There are certain parts of the body where an itch can be extremely uncomfortable and inconvenient. Anal itching is hands down number one on that list.
In fact, intense anal itching can be infuriatingly irritating (and embarrassing). Also called pruritus ani , a persistent itchy feeling on the skin around the anus is a fairly common condition. In addition to itchiness, we may also experience other symptoms including irritation, pain, scratching, or thick skin around the anus.
Anal itching can have numerous reasons for its appearance. To treat, it is necessary to know the origin.
Hemorrhoids are the veins that we all have inside our rectum (internal) or outside the anus (external). But if they fill with blood due to higher pressure, they can become symptomatic with bleeding, pain, and itching.
If we have large external hemorrhoids, we may find it difficult to clean ourselves properly after having a bowel movement. The problem is that if stool remains in the skin folds around the anal area, it can cause irritation. Also, internal hemorrhoids can lead to a leaky anus, which can create the same unhygienic problem.
An anal fissure, a tear in the skin of the anal canal, is also linked to bothersome anal itching. Anal tears are often attributed to trauma to the area, which can be the result of constipation, straining during a poop session, prolonged bouts of diarrhea, anal sex, or anal stretching.
In addition to itching, anal fissures can also be extremely painful, especially during and after a bowel movement. To diagnose an anal fissure, the doctor should perform a rectal exam and then treat based on severity, starting with stool softeners, creams, and procedures [such as Botox injections or surgery] if necessary.
Pinworms (small, thin, white roundworms about the size of a staple) can live in the human colon and can cause that itchy feeling in the perianal area. When an infected person sleeps, these parasites (called Enterobius vermicularis) exit the intestine through the anus and lay their eggs on the surrounding skin, aggravating the area and initiating itching.
Pinworm infections are common. Approximately one billion people (mostly children) are affected by these parasites. They are also highly contagious: we can catch them if we touch the sheets, underwear or towels of someone with pinworms. As common as this infection is, pinworms are difficult to diagnose because they are not found in a typical stool parasite test.
A yeast infection can occur anywhere in the body, including the anus. The most common cause is a yeast called candida, which creates an extremely itchy rash around the anus. A candida overgrowth can occur any time the body’s natural balance of yeast and bacteria is disrupted.
This overgrowth can be caused by the use of medications such as antibiotics, steroids, or medical conditions such as diabetes. An anal yeast infection is diagnosed by physical examination and treated with antifungal creams. Good anal hygiene, which includes keeping the area clean and dry, can also reduce the risk of a yeast infection.
Not even the anus is exempt from skin problems such as psoriasis. This is because the anal region is covered with skin, which means that it is an easy target for the same dermatological disorders that develop in other parts of the body. Although psoriasis most commonly affects the knees, elbows, trunk, and scalp, it is an itchy autoimmune rash that also affects the perianal region.
This diagnosis requires a thorough examination by a doctor and is treated with creams and, in the most severe cases, immunomodulatory medications to calm an overactive immune system.
Certain trigger foods
Some of our favorite foods, like our morning cup of coffee, have been associated with anal itching. Yes, foods with a lot of caffeine, such as coffee, tea, chocolate, energy drinks, and some soft drinks, can relax the internal anal sphincter muscle. Caffeine is thought to be a major contributing factor, as it can reduce resting anal pressure and contribute to stool leakage that causes irritation and itching.
Other foods that can induce anal itching include citrus fruits, tomatoes, spicy foods, beer, and dairy products.
While most people don’t care as much about the perianal area as they do about the facial region, the skin down there is just as sensitive and susceptible to irritation from certain types of products. Things like scented soaps, powders, lotions, creams, and ointments can trigger an allergic reaction and lead to anal itching.
If we clean the anus with baby wipes, we may have a similar problem. That’s because many wipes contain chemicals that can dry out the delicate skin on your butt. And alcohol-free wipes are no better; they can still include substances that can be hard on your rear.
In chronic case of diarrhoea, this can result in an itchy and irritated back. We have a higher chance of anal itching if we have constantly loose poop. Diarrhea often leads to suboptimal perianal hygiene. That’s because if you poop persistently, it’s more likely that stool debris will stick around your anus and aggravate the skin there.
Additionally, itchiness and irritation are also possible side effects of sitting on the toilet for too long.
sexually transmitted infection
Sexually transmitted infections can also cause itching in the anal region. Common culprits include chlamydia, gonorrhea, syphilis, human papillomavirus (HPV), genital warts, and herpes simplex virus.
In addition to anal itching, sexually transmitted infections with anorectal involvement can also cause pain, suppuration, bleeding, ulcerations, inflammatory lesions, and proctitis (inflammation of the lining of the rectum).
anxiety or stress
Anal itching could be related to psychological well-being. Anxiety, stress, and depression can also affect the butt. These conditions can contribute to anal itching through the gut-brain axis. The gut-brain connection, also known as the enteric nervous system, consists of more than 100 million nerve cells that line the gastrointestinal tract, from the esophagus to the rectum. These nerve cells play a prominent role in mood.
That means the real brain and the butt can communicate. And if you have psychological distress, it’s possible that this could increase tenderness in the perianal area.
If anal itching is due to an infection, your doctor may prescribe antifungal, antibacterial, or antiparasitic treatment to kill infectious organisms. Prescription ointments that have higher doses of steroids can also decrease itching and reduce inflammation.
Hemorrhoids that cause anal itching may require more invasive treatments, such as hemorrhoid shrink banding or surgical removal of the hemorrhoid. Avoiding foods and medications that are known to cause an itchy anus can also reduce symptoms.
We can also adopt several habits at home to treat anal itching:
- Apply petroleum jelly to the affected area.
- Clean the area with water and a soft cloth when we bathe.
- We will dry the anal area well after using the bathroom.
- Refrain from scratching the anal area.
- Refrain from using bath products that contain perfumes or dyes, which can irritate the skin or cause a reaction
- Use toilet paper that does not contain strong dyes or bleach.
- Wear breathable cotton underwear that is not too tight.
- Clean with moistened wipes or toilet paper moistened with water to prevent feces from remaining on the skin of the anus.
- Sitz bath. In a sitz bath, we will place your butt and hips in warm water for up to 20 minutes.