A persistent need to scratch your bottom, also called pruritus ani, is a relatively common condition. There are a number of reasons why anal itching occurs and, it can be successfully treated. Pruritus ani is the medical term for anal itching or itchy bottom. It is defined as intense itching around the anus. Other terms include:

  • Anal pruritus
  • Perianal itching
  • Anorectal itching
  • Itchy butt/bum/bottom

Itchy Bum Hole

Causes of itchy bum hole

Itchy bum hole

Anal itching is a symptom, not a disease in itself; it is a common problem, which many people are too embarrassed to see their doctor about.  Pruritus ani can happen to anyone but is said to be more common in men than women and also more common in adults than children or the elderly.

The problem usually can begin as a brief irritation and soon become a chronic problem as the scratch-itch cycle continues. Scratching causes tiny little breaks in the skin that are intensely itchy when moisture and humidity of the perianal area comes into contact with them. This causes more scratching and further tiny itchy cuts.

The cause of itchy bottom is not always known. However, it can sometimes be a symptom of an underlying condition. When urine passes over the cuts in women, it causes stinging, which is then relieved by over-vigorous wiping with toilet paper, again further damaging the skin.

Usually, the condition can be cured by a strict no-scratching period, which allows the skin to heal and breaks the cycle. However, a physician should examine the skin and lower bowel to make sure there are no medical problems.

Symptoms of itchy bum hole may indicate infection in your body’s digestive system or it may be just a simple reaction to what came into contact with your bum hole or anus. Below are some symptoms that are common with that itch on your bum hole;

  • Blisters result into sore anus that may worsen when pooping
  • Red dots may appear around the bum hole or anal area and the butt crack
  • Sleepless nights due to burning sensation around the anal area at night
  • You may feel an itch irritation on the bum hole or anus when you wipe
  • Burning sensation when bathing, swimming or soaking in a tub
  • Irritation on the anal area after diarrhea or pooping
  • A scorching pain in or around the anus
  • Bleeding and sores around or on the bum hole
  • You may develop itchy bumps and lumps on the bum hole
  • In severe cases from other diseases, itchy bum hole may be accompanied with a mucus discharge form the bum hole
  • An itchy feel on the anus or the but crack area in the morning or at night
  • Itchy but crack that may come and go when walking or after long walks

Always be careful not to ignore even these mild symptoms especially for gay couples. Seek medical advice to verify severe symptoms for proper diagnosis. This scratch-itch cycle is made worse by nighttime scratching when the sufferer is half asleep and unaware that they are scratching, especially as loose nightclothes allow easier access.

Causes of Itchy Bum Hole

Pruritus ani can have a primary or secondary cause: Primary cause – the itching is not the result of another condition and Secondary cause – the itching has an underlying condition that causes the itching. The causes may involve the following:

Infection

An itchy bottom may be a sign that your body is trying to deal with an infection. The infection may be:

  • bacterial – such as the streptococcal bacteria, or the staphylococcal bacteria  which are well known for their respective infections
  • fungal – such as the Candida albicans fungus that causes vaginal thrush (itching, irritation and swelling of the vagina and surrounding area)
  • parasitic – such as thread worms (small worm parasites that infect the intestines), or scabies (tiny mites that burrow into the skin)
  • Viral – such as the herpes simplex virus, this causes cold sores.

An itchy bum hole can sometimes be a symptom of sexually transmitted diseases. If you have had unprotected sex and think you could have an STI, visit your physician for examination. They can offer advice and provide testing and treatment.

