13 reasons your butthole itches and how to get quick relief - Insider

• Anal itching, aka pruritis ani, is very common.
• Your butthole could be itchy for a number of reasons including diarrhea, an STI, or parasites.
• Cleaning your butthole using scented wipes, or aggressive wiping with toilet paper, could cause anal itching.

Anal itching, or pruritis ani, is a common health issue — even if a bit socially awkward — that can be caused by hygiene, dietary habits, or an underlying medical condition. 

Although unpleasant, it's rarely a sign of a serious medical problem — most cases can be managed with lifestyle changes or medical treatment.

Here are some common reasons you might have anal itching and what to do about them.

1. Hygiene

Bethany Malone, MD, a colon and rectal surgeon in private practice, says hygiene practices are the most common cause of anal itching — but not in the way you might expect. 

"It is actually over hygiene of the anal area, meaning aggressive wiping or using wet wipes that contain skin irritants like alcohol, witch hazel, or fragrances," says Malone.

Treatment and remedies

If you feel the need to use wet wipes for cleanliness, use water-based wipes that are alcohol- and fragrance-free, says Malone. Another option is using a bidet instead of toilet paper to avoid scratching and irritation of the area.

2. Dietary irritants

Some foods can irritate the anal area and cause itching, including:

• Spicy food
• Coffee and tea
• Cola
• Milk
• Citrus fruits
• Tomatoes

"One of the first steps in treating a patient who has this condition is to remove all those things from the diet," says Malone.

Treatment and remedies

"While cutting out these exposures can cause relief eventually, barrier ointments can be used for more immediate relief," says Malone.

These OTC ointments include diaper-rash creams that have zinc oxide or Calmoseptine, which "has a little bit of menthol in it, and the cooling sensation can really help relieve the itching," says Malone.

3. Environmental irritants

Another irritant that can cause anal itching is fragrance found in laundry detergent, soaps, and wipes. Fragrance allergies are very common and affect around 1% of adults. 

When laundry detergent with fragrance is used to wash clothing, the allergens in the fragrance transfer to the clothing. This clothing and underwear can irritate the skin — and the skin around the anus — when it is worn. 

Touching irritated skin with hands that have been washed with fragranced soaps can further irritate skin. This irritation manifests as dry, itchy skin or a red itchy rash. 

Additionally, using fragranced soaps when bathing can also cause inflammation and irritation.

Treatment and remedies

When a fragrance allergy irritates your anus, the first step is to identify the cause of the irritation. Start by switching to a fragrance-free laundry detergent and body wash or soap. This change will help to prevent future irritation. 

To treat a rash caused by a fragrance allergy, you can:

• Use topical creams and moisturizers. Topical steroid creams or ointments can act as an anti-inflammatory to relieve itching and redness.  
• Use emollients. They can be used to moisturize and soften the skin, helping to combat dryness associated with contact dermatitis. 
• Try corticosteroids. With a doctor's prescription, corticosteroids can be given via injection or oral medication to relieve itching, inflammation, and swelling. 

However, it is important that these ointments are only used topically on the skin of the anus and not inserted inside the body.

4. Hemorrhoids

Hemorrhoids are a common condition that occur when veins in the anus and lower part of the rectum swell. An estimated half of people will experience them by age 50, and they can be either external — outside the skin of the anus, or internal — inside the anus.

You might have hemorrhoids with no symptoms, but when they are inflamed it can be difficult to wipe and clean yourself properly leading to anal itching. 

You are more likely to get hemorrhoids if you:

Some other symptoms of hemorrhoids include:

• Pain in the anal region, especially when sitting
• Swelling near your anus
• Hard tender lumps near your anus 
• Rectal bleeding

Treatment and remedies

You can treat hemorrhoids at home with OTC topical creams or suppositories. You can also try NSAIDS to relieve discomfort and sitz baths to reduce swelling. 

You can expect symptoms to go away within a week after starting treatment. However, if your symptoms persist or you have severe pain or bleeding you should check in with your doctor — sometimes hemorrhoids need to be surgically removed.

Hemorrhoids don't usually cause problems beyond being uncomfortable. However, if untreated, some rare complications are:

• Anemia due to blood loss
• A blood clot, which is not dangerous but is painful
• Infection
• A strangulated hemorrhoid — when the blood supply to a hemorrhoid is cut off, causing extreme pain

After treating hemorrhoids, you can prevent them from coming back by consuming more fiber and water.

