Anal Itching (Pruritis Ani)

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. Many factors lead to anal itching. Causes of anal itching include:

  • Excess moisture on the skin around the anus. This can be from sweating, or from stool remaining on the outside after a bowel movement.

  • Hemorrhoids

  • Anal fissures and fistulas

  • Infections, particularly fungal or from parasites like pinworms

  • Abscesses

  • Skin disorders

  • Rectal polyps or cancer

  • Foods such as caffeine, dairy products, chocolate, spicy foods, and acidic foods (tomatoes, citrus)

  • Alcoholic beverages

The cause is not from poor cleaning, but from irritation. In fact, excessive cleaning with soap, and too roughly rubbing or wiping with tissue or a washcloth, can make it worse.

A doctor can ask you questions to help figure out the cause of your anal itch. You may be examined and lab tests may be done. Sometimes the doctor needs to perform a digital rectal exam, and look into the anus or the rest of the large intestine. Stool tests may also be done. These help the doctor decide how best to treat the problem.

Home care

Your healthcare provider may prescribe medicines. These can relieve pain and itching to help the affected skin heal. These medicines may include skin ointments, steroid creams, antibiotic creams, or antihistamines. You may need antibiotics if there is an infection. Follow the provider’s instructions for using these medicines. 

The following are general care guidelines:

  • Don't scratch—this irritates the anus and makes itching worse.

  • Gently wash and dry 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.

  • Use unscented, soft toilet paper.

  • Avoid skin irritants in the anal area. These include soap, bubble baths, genital deodorants, and scented wipes.

  • Wear loose-fitting underwear made of cotton. Avoid pantyhose and tight pants. Change underwear every day.

  • Shower after exercise to rinse sweat from the anal area. Dry gently.

  • Avoid foods and drinks that cause irritating bowel movements. These include coffee, acidic foods such as citrus and tomatoes, chocolate, nuts, and spicy foods.

  • Eat more fiber in your diet.

  • Don't use laxatives unless your provider tells you to.

Follow-up care

Follow up with your healthcare provider, or as advised.

When to seek medical advice

Call your healthcare provider right away if any of these occur:

  • Fever of 100.4°F (38°C) or higher

  • Stool leaking from the anus

  • Increase in pain, rash, swelling, or itching after using prescribed medicine

  • Blood in stool

  • Small worms (pinworms) in the stool or around the anus.

  • Bleeding from the anus that doesn’t stop

  • Foul-smelling discharge from the anus that is not stool

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© 2000-2020 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.