Anal itching is a common condition. The itch, situated in or 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 possible causes, such as skin problems, hemorrhoids, and washing too much or not enough.
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 be associated with redness, 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. See your doctor if:
- Anal itching is severe or persistent
- You have anal bleeding
- The anal area seems to be infected
- 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:
- Personal care habits. Your skin care routine may include products or behaviors that irritate the skin. These include washing too much, washing too little, and using soap, moist wipes or toilet paper with dyes and perfumes.
- Infections. Sexually transmitted infections may involve the anus and cause anal itching. Pinworms can cause persistent anal itching. Other parasites may cause similar itching. Yeast infections, which usually affect women, can also cause itching in the anal area.
- Skin conditions. Sometimes anal itching is the result of a specific skin condition, such as psoriasis or contact dermatitis.
- Other medical conditions. These include chronic diarrhea, hemorrhoids, anal tumors and diseases that affect the whole body, such as diabetes.
Often you won't need to see a doctor about anal itching. If the itching persists even after taking self-care measures, bring it up with your primary care doctor. He or she 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 get ready for your appointment.
What you can do
Before your appointment make a list of:
- Symptoms you've been having, including any that may seem unrelated to anal itching
- How long you've been experiencing your symptoms
- All medications, vitamins and supplements you take, including the doses
- Questions to ask your doctor
For anal itching, some basic questions to ask your doctor include:
- What's the most likely cause of my symptoms?
- What tests do I need?
- Is this problem temporary?
- What treatments are available? Which do you recommend?
- Do you think I need to see a specialist?
- Do you have any brochures or other printed material that I can take with me? What websites do you recommend?
What to expect from your doctor
Your doctor is likely to ask you a number of questions, such as:
- Have your symptoms been continuous, or do they come and go?
- How severe are your symptoms?
- Have you had recent changes in your bowel movements, such as diarrhea?
- What type of soap or other products do you use on your body?
- Does anything seem to improve your symptoms?
- What, if anything, worsens your symptoms?
- Have you noticed any other changes in your general health?
- Are others in the home experiencing a similar itch?
What you can do in the meantime
Cleanse the anal 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, medical history and personal habits. If pinworms are suspected, your doctor may suggest doing a test for pinworms. He or she may also give you a physical exam, including a digital rectal exam.
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). He or she may do other tests, such as proctoscopy or colonoscopy to view more of the digestive tract. But it's possible the cause of the itching may never be identified.
Treatment of anal itching depends on the cause of the problem. It may include taking self-care measures such as nonprescription anti-itch cream or treating an infection or hemorrhoids.
If your symptoms are worse at night, your doctor may prescribe an oral antihistamine until an anti-itch cream takes effect.
With proper care most people experience relief from anal itching. See your doctor if the itching persists.
Prevention of anal itching mainly involves washing properly, keeping the area clean, cool and dry, and avoiding irritants. If you already have anal itching, try these self-care measures:
Cleanse gently. After bowel movements, clean the area with plain water or mild soap. It may help to use moist cotton balls or a small squeeze bottle of water. Don't scrub. The goal is to keep the area clean without further irritating the skin.
When traveling by air, take an empty squeeze bottle that you can readily fill with water in bathrooms.
- Dry thoroughly. After cleansing, pat the area dry with toilet paper or a towel. Or use a hair dryer set on low. Unmedicated talcum can help keep the area dry. Avoid cornstarch powder, which can foster bacterial growth. You could place a moistened or dry cotton ball against the anus to help absorb moisture. Replace it as needed.
- Don't scratch. Scratching further irritates your skin and leads to persistent inflammation. You may find some relief by applying a cold compress to the area or taking a lukewarm bath. Trim your nails short and wear cotton gloves while you're sleeping to help prevent scratching.
- 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, genital deodorants, perfumed soaps, moist wipes, witch hazel products and other items that might irritate the anal area. Cut back on or avoid coffee, cola, alcohol, citrus fruits, chocolate, spicy foods, tomatoes and foods that may cause diarrhea. Avoid overuse of laxatives.
- Apply ointments or gels. Protect your skin from moisture by applying a thin layer of a zinc oxide ointment (Desitin, Balmex) or petroleum jelly. You could also use a 1 percent corticosteroid cream (Cortaid, Preparation H Anti-Itch Cream) two or three times a day to relieve itching. But don't use this type of cream for more than two weeks because of possible side effects, such as thinning of the skin.
- 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, 2015
- Breen E, et al. Approach to the patient with anal pruritus. www.uptodate.com/home. Accessed Aug. 7, 2015.
- Bope ET, et al. Diseases of the skin. In: Conn's Current Therapy 2015. Philadelphia, Pa.: Saunders Elsevier; 2015. http://www.clinicalkey.com. Accessed Aug. 7, 2015.
- AskMayoExpert. Pruritus ani. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2014.
- Klein JW. Common anal problems. Medical Clinics of North America. 2014;98:609.
- Nasseri Y, et al. Pruritus ani: Diagnosis and treatment. Gastroenterology Clinics of North America. 2013;42:801.
- Pruritus ani. American Society of Colon and Rectal Surgeons. http://www.fascrs.org/patients/conditions/pruritus_ani/. Accessed Aug. 7, 2015.
- Markell KW, et al. Pruritus ani: Etiology and management. Surgical Clinics of North America 2010;90:125.
- Fargo MV, et al. Evaluation and management of common anorectal conditions. American Family Physician. 2012;85:624.
- Ferri FF. Pruritus ani. In: Ferri's Clinical Advisor 2016. Philadelphia, Pa.: Mosby Elsevier; 2016. https://www.clinicalkey.com. Accessed Aug. 19, 2015.