5. Diarrhea 

Diarrhea is more acidic than typical stool and takes more wiping than usual to clean yourself. More wiping can irritate the skin and cause anal itching, says Malone. This is especially likely to happen in those with chronic diarrhea — diarrhea that lasts longer than four weeks.

The cause of chronic diarrhea is often an underlying condition such as:

Treatment and remedies

• OTC antidiarrheal medication: For short-term diarrhea, you can use medication to relieve symptoms. 
• Stay hydrated. Drink plenty of water and electrolyte-rich drinks like Pedialyte, Gatorade, or Powerade. Just be conscious that some of these drinks are high in sugar so it's best to dilute them with water or opt for diet versions, if you're watching your sugar intake.
• Avoid high fat and sugary foods. Instead, stick to bland, easy-to-digest foods like soup, boiled vegetables, and low-fiber bread.

For chronic diarrhea, you will likely need to visit a doctor to identify the cause and receive proper treatment. Left untreated, chronic diarrhea can lead to dehydration and malnutrition. 

Quick tip: "If you have new onset diarrhea and you cannot quite figure out what it is, it is always a good idea to see a doctor to schedule sensitivity testing or even a colonoscopy," says Malone.  

6. STIs

Sexually transmitted infections that can lead to perianal itching include gonorrhea, herpes, HPV, and chlamydia.

Different STIs each have different symptoms, but if you have any of the following symptoms check in with your doctor about a diagnosis:

• Burning urination
• Thick, cloudy, bloody discharge from you genitals
• Blisters, sores, or warts in the genital region
• Pain or itching around genital area or anus
• Unusual vaginal bleeding
• Pain during sex

Important: "A common misconception about STIs affecting the anus is that you have to have anal receptive intercourse in order to get them. That is not true. They are passed through body fluids and body fluids can get anywhere in that area," says Malone.

Treatment and remedies

There is no cure for HPV or herpes, but herpes outbreaks can be managed and reduced through antivirals. Moreover, the HPV vaccine prevents most cancer-causing infections. 

Gonorrhea and chlamydia are treatable with antibiotics — it is important that you see a doctor if you have symptoms as these infections can lead to pelvic inflammatory disease if left untreated.

 7. Yeast infection

Yeast infections are caused by an overgrowth of the fungus candida. Normally the fungus lives on your skin without causing issues, but in some environments, like in the summer "when the humidity is high or when you sit in a wet swimsuit too long, yeast can overgrow," says Leann Poston, MD, a medical communications writer and educator at Invigor Medical.

Commonly thought of as vaginal infections — three in four women will get a yeast infection in their lifetime. These infections can also occur in the mouth or elsewhere on the skin, including the anal area, causing an itchy, red, and sometimes painful rash.

Yeast infections are not contagious or sexually transmitted. You are more likely to get a yeast infection if you:

Treatment and remedies

Yeast infections can usually be treated with OTC topical antifungal medications — symptoms should recede within two to three weeks after starting treatment.

8. Pinworms

Pinworm infections are the most common intestinal-worm infection in the United States. Anyone can get pinworms, but they are most common in children between the ages of 5 and 10. In fact, up to half of children will get a pinworm infection at some point.

Pinworm infections are sometimes asymptomatic, but if the worms are mature enough to lay eggs around the anus, which they typically do at night, it can cause itching as well as:

Pinworm infections are spread through a fecal-oral route, like when someone with an infection doesn't wash their hands after using the bathroom and ends up spreading eggs from their hands to surfaces where other people come into contact with pinworm eggs.

"Pinworms are easily diagnosed by looking at the rectal area about an hour after going to sleep. The adult worm leaves the rectum to lay eggs on the perianal skin and can be seen with the naked eye. You can also adhere a piece of transparent tape to the anal area. Pull it off and look for eggs. If unsure, take the tape to your healthcare provider," says Poston.

Treatment and remedies

Pinworms are easily treated with anti-parasitic medications and your doctor may prescribe them to everyone in a household to stop transmission.

9. Skin conditions

Eczema and psoriasis are skin rashes that can cause anal itching if they're located in that area of the body. 

The two conditions look similar — they both cause patches of raised, red, itchy skin. But they have different causes: Psoriasis is an autoimmune condition, and while the exact cause of eczema is unclear, it is often triggered by environmental factors like cold air, stress, or allergies.