Gastrointestinal conditions

These are conditions that affect your digestive tract, which is, your mouth, throat, stomach, intestines and anus. Gastrointestinal conditions that may cause an itchy bottom include hemorrhoids which are the swellings in and around your anus that contain enlarged and swollen blood vessels, anal fistula –where a small channel develops between your anal canal and the surface of your skin, near the anus. Others include:

  • anal fissure – a tear or ulcer that develops in the lining of the anal canal
  • Sphincter incompetence – where the sphincter (the ring of muscle that opens and closes your anus) stops working properly, causing bowl incontinence.
  • long-term diarrhea – passing loose, watery stools
  • long-term constipation– an inability to completely empty your bowels

Skin conditions

Some skin conditions can affect any area of skin on your body, including the skin around your anus. Skin conditions that can be associated with an itchy bottom include:

  • psoriasis – where red, flaky, crusty patches of skin develop because your skin cells reproduce too quickly
  • contact dermatitis – where your skin reacts to certain substances (allergens), causing it to become inflamed
  • lichen sclerosis – a long-term skin disorder that causes itchy or sore white spots to develop on the skin around the genitals
  • atopic eczema – where your skin becomes dry, red and flaky

Systemic conditions

Systemic conditions affect your whole body and can sometimes make your bottom feel itchy. Systemic conditions include:

  • diabetes – a lifelong condition that causes your blood sugar level to become too high
  • kidney failure – where your kidneys stop working properly
  • iron deficiency anemia – a decrease in the number of red, oxygen-carrying blood cells, causing tiredness and a lack of energy (lethargy)
  • overactive thyroid – too much thyroid hormone in your body

Dermatological (skin) causes

They may include the following:

  • Prolonged contact with feces can cause irritation.
  • People who have little or no control over bowel movements can have leakage, which can cause irritation and itching.
  • Persistent diarrhea can cause irritation by nature of the frequency or bowel opening and wiping clean.
  • Eczema and idiopathic dermatitis can affect the anal area. This is inflamed skin of no known cause.
  • Keloid scar of skin – these are hard, smooth growths that develop when scar tissue develops excessively.

Anal and bowel cancer

In rare cases, itchy bottom can be a symptom of a gastrointestinal cancer, such as anal or bowel cancer. Most cases of itchy bottom aren’t caused by cancer, but it’s important that your GP rules out all possibilities.

Itchy Bum at Night

Itchy bum hole at night

Itchy bum at night

Sometimes, itchy bum hole at night also causes inflammation of the anus and complicates things a bit. Itching severity may vary from person to person, but certain factors can make things worse, such as your sitting posture and the type of clothing worn. Itchy bottom at night can make you extremely uncomfortable and interrupt your sleep. What you need to understand is that it may be an indication of an underlying health condition.

Possible Reasons for an Itchy Bottom at Night

Resisting the temptation to scratch your bottom can be quite tough. It can be quite embarrassing to do it in front of others, but some people find it intolerable. To find a treatment option, you first need to identify the causes of your condition.

Too Much Moisture

You are more likely to develop anal itching if moisture levels around your anal area are high. This could be due to diarrhea, allergies, over-sweating, fecal incontinence, or inappropriate clothing.

Hemorrhoids

You have hemorrhoids if the veins in your rectum or around the anus are inflamed or swollen. Hemorrhoids can develop externally or internally. If you have hemorrhoids, this may explain why you have itchy bottom at night.

Skin Conditions

Your chances of developing anal itching increase when you have an existing skin condition, such as seborrhea, eczema, or psoriasis. You may also experience itching on other parts of your body.

Rough Handling

Not cleaning your bottom properly after using the bathroom may well be among the reasons why you have developed anal itching. Abrasive rubbing using low-quality toilet paper may irritate your skin and lead to itching. Over-washing the anal area may also result in the same. Similarly, you may be using douches, soaps, or body sprays that contain harsh chemicals. These chemicals can irritate your skin and lead to anal itching.

Now that you know what causes the embarrassing itchiness, it is possible to take some steps and resolve the problem. In most cases, you can treat this problem by taking simple self-care measures to prevent your bottom itching. As mentioned already, one of the biggest causes of anal itching is high moisture levels around anal area. It is therefore important to take steps to keep this area clean and dry. Here is what to do:

  • Use water to clean your anus gently after having a bowel movement and do the same before going to bed.
  • Use only mild soap to clean your bottom to avoid skin irritation.
  • Dry your bottom gently after every wash. Never rub it vigorously. Pat drying with a soft towel will do.
  • Use a hair dryer if you want to be absolutely sure that your anal area is dry – use it on a low heat setting.
  • Use damp toilet paper after using a public toilet and pat your bottom dry.
  • Place a cotton tissue in your underwear if you have a tendency to sweat a lot.

