What is an itchy anus?

An itchy anus (bottom or bum) can be an embarrassing and uncomfortable problem. The itch in or around the anus, can be extremely intense and persistent, causing a constant urge to scratch.

If you have an itchy anus, your scratching may trigger an ‘itch-scratch-itch’ cycle. This is when you feel itchy, so you scratch to make it feel better. But scratching can actually cause more irritation and make it worse, which creates a cycle of itching and scratching.

However, once the cause is discovered, there are many options available to help relieve symptoms.

Itchy anus is also known as pruritus ani.

What are symptoms of an itchy anus?

At first, the skin around your anus will be red and scratched. If your itch is ongoing and you can’t stop scratching, the skin around your anus becomes thickened from all the rubbing and irritation.

If your itchy anus is caused by threadworms, your itch may be worse at night. You might be able to see small white worms in the area.

What causes an itchy anus?

There are many possible causes for having an itchy anus. Some of them are due to diet or lifestyle habits, such as:

• diet — food intolerances and foods associated with itchy anus include caffeine, alcohol, chocolate, tomatoes, spices and citrus fruits
• sexually transmitted infections — genital herpes, syphilis, gonorrhoea or chlamydia
• hygiene — one of the most common causes is overcleaning
• leakage of poo (stool) from your rectum — because of diarrhoea, constipation, laxatives or enemas

Some causes of an itchy anus relate to a medical cause, such as:

• skin conditions — eczema, psoriasis and contact dermatitis which can be an allergic reaction to soaps, creams or perfumed or bleached toilet paper
• conditions affecting your anus — haemorrhoids, abscesses or anal fissures
• other health conditions — diabetes, underactive thyroid, or rarely, cancer of the anus
• infections — bacterial infection, tinea or threadworm in young children or their family

How can I care for an itchy anus at home?

If you know the cause of your itchy anus, your treatment should focus on managing it.

There are also several lifestyle changes you can try that may ease the itching.

Stop scratching

• Repeated scratching and rubbing can cause the skin around your anus to thicken. This makes the itchiness worse.
• Sometimes when you sleep scratching is unavoidable.
• Try and break the itch-scratch-itch cycle, so your skin can start to heal — ask your doctor or pharmacist for help.

Diet

• A high fibre diet may be helpful if frequent loose poos are causing your itchy anus.
• Avoid caffeine, alcohol, tomatoes, spices and citrus fruit.

Clothing

• Wear loose clothing made from natural fibres, such as cotton.
• Avoid wearing nylon underwear.
• Males should wear cotton boxer shorts.

Personal hygiene

• After going to the toilet: Avoid harsh wiping. Some people find wiping with cotton wool balls dipped in warm water more comfortable than using toilet paper. Do not rub the area, as this has the same effect as scratching.
• Showers: Keep showers short and not too hot. Some people find a quick shower after going to the toilet helpful.
• Hygiene products: Choose sensitive skin care products, such as perfume-free creams and toilet paper.
• Stop using soaps: Try using soap substitutes. Soaps, shampoos, bubble baths all remove the natural oils from your skin making it dry and itchy. Ask your pharmacist for a recommendation.
• Sweating: If you find sweating makes you itchier, try folding a perfume-free tissue into a small square and placing it over the area to absorb any sweat. Change the tissue often.

Medicines

• Your doctor may prescribe you a low strength steroid ointment.
• If threadworms are causing your itching, you can buy over the counter medicines from your pharmacy. This treatment should be repeated 2 weeks later. The whole family will need to be treated.

When should I see a doctor?

Despite taking these measures, it’s important to see your doctor if:

• you have any anal bleeding
• the area seems to be infected
• you don’t know what’s causing the itch
• the itch is intense
• the itch lasts longer than 2 months

Your doctor can check that rare and specific causes of itchy anus (such as worms and anal cancer) aren’t overlooked. They can prescribe treatments for the cause of the itch, and can also give you advice to manage your symptoms, so you are less likely to scratch.

How is itchy anus diagnosed?

As with all general health issues, the best place to start is by seeing your GP. Depending on your symptoms and any other co-existing health conditions, your doctor may refer you to a dermatologist (skin specialist) who will examine your body. They will check if your itchy anus is caused by a skin condition.

Sometimes your doctor may choose to do the following tests:

• skin biopsy: to rule out any specific causes
• blood tests: to check for diabetes
• allergy testing: to check if your itch is due to an allergic reaction
• proctoscopy: a colorectal surgeon will put a small camera in your anus to look for haemorrhoids, anal fissures or warts

Resources and support:

• Read more about itchy anus on The Australasian College of Dermatologists ‘Pruritus Ani’ page.
• Learn more about haemorrhoids, a condition that can cause itchy anus on our healthdirect ‘Haemorrhoids’ page.
• Call healthdirect on 1800 022 222 (known as NURSE-ON-CALL in Victoria) for more information and advice. A registered nurse is available 24 hours a day, 7 days a week.