Home > Body Itch > Anal Itch

Table of Contents

• Causes of External Anal Itch
• Symptoms
• Diagnosis
• Treatment
• Topical Ointments
• Home Remedies
• Free Brochures

"Pruritus Ani otherwise, called anal itch or pruritus 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. It can occur in situations where a dermatologist may not be able to identify any specific skin disorder. External anal itching can cause lichenification, which is scratching which makes the skin thick and leathery. There may be a genetic component to the problem. In the majority of cases the cause for anal itching is unknown (idiopathic pruritus ani). 

Anal itching as a symptom indicates 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.

Some quick tips are to cut back on caffeine from coffee or chocolate (excess caffeine is a major cause of anal itching), wipe gently or with baby wipes, avoid hard or soft stools by increasing your fiber intake and try some baby powder after bathing to reduce moisture." 

What is Anal Itch?

Anal itch or pruritus ani has multiple causes, with the most common cause being unknown  Four times as many men have anal itch vs. women.  In some cases the cause is due to hemorrhoids, with surgery improving the situation. Hemorrhoids cause itching when they stick out of the anus (prolapsed). If the hemorroids are normal size or slightly larger than normal, then surgery will not help any itch symptoms.

When the cause is unknown there is no cure, but the feeling that your tush is on fire may be able to be controlled. This includes making dietary changes and improving the consistency of the stool.

Causes For Anal Itching

Some of the reasons for anal itching are:

• Too much moisture. Moist sticky stools or excessive sweating around the anus can lead to itching.
• Chemical irritants That Cause Dermatitis. Douching, laundry soap or detergent, birth control medication and colognes can contain chemicals that irritate the anal area triggering a rash.
• 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.
• Fungal Infections
• 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.  Crohn's can cause an anal fissure, which is a tear in the anal canal.
• Anal Abscess: A lump that forms when an anal gland becomes infected.

• Hemorroids: Hemorroids are swollen veins. These help control the stool as it exists the body.  They can cause anal itching when they become inflamed.
• Anal Fissures: when a tear occurs in the anal canal (lining of the lower rectum) caused by frequent diarrhea, passing a large stool, passing a hard stool when constipated or during birth.
• Pinworm Infection (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 pruritus ani.
• Allergy. If you using moisturized wipes or something similar, the chemicals used can trigger an allergic reaction in the anus.
• Poison Ivy or Oak
• Psoriasis: Skin condition that causes itching and rash.
• Sexually Transmitted Diseases (Warts, Herpes, Syphilis)
• Melanoma (skin cancer or anal cancer): It is possible to develop a skin melanoma around the anus. Be particularly aware if family members have experienced melanoma in this region. 70% of melanomas develop on normal skin with high 5-year survival rates (98%) when treated early. There is an increased risk of Squamous cell carcinoma in the anus among AIDS patients.⁽⁵⁾

Symptoms

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.

List of Anal Itch Symptoms

• Dry skin
• Chafing
• Pain
• Soreness
• Irritation
• Burning
• Rash

Diagnosis

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.

Treatment

Anal itching is most often treated with over-the-counter products such as hydrocortisone or zinc oxide (see suggested topical ointments). 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. 

If looking for natural treatment alternative, ingredients such as Fagopyrum, Croton and Sulphur are for red and sore areas (see below for home remedy suggestions).

Patients often have soft stools which require excessive wiping. Improving the stool consistency can reduce the need for too much wiping.  To bulk up the stool and bring it to the consistency of a normal stool (think Playdoh), we suggest Konsyl. Use it every morning. Prepare by shaking it with 4 to 5 ounces of juice.  For fiber to work you also need to drink four 8 ounce glasses of water per day.