Itchy Bum Crack

Itchy bum hole and butt crack or bottom area in children or adults can be burning and very uncomfortable to the patient. Sometimes the symptoms may worsen at night. In children, one of the major causes of an itchy sore anus is worms since they put almost anything they touch in their mouth. A lump, bump or rash on bum hole and butt crack may also cause a sore anus and itchy buttocks.

This condition does not have a specific cause or symptoms since there are numerous factors and diseases that may make a child or and adult want to scratch down there due to itchy bum crack

Itchy Bum Worm

Causes of itchy bum hole

Itchy bum worms

An estimated 20-40% of American children carry pinworms at any given time.  They are also known as threadworm, or enterobius vermicularis.  Anyone can have worms.  Pinworms live in the digestive tract and especially the anus.  Pinworms can also infest the vagina in females.  The best prevention is strict hygiene. If your child is a nail biter or thumb sucker, it’s nearly impossible to prevent pinworms.  And once pinworms are in your house, they often spread to the entire family, including parents.

Pinworms are easily treated with either over-the-counter or prescription medicationsBefore you rush off to Walgreens to buy Reece’s Pinworm Medicine or Pin-X, make sure you really have pinworms.  It’s easy to diagnose at home, and these tricks work for grown-ups, too.

How to tell if your child has pinworms

If your child is complaining of anal itching, especially at night, check on them in their bed about 2-3 hours after they fall asleep.  Pick a night when they didn’t have a bath, if possible.  Bring a good flashlight, and have your child lay on their belly with their buttocks in the air.  Spread the butt cheeks and get a good look at the anus.  Ask your child to push out like they are having a bowel movement while you are looking, which will help expose the anus.

How to treat pinworms at home without a prescription

If you found a worm and saw it move, you probably don’t need to see your physician.  Pinworms can be treated completely with over-the-counter medicine.  Take one dose immediately and another dose two weeks later.  If you are having persistent symptoms (anal pain, abdominal pain, blood in stool, or rectal bleeding), be sure to seek medical care immediately.

How to Cure an Itchy Bum Hole

A physical examination may follow so that the doctor can see how the problem looks, checking for signs of skin cracking or inflammation and any bleeding around the anal area. Chronic scratching can cause thickened pale skin.

A visual check may also reveal hemorrhoids, anal fissures, for example. It may simply reveal soiling as the issue. The anus and rectum should also be examined for evidence of cancers. An internal examination will be performed by the doctor – by inserting a gloved and lubricated finger through the anus into the rectum.

The doctor may ask you to clench your bottom, as a test of the anal sphincter, or ask you to push, as a way of looking for internal hemorrhoids that get pushed through to the outside. The whole body should be checked for other conditions that may have pruritus ani as a cause. Investigations for pruritus ani include:

  • Swabs if infection is suspected
  • A biopsy if there is any abnormal skin
  • Stool cultures if there is any diarrhea
  • Routine blood tests to check blood count, renal, liver, thyroid, diabetes, and inflammatory markers

What Your Doctor Will Do

Your doctor will make a careful physical examination that may include a close inspection of the anal area using a plastic device known as an anoscope. You may also be examined for pinworm eggs or scabies

Diagnosis

The first time someone presents the problem of anal itching to their doctor, the consultation will start with questions. This will help to see if the itching is due to local skin problems, or a more general problem with the whole body. The doctor may:

  • Ask about the duration and pattern of the itch
  • Explore dietary intake and hygiene practices to see if there is inadequate or excessive washing, or use of creams, perfumes, or soaps
  • Evaluate how severe the itch is, and work out its impact on life

Other information will help to pin down a possible cause for the pruritus ani:

  • Is there a relevant past medical history, such as anorectal surgery, or diabetes?
  • Has there been any urinary or fecal incontinence?
  • Is there blood on toilet paper, anal pain, or lumps to indicate hemorrhoids?
  • Has there been any bloody diarrhea and abdominal cramps (suggesting inflammatory bowel disease)?

