Anal itching, medically known as pruritus ani, is a common dermatological problem affecting both men and women, although it is more common in men. It can occur at any age but seems to be most prevalent among people in the age bracket of 30 to 50 years.[1]
Pruritus ani is characterized by an excessively discomforting and often embarrassing itching or burning sensation of the skin around the anus (rectal opening). This itch is sometimes so intense that it becomes almost impossible not to scratch.
The incessant scratching, in turn, results in further skin irritation and damage and can even escalate the problem to a chronic stage, resulting in chronically inflamed and thickened skin called lichen simplex chronicus.
Rigorous scratching, particularly at night when the patient is asleep, or abrasive vigorous scrubbing with toilet paper to relieve the itch after urination or a bowel movement can cause tiny ruptures in the affected skin.
As a result of this additional trauma to the anal skin, occasional bleeding occurs when wiping after a bowel movement. Moreover, this tearing of the affected skin can make one more susceptible to developing an infection.
What Causes Anal Itching?
Anal itching can be due to skin related problems or internal medical issues. Skin-related causes include:
- Atopic dermatitis
- Psoriasis
- Excess friction in the anal area
- Excess sweat and moisture around the anus
- Exposure to chemical-based perfumes and dyes
- Improper wiping after a bowel movement
Some of the medical causes are:
- Food allergies
- Anal fissures
- Anal tumors
- Persistent diarrhea
- Constipation
- Leakage due to fecal incontinence
- Hemorrhoids
- Parasitic, sexually transmitted, fungal, and yeast infections.[2]
Signs and Symptoms Associated with Anal Itching
The main symptom is itching in the anal area, which is often intense and causes a strong urge to scratch.
Other symptoms of pruritus ani are burning sensation, dryness, soreness, redness, swelling, ulcers, and a rash in and around the anal region.
The symptoms may be temporary or more persistent, depending on the cause.
Diagnosis of Anal Itching
In order to zero in on the probable cause of your anal itch, the doctor will take into account your symptoms, the duration and pattern of the itch, current dietary intake and medications, your personal care habits such as the way you routinely clean your anal area after a bowel movement, and the regularity of your bowel movement.
The doctor will also inquire about your medical history, particularly any relevant past experience with other rectal problems such as fissures, hemorrhoids, and fistulas as well as skin problems such as eczema, seborrhea, and psoriasis.
This line of questioning will be followed by a physical examination of your anal area, sometimes including a digital rectal examination.
A visual analysis of the area will help reveal the extent of damage caused by scratching as well as any signs of hemorrhoids, eczema, or anal fissures.
The doctor may then probe the anal cavity with a gloved and lubricated finger to rule out rectal tumors or bowel cancer. If you happen to have grappled with skin issues involving other parts of your body in the past, your doctor will want to examine these skin areas as well.
The doctor may rarely administer a more invasive examination using a special viewing instrument called an anoscope. This short tubular device is inserted into your anus to take a closer look inside your rectum, which can help your doctor determine whether the itch is being caused by a problem inside your rectum.
Additionally, the doctor may order the following tests:
- Stool cultures
- A biopsy in case of skin abnormalities
- Anal swabs to rule out infection
- Routine blood tests to get a holistic picture of your renal, thyroid, and liver function as well as general health markers regarding diabetes, blood count, and bodily inflammation
Treating Anal Itching
Your healthcare provider may prescribe medicines. These can relieve pain and itching to help the affected skin heal.
These medicines may include skin ointments, steroid creams, antibiotic creams, and antihistamines. You may need antibiotics if there is an infection.
Precautionary Measures for Anal Itching
Anal itching or irritation may be prevented or treated if you take some precautionary measures, including the following:
- Avoid scratching as this will only exacerbate the condition. To get temporary relief from itching, apply a cold compress.
- To prevent unconscious scratching while sleeping, wear cotton gloves at night until the symptoms subside.
- Use damp toilet paper to clean yourself thoroughly after a bowel movement. Then, give a final wipe with dry paper to soak up any excess moisture.
- Avoid using scented or colored toilet paper, as these may aggravate the condition. Always use white, unscented toilet paper.
- Always make sure that you dry your bottom well after using the bathroom.
- For anal itching caused by excessive sweating, apply talcum powder on the affected area to absorb moisture.
- Do not sit in the same position for hours, as it may lead to a buildup of moisture or sweat in the anal area, causing more itching.
- Avoid using scented soaps on the affected area, as these may cause irritation.
- Avoid wearing tight-fitting underwear. Choose underwear made of cotton, rather than synthetic fabrics.
- Never use cornstarch on the affected area, as it may worsen the skin infection.
- Manage stress. This will help overcome anal itching.
When to See a Doctor
Generally, anal itching is not a serious problem and usually does not require medical attention.