Topical Treatments

• Steriods are an effective way to control anal itching. They work by stopping the release of histamine.  Doctors often prescribe the ointment Analpram 2.5% for use 2x a day over 2 weeks.
• Calmoseptine is another ointment that uses a combination of Zinc Oxide (to protect the skin) and Calamine lotion (soothing action) to bring relief. Unlike Steroids, it can be used as long as needed. Calmoseptine is available without a prescription.
• Balneol is a cleansing lotion without steriods or alcohol that can be used as long as needed.  It is alcohol free and is formulated to clean and soothe the skin.  No prescription is needed.
• Preparation-H: This ointment has a soothing action.  It is worth a try if other approaches fail.

Role of Diet

Some foods such as caffeine, chillies and spicy foods can irritate tissues in the anal canal.  

• Excessive caffeine intake can also result in anal itching.   Studies show that there is a direct correlation between the severity of anal itching and coffee consumption. Chocolate also has caffeine, so cut down on excess chocolate as well.
• Eat more vegetables and fruits to avoid straining during bowel movements. 
• Cut down on citrus and tomatoes.  Tomatoes are acidic and irritate the anal skin.
• Avoid Beer and cola

Home Remedies for Anal Itch Treatment

Try some of these home remedies when looking for natural ways for hot to stop an itchy bum hole. Try more than one to learn which one will help your specific condition to stop this sometimes embarrassing medical problem. 

• Soaking in a Hot Bathtub: Soaking in warm water will help increase blood flow to the anus.  It also relaxes the anal sphincter.  Add oatmeal to the water to help heal skin irritation.
• Vitamins: Try an ointment with Vitamin D, A, and aloe.
• Reduce Sweat: If you are overweight you sweat more. The moisture in the anus from sweating extends fissure healing time.
• Treat Diarrhea: Watery diarrhea contains acid that can burn raw skin in the anus.  Increase the amount of fiber you consume to stiffen the stool.
• Don't Overuse Wipes or Toilet Paper: Products with alcohol are drying.  Try an alcohol-free product that contains Aloe such as Freshies.  Another alternative is using moisturized tissues instead of toilet paper. If using toilet paper, gently wipe or moisten the toilet paper with water before you wipe. 
• Avoid Cleaning Your Bum (Anus) with Soap: Soap drys the skin and causes cracking when used in the anus.  Only use a washcloth and water.  Also don't use witch hazel to clean or as an astringent the anus since it causes dry skin.
• Try Baby Powder: After showering or bowel movement, use some baby powder in the anus.  It will absorb any remaining moisture and reduce friction. Consider Johnson's or Ora's Amazing Herbal Powder.  Also wear loose cotten clothing.
• Use Vaseline: Lubricate the anal canal by inserting some petroleum jelly 1/2" into the canal.  
• Drink more water: Stay hydrated if your stools are hard to avoid fissures and hemorrhoids. Drink 4 - 8 ounce glass a day (coffee doesn't count).
• Try a Bidet: A Bidet or portable travel bidet can be an alternative to wiping. It works by shooting water where you need to clean.
• Shorten Your Bathroom Stay: Reading for extended periods of time when on the toilet can constrict blood flow to the area, causing blood in the anal area to become engorged.
• Sit on a Pillow: Sitting on a gel-filled pillow can provide some comfort and reduce pain.
• Pause anal intercourse: Intercourse can cause tears.  If you do engage use a lubricant.
• Try Unscented Laundry Detergent: Wash underwear using a gentle laundry soap.
• Apple Cider Vinegar: Take two tablespoons of Apple Cider Vinegar to 1 glass of water.  Add some honey for taste. Take every day consistently.

Office Treatment to Stop The Itching From Hemorroids

See a Doctor if the problem persists and you can't get a handle on the problem. You will not be the first patient to seek relief from this "irritating" problem.

A Proctologist can perform Hemorrhoid therapy which helps lessen the itching sensation by reducing the amount of mucous that is secreted from the hemorroids.  The painless procedure involves injecting a substance into the hemorrhoids causing the hemorroids to shrink.

Brochure

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