Having an itchy butt may feel uncomfortable, but talking about it shouldn’t be. This unpleasant problem, medically termed pruritus ani, is much more common than you might think. Most estimates suggest that 1-5% of Americans are affected by an itchy anus, but since so many people are reluctant to discuss this problem, actual numbers are likely much higher. One survey found that about 20% of people had experienced significant anal discomfort.
So what might be causing an itchy anus and what can you do about it? As @RyanKingRobot27 asked on Twitter:
There are many possible explanations for anal itching, most of which are unpleasant, but otherwise relatively harmless. The majority of people with this problem are suffering from local skin irritation due to leftover fecal material or eating certain foods. One study showed that fecal soilage was responsible for 50-75% of cases of pruritus ani. Most often, stool consistency is responsible – stools that are loose or pasty in consistency may stick to the skin more than a bulky, formed stool. Alternatively, other people may have abnormal relaxation and pressure of their anal sphincters, which could allow small amounts of stool to seep out unintentionally.
Certain foods such as coffee, tea, cola, chocolate, tomatoes and citrus may also cause anal itching. Though researchers are not sure why these foods might be to blame, one possibility is that they affect anal sphincter relaxation in the same way that they can cause esophageal sphincter relaxation, which can lead to heartburn.
There are also some more serious conditions that may cause an itchy bottom, which is why it’s always a good idea to touch base with your doctor about any discomfort. For example, one very common problem – hemorrhoids, or swollen veins in the rectum – could be to blame, and can be treated. Other problems, such as skin diseases, abscesses or fissures (skin tears) can also cause itching and should be looked at by a doctor. Infection with certain parasites or a sexually transmitted disease may also be responsible. Though this is rare, itching may be a symptom of rectal or anal cancer. Any anal or rectal bleeding or masses should be examined right away by a doctor.
Luckily, there are many options to improve or get rid of an anal itch – in fact, conservative treatments are successful in about 90% of patients. As an initial step, you can try eating more fiber or taking a fiber supplement to give your stool more bulk. It is also reasonable to try cutting out the foods I mentioned above. Make an effort to keep the area around the anus clean and dry, but overzealous cleaning can also irritate skin, making the problem even worse. If you can, wash yourself gently with water after a bowel movement and then pat yourself dry or use a hair dryer on cool to dry the area, as this is easier on your skin than wiping. Alternatively, a wet wipe or moistened tissue can also be a gentler cleaning option. Patting the area with a little unscented talcum powder after cleaning can help absorb moisture and keep the area dry. Unless instructed by a doctor, avoid medicated wipes or lotions that may further irritate the skin.
For people with significant itching, applying a small amount of 1% hydrocortisone cream to skin around your anus twice daily for no more than two weeks may help decrease discomfort. Taking an antihistamine such as diphenhydramine before bed may also help if the itching is keeping you awake. Remember, before starting a new medication or if your symptoms continue, you should always consult your physician.