However, seek medical advice if the itching becomes unbearable or persistent or if there is blood in the stool or stool leakage.
Simple Ways to Treat Anal Itching at Home
You may find anal itching to be embarrassing and uncomfortable. You can treat it at home with simple lifestyle changes and easy-to-follow home remedies.
Here are 10 home remedies for anal itching.
1. Drink Apple Cider Vinegar in Water
Both yeast and fungal infections can cause anal itching. In these cases, you can use apple cider vinegar to help control the infection. In addition, it helps alkalize the body.[3]
- Mix 2 tablespoons of raw, unfiltered apple cider vinegar in 1 glass of water. Drink it twice daily.
- Another option is to add 1 cup of apple cider vinegar to a hot bath. Soak in this bathwater for 15 to 20 minutes, once daily.
Follow these remedies for several days until the anal itching and irritation subside.
2. Eat Garlic Cloves Daily
Garlic helps treat anal itching from the inside out. It helps eliminate intestinal worms, one of the main causes of this problem.
In addition, the antibacterial, antifungal, and antiseptic properties of garlic help treat any kind of infection responsible for anal itching.[4][5][6]
- Eat 2 to 3 cloves of raw garlic on an empty stomach daily for 1 week.
- Another option is to boil 2 crushed garlic cloves in ½ cup of milk. Drink this milk on an empty stomach for a week.
3. Include Coconut Oil in Your Diet
Coconut oil is one of the best remedies for anal itching. It soothes the skin, and its antibacterial, antifungal, and antimicrobial properties can treat any infection responsible for anal itching.
Moreover, it can help expel intestinal worms.[7][8]
- Eat 2 to 3 tablespoons of extra-virgin coconut oil daily. You can also use this oil for cooking purposes.
- Rub some warm coconut oil in and around the affected area several times a day to relieve itching and burning sensations.
4. Apply Aloe Vera Gel to the Affected Area
Aloe vera has soothing and calming properties that can relieve anal itching, soreness, and inflammation. Aloe vera also helps reduce the irritation of hemorrhoids or anal fissure, one of the main causes of anal itching.[9][10]
- Slice away the thorny edges of a fresh aloe vera leaf and then cut it open.
- Extract the gel and rub it in and around the anus for 5 minutes.
- Reapply the gel every few hours to get rid of the itching and soreness.
5. Take an Oatmeal Bath
You can also use oatmeal to treat an itchy anus. Oatmeal contains anti-irritating, anti-inflammatory, and soothing properties that help heal irritated, inflamed, and itchy skin.[11][12]
- Mix 1 to 2 cups of colloidal oatmeal or unprocessed oat flour in a bathtub filled with lukewarm water.
- Soak in this water for about 15 to 20 minutes.
- You can take an oatmeal bath 1 or 2 times a day.
6. A Dose of Probiotic Yogurt can Help
To treat a yeast infection, which may cause anal itching, you can use yogurt. Not all types of yogurt are beneficial.
You must use probiotic yogurt with live active cultures (good bacteria). These bacteria can help control the growth of the infection. Use plain, unsweetened probiotic yogurt only.[13]
- Rub some plain yogurt on the affected skin. Let it sit for at least 20 to 30 minutes, preferably overnight. Then, rinse it off with warm water and dry the area thoroughly.
- Also, eat 2 to 3 cups of plain yogurt daily.
7. Warm Epsom Salt Bath can Provide Relief
An Epsom salt bath is great for skin disorders such as eczema and psoriasis, two key causes of anal itching.
It helps relieve the itching and burning sensations.[14]
- Mix 1 to 2 cups of Epsom salt in a bathtub filled with warm water.
- Soak in it for 15 to 20 minutes.
- Finally, pat your skin dry thoroughly.
- Enjoy this soothing bath two or three times a week.
8. Drink a Mixture of Licorice and Honey
According to Ayurveda, licorice can also help treat anal itching.
Licorice is good for skin conditions such as eczema and psoriasis that cause anal itching. It helps reduce itching, redness, and irritation.[15][16]
- Slightly roast a mixture of equal amounts of licorice, rind of chebulic myrobalan (also called haritaki), and cardamom.
- Grind them into a fine powder.
- Mix ¼ teaspoon of this powder and 1 teaspoon of honey in a glass of water.
- Drink this mixture once daily until you get relief.
You can also apply an over-the-counter licorice cream on the affected area a few times daily.
9. Increase Your Fiber Intake
A common cause of anal itching is constipation. When the constipation is treated, anal itching will automatically resolve.
To treat constipation, the best option is to increase fiber intake. Fiber promotes healthy digestion and can soften the stool and increase its bulk.
- Eat high-fiber foods such as beans, potatoes, carrots, brown rice, quinoa, prunes, buckwheat, fresh fruits, green leafy vegetables, nuts, pumpkin seeds, sunflower seeds, broccoli, and peas.
