belt buckles, the buttons on pants, and jewelry, including piercing jewelry.
  • Poison ivy.
  • Various types of perfumes, including those founds in soaps, fabric softeners, and detergents.
  • Of course, there are many more.

Symptoms include red, itching, scaling, flaking skin that may be painful due to the irritation and inflammation.

Diagnosis is made through first avoiding contact with any suspected substance, to see if the dermatitis clears. Patch testing can be done if the results are not certain.

Treatment involves fully avoiding the allergy-provoking substance and using topical steroid cream as prescribed. Cool compresses and calamine lotion can help to ease the discomfort.

Rarity: Common

Top Symptoms: butt itch, butt redness, scabbed area of the butt

Symptoms that always occur with allergic contact dermatitis of the butt: butt redness

Urgency: Self-treatment

Chronic or recurrent hemorrhoids

Chronic, or recurrent, hemorrhoids are swollen veins in the anus and rectum that never really resolve and may be symptomatic more or less constantly.

Hemorrhoids are caused by anything that puts pressure on the anus from the inside, such as straining during bowel movements; constipation; pregnancy; or anal intercourse.

Most susceptible are pregnant women and older people, though anyone can be affected.

Symptoms include a small amount of bleeding during or after a bowel movement, as well as discomfort, itching, or swelling around the anus.

A medical provider can suggest treatment to ease the symptoms of chronic hemorrhoids, as well as make certain of the diagnosis since other, more serious conditions can have symptoms similar to hemorrhoids.

Diagnosis is made through patient history and physical examination.

Treatment most often involves simple lifestyle changes such as drinking more water; adding fiber-rich foods to the diet; using fiber supplements and stool softeners; not delaying, or straining, to pass a bowel movement; and using topical medications. Surgical procedures to remove the hemorrhoid can be used in some cases.

Rarity: Common

Top Symptoms: rectal bleeding, rectal pain, pain when passing stools, anal itching, painless rectal bleeding

Symptoms that never occur with chronic or recurrent hemorrhoids: unintentional weight loss

Urgency: Self-treatment

Anal itching quiz

Take a quiz to find out what's causing your itch.

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At-home and professional treatment for anal itching

For most people, anal itching is nothing more than an embarrassing nuisance. But for those who have a persistent case, medical intervention may be necessary.

When to see a doctor for anal itching

Schedule an appointment sooner than later if you're experiencing any of the following along with anal itching:

  • Anal bleeding
  • Signs of infection or severe pain
  • Persistent itching with no obvious cause
  • Intense swelling or dark bruising around the area

At-home treatments for anal itching

There are several treatments and preventative measures you can try at home to relieve anal itching.

  • Thorough cleansing: After bowel movements, use water to cleanse the area instead of toilet paper, which can further irritate broken skin. Make sure to dry thoroughly using a clean towel.
  • Don't scratch: Scratching can make the anal itching worse as it irritates the skin. If you need relief, press a cold compress to the area.
  • Wear cotton: Wearing cotton undergarments and loose clothing will help to keep the area dry and avoid irritation.
  • Ointments: You can apply thin layers of zinc oxide ointments to keep the skin dry and protected. If you're suffering from hemorrhoids, coconut oil is a natural topical that can speed up healing.

FAQs about anal itching

Here are some frequently asked questions about anal itching.

Why does my anus itch after a bowel movement?

Anal itching can be caused by many things, such as stool or urine that remains on the skin after using the restroom. Hemorrhoids may cause itching as they heal after a bowel movement. Partially healed anal fissures and pinworms, a parasite affecting children from consumption of unsanitary food, can also cause itchiness.

Why is my anus itchy and burning?

Itchiness and burning are common symptoms of external hemorrhoids and anal fissures. Microabrasions can occur with excessive diarrhea. Itchiness and burning may also be a sign of a sexually transmitted illness. There are many other causes; if the itching and burning continue, seek medical evaluation.

Why is my anus itchy and bleeding?

An itchy and bleeding anus may be a sign of an anal fissure. This is a small tear in the skin of the anus when a hard stool overstretches the anus. It may cause blood on the stool, in the toilet bowl, or on the toilet paper. If you are experiencing anal (or rectal) bleeding with no known cause, you should seek medical attention.

Can eczema cause an itchy anus?

Yes, atopic dermatitis or eczema can cause skin thickening and raised bumps around the anus as well as itching. It is most common in children 5 to 7 years of age and usually occurs in the flexing areas of the elbows and knees. It can also occur in the gluteal region around the anus.

Does my anus itch because of an infection?

Yes, it is possible for both a sexually transmitted disease and a parasite to cause itchiness around the anus. Parasites are much more common among young children and sexually transmitted diseases are almost exclusively found in adults. If you suspect either cause of infection, you should seek medical attention.

Questions your doctor may ask about anal itching

  • Have you had any changes in your weight?
  • Do you have a rash?
  • Do you have a history of constipation?
  • Do your symptoms worsen when sitting?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

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Certified Nurse Midwife, Takoma Park Gynecology
Carina is a Nurse-Midwife with 20 years of clinical experience in both high- and low-risk obstetrical settings. She received her MS and BSN from Columbia University of Nursing. Most recently she has extended her scope of practice to include care for the peri/menopausal woman, and has NCMP (North American Menopause Society Certified Menopause Provider) certification in this area. Carina also has ex...
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References

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