Treatments

Below are some practical tips to help with the treatment and prevention of an itchy bottom:

Home remedies and self-care for itchy bum hole

  • How to get rid of itchy bum hole naturally

    Home remedies for itchy bum hole

    Avoid highly seasoned and spiced foods, and maintain a regular bowel habit

  • Keep the anal area clean after emptying the bowel
  • Avoid medicated, perfumed, or deodorant soaps – use only plain warm water for cleaning, aqueous cream, or emollients
  • Use moist toilet tissues instead of paper
  • Avoid allowing the anal area to stay moist, and dry it gently by dabbing, not by rubbing
  • Use drying powders, but not medicated or scented ones
  • Avoid scratching the area, which creates further trauma and makes the problem worse
  • Wearing socks or cotton gloves on the hands may reduce the harm from unconscious scratching for people who find they have been unable to resist overnight scratching
  • Wear loose, breathable clothing, avoiding materials such as acrylic and nylon, which trap sweat

Understanding and educating about the scratch-itch cycle is very important. The skin must be allowed to heal to reduce the irritation that causes the scratching. Avoiding irritating soaps and creams, and keeping the skin cool, dry, and clean is essential. Fingernails should be kept short, and intense itching soothed with cool water on cotton wool balls.

Prescribed treatments

  • Antihistamines – if itching is particularly troublesome during the night, doctors may offer an antihistamine such as hydroxyzine.
  • Soothing ointments – bismuth subgallate or zinc oxide, for example – are prescribed for some skin problems.
  • Corticosteroids -inflammation of the perianal skin may receive short-term topical drug treatment in the form of a mild corticosteroid – hydrocortisone, for example. However, some research has shown that, as an initial treatment step, cleansing can be as effective as corticosteroids.
  • Local anesthetics – these can temporarily relieve pain and itching; they include benzocaine, benzyl alcohol, lidocaine, and pramoxine.
  • Vasoconstrictors – these constrict blood vessels and can reduce swelling. They also act as mild anesthetics. These include ephedrine sulfate and epinephrine.
  • Astringents – these chemicals promote protein aggregation within cells, which dries out the skin and helps reduce itching, burning, and pain.
  • Protectants – these form a physical barrier between the skin and any potential irritants. They include aluminum hydroxide gel, cocoa butter, and glycerin.
  • Keratolytics – these cause outer layers of tissue to disintegrate, allowing any medical ointments to penetrate deeper layers.

Other potential treatments:

  • Capsaicin cream – the effectiveness of this treatment requires further investigation
  • Anal tattooing – this has been trialed but, again, needs further evaluation before it can be recommended
  • Hypnosis – the benefits of hypnosis to reduce scratching should also be further evaluated

Prevention

  • Bathe regularly. Wash your anal area with soap and water and dry thoroughly.
  • Make use of moistened tissue. After a bowel movement, cleanse carefully with tissues moistened with vegetable or mineral oil. Several brands of pre-moistened varieties are now available in stores. You can also use toilet tissue that you’ve moistened and lightly soaped, then rinse with plain wet tissue and dry the area.
  • Avoid tight underclothing. Choose roomy, breathable underwear made of cotton rather than synthetics. This will keep the anal area ventilated and relatively dry.

If a medicine you’re taking is causing an itchy bottom, your bottom should itch less after you’ve completed the course of medication. Never stop taking a prescribed medication unless advised to do so by your GP or other qualified healthcare professional responsible for your care. Speak to your GP if you’re taking a medicine on a long-term basis and it’s causing an itchy bottom. They may be able to prescribe an alternative.

More references

  1. Anal itching:
  2. Itchy bottom causes:
  3. Itchy bottom at night:
  4. Itchy bottom hole, crack:
  5. How to diagnose and get rid of pinworms:
  6. Treatment to anal itching:
  7. Anal itching remedies: