This is a bit embarrassing, but I have near-constant itching in my anal area that is driving me crazy. What might be causing this, and how can I stop it?
Known medically as pruritus ani (yes, there’s a name for it), itching around the anus is often a simple problem that home remedies can alleviate. The itching can be intense and may be persistent or occur only after bowel movements. There can also be redness and burning.
Most cases are caused by skin irritation from fecal soilage, whether from diarrhea or loose stools. But having hard stools can irritate the anal area, too. People with hemorrhoids (which may trap small fecal particles) are more prone to itching, as are those with small growths called skin tags.
On top of that, the skin around the anus can become more irregular with age, and thus harder to clean. On the other hand, being overzealously hygienic—rubbing the area too energetically with rough toilet paper, for example—can also injure this sensitive skin.
And once the itch starts, moisture in the area, as may occur in hot weather or if you sweat down there or wear nonabsorbent undergarments, can make it worse. Some experts think stress may also be a factor.
Psoriasis in the genital area can also cause anal itching, while medical conditions such as diabetes and kidney and liver disease can predispose you to itching in general (pruritis).
To manage the itching, clean the area regularly, carefully, and gently—including after bowel movements. Use plain water, not soap, which can be drying and irritating. Then gently pat dry with a towel (or consider carefully using a blow dryer at low setting). You can also use a soothing anal cleansing lotion or wipes, such as Balneol (or the generic equivalent). Use unscented, noncolored soft toilet paper. To keep the area ventilated and relatively dry, wear loose underwear made of cotton or moisture-wicking synthetics.
Applying 1% hydrocortisone cream, two to three times a day for a week, can be helpful (but discontinue if itching does not improve or if it worsens). Avoid topical products that numb skin (such as those containing lidocaine) because they can further inflame sensitive skin. Don’t scratch—doing so causes additional irritation and increases the risk of infection. If you have it really bad, consider wearing lightweight cotton gloves at night to avoid inadvertent scratching.
If having hard stools is a contributing factor, increase fluids and try gradually adding fiber to your diet and taking a fiber supplement (such as Metamucil and other brands containing psyllium). If you have chronic loose stools or fecal leakage, fiber may also help, but talk with your doctor first. Avoiding foods that may relax the anal muscles (sphincter), such as coffee, tea, dairy products, and chocolate, also has, at least anecdotally, been found to help reduce loose stools or fecal leakage.
Very rarely, persistent anal itching may be a sign of a sexually transmitted disease or other infection (including scabies and pinworms), so if the condition doesn’t respond to simple treatments or go away over time—or if the itching is accompanied by bleeding or unusual pain—see your doctor.
