• Anal itching, aka pruritis ani, is very common affecting an estimated 1%-5% of the US population.
  • Your butthole could be itchy for a number of reasons like diarrhea, STI, and parasites.
  • People who clean their butthole too much with scented wipes can irritate it causing itching.

Anal itching, or pruritis ani, is probably near the top of a list of socially awkward body issues, but it can also be very uncomfortable and disruptive to everyday life.

Between 1%-5% of the US population has anal itching and it is four times more common in men. 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.

What to do about it: 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 and environmental 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.

Another irritant that can cause anal itching is fragrance found in laundry detergent, soaps, and wipes.

What to do about it: "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 and Calmoseptine, which "has a little bit of menthol in it and the cooling sensation can really help relieve the itching," says Malone.

3. 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:

  • Sit for long periods of time
  • Strain with bowel movements
  • Have a low fiber diet
  • Are pregnant
  • Engage in receptive anal sex
  • Have chronic diarrhea or constipation

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

What to do about it: 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.

4. Diarrhea 

Diarrhea is more acidic than typical stool and takes more wiping than usual to clean yourself. More wiping can irritate the skin causing 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:

What to do about it: For short term diarrhea, you can use OTC antidiarrheal medication to relieve symptoms. 

Be sure to stay hydrated by drinking 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.

You can also help control diarrhea by avoiding 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. 

"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.  

5. 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

What to do about it: 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 of either as the infections can lead to pelvic inflammatory disease if left untreated.

 6. 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, "for example, 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:

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

7. 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 five and ten. 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 Posto.

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

8. 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.

What to do about it: 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. 

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.

Read the original article on Insider