Anal Itch

" Pruritus Ani) otherwise called anal itch has a variety of causes, from irritation due to rough toilet paper, to chemicals in the food we eat (peppers, hot spices) to anal leakage. Anal itch represents that there is skin irritation in the anus that can become so severe that a person cannot stop scratching, which can lead to further irritation. A visit to your doctor to discuss your symptoms can lead to treatment solutions such as topical creams or an antihistamine. If necessary, other tests can be performed to find the cause of the itch. "  

Causes of External Anal Itch

Some of the causes of an itchy anus include:

  • Too much moisture. Moist sticky stools or excessive sweating around the anus can lead to itching.
  • Chemical irritants. Douching, laundry soap, birth control medication and colognes can contain chemicals that irritate the anal area.
  • Incontinence. Chronic diarrhea or anal leakage can cause itching.
  • Dry skin. As a person grows older, skin tends to become drier. This can cause itching.
  • Excessive washing. The use of strong soaps or strenuous washing can cause anal itching. Also, using rough toilet paper or not washing away the soap after bathing can be a cause.
  • Yeast Infections. A common infection in women can affect both the anal and genital areas.  This is also common in individuals with diabetes mellitus and HIV.
  • Laxatives. Frequent or overuse of laxatives can lead to diarrhea. This can cause itching.
  • Common Skin Disorders. Eczema, seborrhea and psoriasis can be found around the anus and cause itching. Skin tags can also be a cause (growth of anal skin in an abnormal way).
  • Chemicals in Foods. Some spices and peppers can cause itching such as those in hot sauce.
  • Chrons Disease.  In cases of Chrons Disease where there are abnormal fluids that move through fistulas or abnormal pathways to the anus, the fluids can cause skin irritation and itch.

    anal itch
    Anal Itch can be caused by a fistula, which either due to Crohns Disease or a caused by an anal abscess that formed due to clogged anal glands. When the gland becomes infected, it can form an escape pathway to the skin surface, causing itch.
    Source: American Society of Colon and Rectal Surgeons
  • Hemorroids.  These help control the stool as it exists the body.  They can cause anal itching when they become inflamed.
  • Pinworms (also called threadworms). These worms inhabit the small intestine with the female moving to the anus to lay her eggs. As part of this process a substance is secreted which causes anal itching.  The condition is not considered to be dangerous and is treated with the over the counter medications Reese's Pinworm Medication or Pin-X.  Diagnosis is done my using scotch tape to capture some worms from the anus, which is then examined under a microscope.
  • Bacterial infection. Infections such as streptococci or corynebacteria minutissimum (erythrasma) can cause purritius ani.
  • Allergy. If you using moisturized wipes or something similar, the chemicals used can trigger an allergic reaction in the anus.


The symptoms of this condition are quite obvious. The anal area itches and can also be accompanied by soreness, pain or burning. A person can be so irritated by the itching that he continually scratches the area, which can lead to more intense symptoms.


A diagnosis can sometimes be handled by answering simple questions asked by your doctor concerning your symptoms. If this is not enough information to make a diagnosis, your doctor might refer you to a dermatologist or proctologist. In some cases, a rectal exam might be required, or in more questionable cases, a doctor might order a colonoscopy or proctoscopy.


This condition is most often treated with over-the-counter products such as hydrocortisone or zinc oxide. Popular products include Lanacane Maximum Strength.  These products are thinly applied to the outside of the anus and often to the anus itself through something called a pile pipe.

When showering, gently clean the anus and make sure that it is dry.  When going to the bathroom consider using baby wipes as a softer alternative to toilet paper. If your symptoms tend to increase in severity or frequency at night, a doctor could prescribe an antihistamine, as well as the topical treatments. 

A homeopathic alternative formulated to naturally treat itch around the anus and any anal burning is also available called Anal Itch Assist.  It combines several ingredients known to provide relief from skin irritation such as Fagopyrum, Croton and Sulphur (for red and sore areas).  Another natural product, RectoRex Balm, is particularly helpful if the anus is inflamed or raw.


Mayo Clinic


British Association of Dermatologists


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