- You can also opt for fiber supplements after consulting your doctor.
10. Avoid Food Allergens
Certain foods can cause irritation during a bowel movement, leading to anal itching. Moreover, there are certain foods that can increase itchiness and inflammation.
So, it is best to choose foods wisely and avoid food allergens for some time.[17]
- Foods that can increase rectal itching are coffee, tea, soda, alcoholic beverages, and chocolate.
- Avoid spicy foods such as peppers and jalapenos.
- Avoid citrus fruits such as grapes, lemons, and oranges.
Avoid these foods for at least 2 weeks, and then reintroduce them into your diet gradually.
Resources:
- Song SG, Kim S- H. Pruritus Ani. Journal of the Korean Society of Coloproctology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3092075/. Published April 2011.
- Krajnik M, Zylicz Z. Understanding Pruritus in Systemic Disease. Plum X Matrix. https://www.jpsmjournal.com/article/S0885-3924(00)00256-6/fulltext. Published February 2001.
- Manohar J, P. G. Antifungal activity of apple cider vinegar against clinical isolates of Candida species. International Journal of Current Research. http://www.journalcra.com/article/antifungal-activity-apple-cider-vinegar-against-clinical-isolates-candida-species.
- Ross ZM, O’Gara EA, Hill DJ, Sleightholme HV, Maslin DJ. Antimicrobial Properties of Garlic Oil against Human Enteric Bacteria: Evaluation of Methodologies and Comparisons with Garlic Oil Sulfides and Garlic Powder. Applied and Environmental Microbiology. https://aem.asm.org/content/67/1/475#ref-11. Published January 1, 2001.
- T W, H K, K T. Anti-Bacterial Activity of Garlic Extract against Human Pathogenic Bacteria. Journal of Pharmacovigilance. https://www.omicsonline.org/open-access/antibacterial-activity-of-garlic-extract-against-human-pathogenic-bacteria-2329-6887-1000253-99057.html. Published March 5, 2018.
- Venegas A, Touma JH, Bravo J, Perez GP. Progress in Use of Natural Products and Their Active Components against Helicobacter pylori. Advances in Microbiology. http://www.scirp.org/(S(351jmbntvnsjt1aadkposzje))/reference/ReferencesPapers.aspx?ReferenceID=1940082. Published December 28, 2016.
- Varmaa SR, SivaprakasamaIlavarasu TO, Arumugam I, Dilip N, Raghuramana M, Rafiq M. In vitro anti-inflammatory and skin protective properties of Virgin coconut oil. Journal of Traditional and Complementary Medicine. https://www.sciencedirect.com/science/article/pii/S2225411017300871. Published January 17, 2018.
- Lin T-K, Zhong L, Santiago JL. Anti-Inflammatory and Skin Barrier Repair Effects of Topical Application of Some Plant Oils. International Journal of Molecular Sciences. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5796020/. Published January 2018.
- Hashempur MH, Khademi F, Rahmanifard M. An Evidence-Based Study on Medicinal Plants for Hemorrhoids in Medieval Persia . Journal of Evidence-Based Integrative Medicine. http://journals.sagepub.com/doi/full/10.1177/2156587216688597. Published January 24, 2017.
- Rahmani N, Khademloo M, Vosoughi K, Assadpour S. Effects of Aloe vera cream on chronic anal fissure pain, wound healing and hemorrhaging upon defection: a prospective double-blind clinical trial. European review for medical and pharmacological sciences. https://www.ncbi.nlm.nih.gov/pubmed/24763890.
- S KE, W W. Johnson & Johnson Consumer Products Company, Scientific Affairs Department, Skillman, NJ 08558, USA. Journal of drugs in dermatology: JDD. https://europepmc.org/abstract/med/17373175. Published February 1, 2007.
- Sur R, Nigam A, Grote D, Liebel F, Southall MD. Avenanthramides, polyphenols from oats, exhibit anti-inflammatory and anti-itch activity. Archives of Dermatological Research. https://link.springer.com/article/10.1007/s00403-008-0858-x. Published May 7, 2008.
- Wilson L. ANAL ITCHING. drlwilson. https://drlwilson.com/ARTICLES/ANAL ITCHING.htm. Published April 2015.
- Proksch E, Nissen HP, Bremgartner M, Urquhart C. Bathing in a magnesium-rich Dead Sea salt solution improves skin barrier function, enhances skin hydration, and reduces inflammation in atopic dry skin. International journal of dermatology. https://www.ncbi.nlm.nih.gov/pubmed/15689218. Published February 2005.
- Ghoreishi MR, Saeedi M, Ghoreishi MR. The treatment of atopic dermatitis with licorice gel. Journal of Dermatological Treatment. https://www.tandfonline.com/doi/abs/10.1080/09546630310014369. Published July 12, 2009.
