Anal Itching: 11 Common Causes & What to Do

Medical review: Dr. Clarisse Bezerra
Family Doctor
February 2022

Anal itching is a very common symptom that is usually temporary. It is usually caused by excess sweat, intake of food that irritates the intestines or the presence of unwiped feces in the area. (This last cause is especially common in children, who are unable to sufficiently wipe after a bowel movement). 

If anal itching it very intense or if it does not resolve following thorough hygiene in the area, it may be due to other conditions, like intestinal worms or hemorrhoids. 

Anal itching usually has a cure and treatment involves using adequate personal hygiene. Prescription medication like corticoid-based ointments or zinc oxide and camphor creams can also help to relieve discomfort. These creams are usually used to complement the treatment indicated for the specific cause. 

Test to identify the cause of itching 

To identify the possible cause of your anal itching, complete our online test below by entering your symptoms:

  1. 1.Pain or difficulty with bowel movements
  2. 2.Blood with wiping
  3. 3.Skin peeling and redness in the anus
  4. 4.Presence of small white dots in the stool
  5. 5.Itching that occurs during or after antibiotic use
  6. 6.Itching that occurs after hair removal or after wearing menstrual pads or certain underwear
  7. 7.Itching that arises after unprotected anal intercourse

If you suspect worms, hemorrhoids or an intestinal infection, you should see your doctor for assessment and to initiate appropriate treatment. 

Some causes of anal itching include:

1. Inadequate hygiene

Inadequate hygiene in the anus, especially after a bowel movement, can result in feces remaining in contact with the skin and rectal lining. This can lead to anal itching and irritation, which can increase with the presence of sweat. 

What to do: Ideally, you should rinse the anus after each bowel movement with water and neutral soap to remove any remaining feces. If this is not possible, you should cleanse the area carefully with wet, soft toilet paper and then wash whenever possible. To reduce discomfort and relieve itching, you can use steroid-based ointments, like hydrocortisone, zinc oxide and camphor cream, or witch hazel, for no longer than one week. 

2. Excessive wiping

In contrary to inadequate hygiene, excessive wiping with toilet paper or wet wipes after using the toilet can cause dryness, irritation and itching. 

What to do: You should use soft toilet paper or water-based wet wipes with no chemical substances to tipe. Wipe softly to prevent skin irritation, or opt to wash with water and soap whenever possible. 

3. Diet

There are some foods that can irritate the digestive system and cause anal itching when consume in excess or with frequency. Some examples include: 

  • Spicy food
  • Normal or decaffeinated coffee
  • Chocolate
  • Citrus fruits, like orange, lemon, pineapple or kiwi 
  • Tomato or tomato sauce
  • Sodas

In addition, alcoholic drinks like beer, wine, whiskey, and gin can also cause anal itching. 

What to do: You should ideally avoid or reduce the consumption of the above foods. Generally, you should notice an improvement after 2 to 3 days of the diet change. If the symptoms persist, however, you should see your doctor for assessment and treatment as necessary. 

4. Intestinal parasites 

Anal itching, especially in children, is a very common symptom of a pinworm infection. Itching caused by this parasite is usually very intense and occurs mostly at night, when female parasites move toward the external anus to deposit eggs. Pinworms can be confirmed by the presence of small white pinpoints in the anal borders. You should consult a doctor for assessment and treatment if you suspect pinworms. 

Pinworms can be transmitted through contaminated water or food, or through contact with objects contaminated with pinworm eggs. Fecal-oral transmission is common when anal itching is followed by hand-to-mouth contact without hand hygiene. 

In adult women, parasites can exit the anus and enter the vagina and vulva, causing intense anal and vaginal itching. Learn more about the symptoms associated with intestinal parasites. 

What to do: Treatment for pinworms should be prescribed by the doctor and should involve the use of medications like albendazole or mebendazole. Everyone in the family who has been in direct contact with the affected person should also complete treatment. In addition, some hygiene habits should be taken into consideration while treating, like thorough hand hygiene after toilet use, deep-cleaning all toys, washing clothes and bed linens of the affected person separately from others and vacuuming frequently to eliminate any possible eggs that are in the home environment. 

5. Antibiotic use 

Actively taking an antibiotic or having used one recently can alter bacterial flora in the intestines and anus. It can promote the growth of Candida albicans fungus which can lead to a yeast infection and cause anal itching. 

In addition, diarrhea is a common side-effect of antibiotics and it can irritate the skin around the anus and cause itching. 

What to do: If you are using an antibiotic and experience anal itching or diarrhea, you should inform your doctor so that these symptoms can be addressed. Generally, treatment will involve the use of corticoid-based ointments to reduce anal irritation from diarrhea, or antifungal ointments to treat yeast infections. In addition, consuming probiotics like Kefir or natural, unsweetened yogurt while using antibiotics can help to maintain bacterial flora levels and prevent diarrhea or anal itching. 

