Itchy Anus (Pruritus Ani): Causes and Treatments for Anal Itching

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Itchy butt, or pruritus ani, is a fairly common but uncomfortable condition that involves itchiness and irritation around the anus. Many people try to deal with it on their own, but doing so may actually worsen the condition.

There are many potential causes of itchy anus. Learning what it is and why it occurs can help you get the right treatment and quick relief.

What is pruritus ani?

Pruritus ani is a condition where people experience intense itchiness around the anus. It affects up to 5% of the population and is more common in men than in women, and adults over the age of 40. Itchy anus tends to be more bothersome at night and can affect your overall quality of life.

Itchy anus causes

Itchy anus can be triggered by lots of things from lifestyle factors to medical conditions. In general, when the area surrounding the anus is wet - whether from sweat, moisture buildup, or fecal residue from loose or sticky bowel movements - the skin can become irritated. In turn, this can make your butt feel itchy.

You can have an itchy anus caused by a variety of factors including:

• Food (like caffeine, and spicy or acidic foods)

• Fecal residue

• Excess moisture around the anus

• Rough cleaning around the anal area

Medical conditions that can cause an itchy anus

Itchy anus is also commonly linked to certain medical conditions. These can include conditions like:

• Cancer

• Anal fissures

• Abscesses

• Hemorrhoids

• Skin disorders including dermatitis and psoriasis

• HPV, anogenital warts

• Pinworms

• Yeast infection

Since any itchy anus can sometimes be caused by an underlying medical condition, it's important to discuss your symptoms with a healthcare professional, even if you feel embarrassed doing so. They can help identify the cause of your symptoms and develop the best treatment plan for you.

What makes itchy anus worse?

When you have an itchy anus, it's natural to try and find fast relief. But some things that may seem helpful might actually make an itchy anus worse, like:

• Scratching: It might provide temporary relief, but it often results in more trauma and inflammation to the area.

• Excessive cleaning or scrubbing: This can also increase inflammation. Cleaning the area with scented soaps or cleansers, witch hazel, wet wipes, or antiseptic cleansers may also cause a skin reaction and irritation in some people.

Foods to avoid if you have anal itching

Although it may seem surprising, diet may be related to an itchy anus. This is because the anus is where waste from the food you eat exits your body. And while you might feel OK consuming certain foods, they may be irritating to the anal area.

Plus, some foods, like coffee, can relax the anal muscles and potentially lead to stool leakage and irritation.

If you have an itchy anus, you may need to make some changes to what you're eating. Consider removing some of these foods and beverages from your diet for a few days to see if the itchiness improves:

• Coffee (regular and decaf)

• Tea

• Sugary sodas

• Chocolate

• Citrus (orange, grapefruit, lemon, and lime)

• Dairy products

• Alcoholic beverages

• Tomatoes

• Spicy foods

Itchy anus at night

Many people experience more itchiness at night and may actually wake up to find themselves scratching. There are many causes of nighttime anal itching, including:

• Hemorrhoids: These can become more irritated while you sleep, depending on your sleeping position.

• Moisture in the anal area: Bathing, urinating, or sweating can cause nighttime irritation.

• Stool residue: Having a bowel movement during the night can cause inflammation and irritation.

• Pinworms: This infection is typically active at night.

Itchy anus treatment

You might be wondering whether you need to see a healthcare professional if you have an itchy butt. The good news is, there are several things you can try at home first that may take care of the problem. Here are a few general recommendations to keep in mind:

• Avoid the urge to scratch the affected area.

• Keep the anal area clean and dry.

• Use unscented soap and warm water - instead of astringent cleaners, like witch hazel, or any alcohol-based cleaners - to clean the area.

• Wear loose-fitting, cotton underwear, and avoid wearing tight pants if you can. This will help keep the area dry.

• Try avoiding foods that can irritate the anus for a couple of weeks to see if that helps reduce itchiness.

• If diarrhea or constipation are an issue, increasing your fiber intake can help improve your bowel movements and decrease fecal residue.

Anal itch cream

There are many over-the-counter (OTC) anal itch creams that can help reduce itchiness and give time for the affected area to heal on its own, like Anusol HC. Most of these creams are designed for short-term use.

If OTC anal itch creams don't work for you, a healthcare professional may give you Protopic 0.1% ointment (topical tacrolimus), which has been effective in providing relief. This cream is only available by prescription.

OTC medication for anal itching

Here are some examples of other OTC treatments that may help break the itch and scratch cycle:

• Calmoseptine is an OTC anal itch cream that works really well for an itchy butt. This can be a helpful first step in managing itchy butt at home.

• Zinc oxide (Desitin or Balmex) can be used also as a barrier cream and is often helpful at night.

If the itching is bothersome at night, you can ask a healthcare professional about taking a 25 mg diphenhydramine (Benadryl). This can help to control the itch while you wait for other remedies to kick in.

Diet for itchy anus prevention

Simple changes to your diet can prevent the itching from becoming worse. Including fiber in your diet can add bulk to your stools and decrease the chance of having fecal residue. Foods that are higher in fiber include:

• Fruits and vegetables

• Oatmeal

• Dry beans

Probiotics may be another option to add to your diet. Probiotics - found in yogurt, kefir, and other fermented foods - add healthy bacteria to your GI tract. They can help reduce diarrhea and support your immune system.

Keep your anus dry and clean

The most important thing you can do to help prevent or manage an itchy butt is to keep the area clean and dry (without overdoing the cleaning). Here are a few additional tips for cleaning the area and keeping it dry and less irritated:

• After a bowel movement, use a pre-moistened pad or tissue for wiping. You may also find taking a bath or shower to be helpful.

• Using a sitz bath, bidet, or a handheld shower head can help clean the area thoroughly. Be careful when patting the area dry afterwards.

• You can also try talcum powder to help keep the area dry.

When to get care for itchy anus

If you have tried these home treatments without relief, it may be time to check with a healthcare professional. Also, if you see any bleeding or spotting when you wipe or have ongoing diarrhea or anal leakage, these could be signs that you need additional care.

At your visit, you'll likely be checked for an infection, allergy, or other physical reasons for inflammation near the anus. Bring a list of remedies that you've tried at home and any medications you're taking, including OTC creams and ointments.

Here's what to expect when you visit a healthcare professional for an itchy anus:

• They'll ask a lot of questions about your condition. They may ask how long you've had it, has it happened in the past, what makes it better or worse, and when does it bother you the most.

• A thorough exam of the anal area. This means they'll need to take a good look at the outside of your anus.

• They'll look for visual signs of hemorrhoids, yeast, fissures, warts, or skin irritation.

• They may need to do a "tape test" to check for pinworms. If so, the healthcare professional will apply a piece of clear tape near the opening of the anus, remove it and look at it under the microscope. If tiny eggs are present, it suggests pinworms as the cause.

• They may do a digital rectal exam. Sometimes everything looks normal on the outside, but hemorrhoids or warts can happen just inside the anus. A rectal exam can sometimes help pick up those conditions.

Keep in mind that this is not an exhaustive list. They may suggest other tests or procedures based on what they find during the visit.

Frequently asked questions

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