- F EL, Jr FJF, S RD, C TS. Natural advances in eczema care. Cutis. https://europepmc.org/abstract/med/18277662. Published December 1, 2007.
- Siddiqi S, Vijay V, Ward M, Mahendran R, Warren S. Pruritus Ani. annals. https://publishing.rcseng.ac.uk/doi/full/10.1308/003588408X317940. Published September 6, 2008.
If you apply room temperature buttermilk to your anus, itching decreases significantly. It works better than whole or skim milk because it’s thicker. Apply 4-5 times a day and throughly before bed. Some assistance may be required.
for how long do I need to keep the butter milk on before I wash it?
Which butter milk do h buy
I have had this problem for eight years, I had tried everything and had a number of tests from the doctor but the problem kept coming back, annoying anal itching (Anus Puritus). It was interrupting my sleep and I was getting depressed about it. I was skeptical at first but I was desperate to get rid of it and was willing to try anything and everything to sort it, I found that Simply Soothing Wipes really sorted me out, they have made me feel normal again. Within a day the itch had subsided and it had gone in 3 days.
Where do you buy these…I’m desperate!! Thanks
What did you had done for this
thank you for let the herbal treatment
have this same problem been to the doc and she said us a fungi infection. prescribed a topical cream which works fine in the day but at night the itching is really intense… HELP please!
My anal swelling and itching what I have treart
My dad uses hand sanitizer and says it works wonders.
Hi,
What kind white patches you have. I m getting patches on skin mostly on upper chest and stomach area and some dots on back..
I m very much worried, and hoping its not vitiligo.. Cold you please help me to inform the best way to treat them.
Thanks, awaiting for reply.
its already been a week .. should i visit the doctor ?
Here is my short story….I had a severe butt crack itch years ago that took months to get rid of, 2 days ago it flared up again and I was in panic mode. So this time I decided to use coconut oil, the itch was again like it was years ago, intense and crazy. So I lubed my entire area and went to bed, the relief happened almost right away, short lived though, the itch was back in 3 hours, so I re-applied after cleaning off the old stuff and Back to bed, 3 hours later same thing. So in the morning it was overall a bit better so the routine continued throughout the day, by the end of the day at 10 pm I would say a 40 percent improvement which was amazing. During the night same routine, coconut oil every 3-4 hours, by the morning another 30 percent better, by the evening I can say I’m at 95 percent better, I’m going to continue with the treatment for a few days more but I am in awe as to how fast this worked. So I say just try it and re-apply every 2-3 hours and don’t give up. So why did I have this flare-up in the first place? Well, I was under company stress and I had 3 bowls of onion soup on an empty stomach the evening before, plus 3 beers before the onion soup. Was that the trigger? Who knows…. I hope this helps you, do research on coconut oil and skin rashes.
where do you get this wipes (simply soothing wipes)
Do you apply the aloe vera for 5 minutes only if you’re gay and one minute if you’re straight?
Other cures for anal itching include natural probiotic yogurt, sea weed (iodides), sitting in salty sea water for 30 mins at least, diet change to more vinegar based drinks, apple cider, sider-garlic etc. Avoid all chemical soaps/shampoos on anus when washing. Clean your anus with warm water, your saliva and natural wet-wipes after pooing, also last thing at night and first in the morning. (no chemicals). Common creams like Anusol, Bepanthen also provide quick relief. Don’t wear itchy-scratchy underwear. Detox using cider-vinegars/sparkling water. Give up beer drinking or other yeast alcohols. They cause itchy anus. Give up alcohol and the itching stops after a few days (C2H5OH Alcohol promotes anal itching). Give up all heavy sugar-based foods/drinks as (like alcohol) they also promote the bacteria that causes itchy anus. Avoid high heat or over heating. Your anus needs to be cool. If you have worms or you are not sure take a wormer anyway to eliminate the possibility. Try all the above and you will have relief. if not (after trying the above for 2 or 3 weeks) see a doctor who may refer you to a IBS specialist. Get an enema – flush out your pipes, start afresh.
I tried the oats and so far so good. I soak rolled oats in purified water in a container and keep it in the fridge. Note I do not cook the oats. Morning and evening after washing the area around anus with spring water (purified water, not tap water) I apply the liquid from the oats using toilet paper. Itchyyess gone! It also help my husband with his itchy back and legs!
I took a hot bath with oats in cheese cloth or tea bag which I squeezed in tub and rubbed on itchy area, 1/2 cup apple cider vinegar and drank a table spoon of it and ate one garlic clove which I still Taste and drank lots of water and added a cup of epsom salt in bath and soaked for 20 minutes. Then I air dried my hiney for a while with legs and cheeks spread. I feel like I healed it already, worked great and no itching.
My anus is itching very much what medicine can I use?