6. Allergy

Some allergies caused by hygiene products, like scented toilet paper, deodorant, talc powder or scented soaps can irritate the skin and cause wounds, which can lead to anal itching. 

In addition, waxing, menstrual pads or even clothing fabric can cause skin reactions, resulting in skin irritation and itching.

What to do: In this case, you can use a steroid-based ointment to relieve discomfort and reduce the reaction, which will help with anal itching. In addition, other considerations like using unscented and soft toilet paper and avoiding deodorizer in the genital area can prevent itching. 

7. Hemorrhoids

Hemorrhoids occur due to swelling and inflammation of the blood vessels in the skin and borders of the anus. They usually cause pain and bleeding with bowel movements, however hemorrhoids can also cause anal itching. Learn about what can cause hemorrhoids.

In addition, hemorrhoids can make cleaning of the anal region more difficult, which can lead to more itching. 

What to do: To reduce anal itching, you can use anesthetic creams, anticoagulant creams or steroid-based ointments. You may find relief from medications like anti-inflammatories (like ibuprofen or diclofenac), which should be prescribed by the doctor. Treatment will often vary depending on whether you have internal hemorrhoids or external hemorrhoids

In addition, to treat the hemorrhoid and reduce itching, stool softeners like docusate or psyllium are recommended, as well as 10-minute sitz baths in warm water after each bowel movement. You can also use ice compresses to reduce swelling and relieve symptoms. You should also avoid using toilet paper altogether, and opt to clean the anal region with water and soap after each bowel movement, making sure to pat dry after washing. 

8. Infections

Infections that can cause anal itching incude: 

  • Fungal infection: Yeast infections are the most common type of infection that cause anal itching. It occurs with imbalances in bacterial flora, caused by poor hygiene, a weakened immune system (like in diabetes or HIV), excessive sweat or heat from physical activity, obesity, or antibiotic use. 
  • Scabies infection: This occurs due to a Sarcoptes scabiei infection. It can cause intense itching with red bumps in the anal area, as well as on the rest of the body. 
  • Crabs: This infection is caused by the Phthirus pubis insect, which infects the pubic area. It can cause intense anal itching as well as itching in the pubic area. 
  • Sexually-transmitted infection (STI): Anal itching can be a symptom of an STI, like HPV, genital herpes, syphillis and gonorrhea. 

Another infection that can cause anal itching is erythrasma, which is caused by the Corynebacterium minutissimum bacteria. Symptoms include skin flaking and redness in the anal area, groin and thighs, and it is occurs most commonly in diabetics and people who are overweight. 

What to do: In these cases, a medical assessment is advised to identify the type of infection so that appropriate treatment can be initiated. Treatment usually includes the use of medications like antifungals, antibiotics or antivirals. Learn more about the treatment typically used to resolve yeast infections.

Home remedies for anal itching 

A good home remedy for anal itching is using a witch hazel ointment. With hazel contains astringent and anti-inflammatory properties that help to soothe irritation. 

Ingredients

  • 60 ml de liquid paraffin
  • 4 tablespoons of dried witch hazel
  • 60 ml de glycerin

How to prepare

Pour the paraffin and witch hazel in a pot and boil for 5 minutes. Then strain and add to the glycerine. Place the mixture in a container with a lid and store in the fridge. Use this on a daily basis, 3 to 4 times a day, for a maximum of 7 days. 

When to go to the doctor

You should see a doctor when you your anal itching is accompanied by symptoms like: 

  • Pain
  • Bleeding 
  • Decreased sensitivity or feeling in the surrounding skin  
  • The sensation that the surrounding skin is becoming thicker
  • The presence of pus

In addition, if anal itching does not improve in 2 weeks, even with improved hygiene practices, use of ointments or diet changes, you should seek a medical opinion for diagnosis and treatment to relieve your symptoms. 

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Atualizado por Tua Saude editing team, em February de 2022. Medical review por Dr. Clarisse Bezerra - Family Doctor, em February de 2022.

References

  • KREUTER, Alexander. Proctology – diseases of the anal region. Journal of the German Society of Dermatology. 14. 4; 352-373, 2016
  • SWAMIAPPAN, Murugan. Anogenital Pruritus – An Overview. J Clin Diagn Res. 10. 4; WE01–WE03, 2016
Show more references
  • ANSARI, Parswa. Pruritus Ani. Clin Colon Rectal Surg. 29. 1; 38–42, 2016
Medical review:
Dr. Clarisse Bezerra
Family Doctor
Dr. Bezerra possesses a medical degree and specializes in family medicine. She is licensed to practice under CRM-CE licence #16976.