Treatment and remedies

If you have an unidentified rash, talk to your doctor so they can diagnose and recommend treatment. Both eczema and psoriasis can be treated with topical corticosteroids, biologics, and light therapy.

10. Anal fissures

Anal fissures are small tears in tissue that lines your anus. Most cases occur when passing hard or large bowel movements that damage the large intestine and soft tissue. These fissures can also be caused by:

• Persistent diarrhea
• Crohn's disease and ulcerative colitis or another inflammatory bowel disease
• Pregnancy and childbirth
• Syphilis or herpes, which can infect and damage the anal canal
• Having tight anal sphincter muscles (can increase the tension in your anal canal, making it more susceptible to tearing)

Anal fissures are characterized by pain in or around the anus that can sometimes last several hours. Other indicators include:

• Bright red blood on stool or toilet paper 
• Visible cracking in the skin around the anus
• A small lump in or around the anus

Treatment and remedies

When you notice blood in your stool, it's best to seek advice from your general practitioner. Your doctor can then prescribe you pain-killing ointment to help relieve side effects from anal fissures. Additionally, your doctor may prescribe laxatives to avoid further irritating your large intestine and anus. 

In most cases, anal fissures heal naturally within a few weeks without medical intervention. Regular exercise, staying hydrated, and implementing more fiber into your diet are preventative measures you can take to avoid further irritation and help existing anal fissures heal on their own. 

In severe cases, surgery may be necessary to heal anal fissures that have not responded to medicine and have not healed on their own. 

11. Nerve damage

Anal irritation may be caused by damage to the nerve fibers in the skin around the anus. This damage can be brought on by excessive itching, scratching, or wiping after using the bathroom. When the nerve fibers become chronically active after this repetitive trauma, your anus may become irritated, inflamed, and itchy. 

Nerve damage in the anus may also be caused by:

• Pregnancy and childbirth
• Consistent straining during bowel movements
• Injury to the spinal cord
• Stroke

Treatment and remedies

In severe cases of nerve damage in the anus, surgery may be required. Otherwise, medications may be prescribed to help repair the damaged nerves. This medication is often used in conjunction with laxatives and pain-relieving medicine to avoid further irritation to the area. 

12. Anal cancer

Anal cancer occurs when malignant cells form in the tissue around the anus. Many cases of anal cancer are caused after contracting human papillomavirus (HPV). This risk may be amplified if you have multiple sexual partners or are engaging in receptive anal intercourse frequently. 

Besides itching, other symptoms of anal cancer include: 

• Bleeding from the rectum or anus
• Small lumps in or around the anus
• Pain or pressure in the anus
• Discharge from the anus
• A change in bowel habits, such as frequent bowel movements

Treatment and remedies

There are three main treatments to anal cancer: surgery, chemotherapy, and radiation therapy.

In cases where the cancer is small and has not spread, local resection therapy may be used to remove the cancer from the anus. In more severe cases, an abdominoperineal resection may be required to remove the anus, the rectum, and part of the colon. In its place, the patient is equipped with a stoma on the surface of their abdomen where body waste can collect. 

Additionally, radiation therapy or chemotherapy may be used to kill existing cancer cells and stop the growth of additional cancer cells. 

13. Scabies

Scabies is characterized with very itchy skin caused by tiny mites that burrow into the affected area. The body generally has an allergic reaction to these mites, causing itching and inflammation. 

Scabies causes two main symptoms:

• Severe itching
• A rash with small blisters or sores

These mites spread through close person-to-person contact. Though scabies can be passed through sexual intercourse, they might also be passed simply by sleeping in the same bed or through sharing towels, clothing, or other personal items. 

Treatment and remedies

The most common treatments for scabies are a topical (cream or ointment) medication, such as permethrin cream. This cream is typically used alongside an antiparasitic pill called ivermectin. To relieve itching and avoid further irritation, use an antihistamine cream to quell symptoms and inflammation. 

When treating scabies, it is also important to keep the area as clean and dry as possible, and avoid excessive scratching. Cleaning your bedding and any clothes you were wearing up to three days before you noticed symptoms of scabies is another effective way to prevent further irritation and future infection. 

Insider's takeaway

Anal itching is more common than you might think, and "while anal itching may sound like a trivial reason to see a doctor, it can be ridiculously uncomfortable and really take over a patient's life," says Malone.

Fortunately, most underlying causes of anal itching are treatable with lifestyle changes or medications.

Adam Barnes

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