Anal itching is a common condition. The itch, situated in your anus or on the skin just around your anus, is often intense and may be accompanied by a strong urge to scratch. You may find anal itching to be embarrassing and uncomfortable.
Also called pruritus ani (proo-RIE-tus A-nie), anal itching has many causes, such as skin problems, excessive washing or hemorrhoids.
If anal itching is persistent, talk with your doctor. With proper treatment and self-care measures, most people get complete relief from anal itching.
Anal itching may also be associated with burning and soreness. The itching and irritation may be temporary or more persistent, depending on the cause.
When to see a doctor
Most anal itching doesn't require medical care. However, see your doctor if:
- Anal itching is severe or lasts longer than one to two months
- There's bleeding from the rectum
- You can't figure out what's causing a persistent itch
Persistent anal itching may be related to a skin condition or other health problem that requires medical treatment.
Possible causes of anal itching include:
- Skin irritation. Friction and moisture can irritate the sensitive skin in the anal area. This irritation sometimes causes anal itching. Scents, dyes and softening agents in products such as soap and toilet paper may also trigger irritation and anal itching. Overuse of these products often aggravates the problem.
- Digestive problems. Repeated bouts of diarrhea can cause anal irritation and itching. Accidental leakage of feces (fecal soiling or incontinence) is often a contributing factor.
- Hemorrhoids. Hemorrhoids are engorged veins located just under the membrane that lines the lowest part of your rectum and anus. They often occur as a result of straining during a bowel movement. Anal itching can be a symptom of hemorrhoids.
- Infections. Sexually transmitted infections may also involve the anus and can cause anal itching. In children, the parasite that causes pinworms can cause persistent anal itching. Adults in the same household can also be infected. Other parasites may cause similar itching. Yeast infections, which usually affect women, can also cause itching in the anal area.
- Skin disease. Sometimes, anal itching is the result of a specific skin disease, such as psoriasis or contact dermatitis.
- Anal tumors. Rarely, benign or cancerous tumors in or around the anus may be a cause of anal itching.
Often, you won't need to see a doctor about anal itching. If the itching is persistent, bring it up with your primary care doctor. Depending on the cause of your anal itching, your primary care doctor may refer you to a skin specialist (dermatologist) or a doctor who specializes in treating rectal and anal problems (proctologist).
Here's some information to help you prepare for your initial appointment.
What you can do
- Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
- Make a list of all medications, vitamins or supplements you're taking.
- Write down questions to ask your doctor.
Preparing a list of questions for your doctor will help you make the most of your time together. For anal itching, some basic questions to ask your doctor include:
- What's the most likely cause of my symptoms?
- What kinds of tests do I need?
- Is this problem temporary?
- What treatments are available? Which do you recommend?
- Should I see a specialist?
- Are there any brochures or other printed material that I can take home? What websites do you recommend?
What to expect from your doctor
Your doctor is likely to ask you a number of questions, including:
- When did you begin experiencing symptoms?
- Have your symptoms been continuous or do they come and go?
- How severe are your symptoms?
- Have you had recent changes in bowel habits, such as diarrhea or loose bowel movements?
- What type of soap or other cleansers do you use on your body?
- Does anything seem to improve your symptoms?
- What, if anything, worsens your symptoms?
What you can do in the meantime
Cleanse the area gently immediately after bowel movements and dry thoroughly. Wear cotton underwear and loose clothing. Try not to scratch.
Your doctor may be able to diagnose the cause of your itching simply by asking you questions about your symptoms.
If the cause of your itching isn't obvious, your doctor may refer you to a skin specialist (dermatologist) or a doctor who specializes in treating rectal and anal problems (proctologist) for further evaluation. A rectal exam may be all that's required for you to get an answer — and a solution — to a very uncomfortable problem.
Other tests, such as proctoscopy or colonoscopy to view more of the digestive tract, are sometimes needed to identify an underlying cause of anal itching. However, the precise cause of the itching may never be identified.
Treatment of anal itching depends on the cause of the problem. It may include self-care measures, changes to your diet, treatment of infections or, rarely, surgery to correct an underlying problem.
Medications that might help include:
- Over-the-counter cream or ointment containing hydrocortisone (Cortaid, Preparation H Anti-Itch Cream). Apply sparingly to the affected area to reduce inflammation and itching.
- A protective ointment that contains zinc oxide (Desitin, Balmex). Applied to the affected area, this also may help.
- Antihistimine. If your symptoms are worse at night, your doctor may prescribe an antihistamine to reduce itching until topical treatments take effect.
- Anti-parasite treatment. Several medications are available for treating pinworm infections. A single dose may cure the infection, but often a second dose is given one to two weeks later.
With proper treatment, most people experience relief from anal itching in less than a week. Anal itching that continues for more than one to two months needs to be evaluated by your doctor.
Prevention of anal itching mainly involves washing properly and avoiding irritants. If you already have anal itching, try these self-care measures:
- Cleanse gently. Wash the area immediately after bowel movements. Don't scrub and avoid using soap. Instead, use a wet washcloth, wet unscented toilet paper or a small squeeze bottle of water to cleanse the area.
- Dry thoroughly. After cleansing, pat the area dry with toilet paper or a towel or use a hair dryer. Cornstarch powder can help keep the area dry.
- Don't scratch. Scratching further irritates your skin and leads to persistent inflammation. If you can't tolerate the itching, apply a cold compress to the area or take a lukewarm bath to find some immediate relief.
- Wear cotton underwear and loose clothing. This helps keep the area dry. Avoid wearing pantyhose and other tightfitting garments because these can trap moisture.
- Avoid irritants. Avoid bubble baths and genital deodorants. Cut back or avoid beverages, such as coffee or cola, and foods that you know might cause diarrhea. Avoid overuse of laxatives.
- Maintain regular, firm bowel movements. If soft stools or frequent bowel movements are a problem, gradually adding fiber to your diet may help. Fiber supplements, such a Metamucil or Citrucel, also may help.
Oct. 09, 2012
- Breen E, et al. Approach to the patient with anal pruritus. http://www.uptodate.com/home/index. Accessed Aug. 10, 2012.
- Markell KW, et al. Pruritus ani: Etiology and management. Surgical Clinics of North America 2010;90:125.
- McPhee SJ, et al., eds. Current Medical Diagnosis & Treatment 2012. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/content.aspx?aID=747. Accessed Aug. 9, 2012.
- Pruritis ani. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/gastrointestinal_disorders/anorectal_disorders/pruritus_ani.html?qt=Pruritus%20Ani&sc=&alt=sh. Assessed Aug. 9, 2012.
- MacLean J, et al. Pruritis ani. Australian Family Physician. 2010;39:366.
- Stermer E, et al. Pruritus ani: An approach to an itching condition. Journal of Pediatric Gastroenterology and Nutrition. 2009;48:513.
- Pruritus ani. American Society of Colon and Rectal Surgeons. http://www.fascrs.org/patients/conditions/pruritus_ani/. Accessed Aug. 10, 2012.