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Causes
By Mayo Clinic staffMost cases of anal itching are caused by a harmless problem. Occasionally, however, anal itching can be a sign of more serious medical issues. Possible causes of anal itching include:
- Dry skin. As you age, skin in and around your anus is more prone to dryness. Dry skin can cause persistent, intense anal itching.
- Too much moisture. Moisture around your anus from excessive sweating or from moist, sticky stools can be irritating.
- Fecal incontinence. Anal itching can also be caused by frequent diarrhea or the escape of small amounts of stool (fecal incontinence).
- Excessive washing. Excessive wiping with dry, harsh toilet paper or excessive scrubbing with harsh soaps can cause or aggravate anal itching. Failure to rinse away the soap completely also can cause irritation.
- Overuse of laxatives. Excessive or improper use of laxatives can lead to chronic diarrhea and the risk of anal irritation and itching.
- Chemical irritants. Certain laundry soaps, colognes, douches and birth control products contain chemicals that can irritate skin in and around your anus. Scented or colored toilet paper can be irritating to people with sensitive skin.
- Skin disorders. Common skin problems — such as psoriasis, seborrhea and eczema — can involve and irritate the area in and around your anus.
- Yeast infections. This common infection, which usually affects women, can irritate your genital and anal areas.
- Hemorrhoids. Hemorrhoids are engorged veins located just under the membrane that lines the lowest part of your rectum and anus. They often occur as a result of straining during a bowel movement. Anal itching can be a symptom of hemorrhoids.
- Anal abrasions, fissures and fistulas. An anal abrasion is a small tear in your anus, usually caused by forced bowel movements through a tight anus. An anal fissure is a deeper tear. An anal fistula is a small tunnel that forms under the skin and connects a previously infected anal gland to the skin on the buttocks outside the anus. All three conditions can cause anal itching, as well as painful bowel movements and bleeding.
- Food irritants. Anal itching may be the result of irritating chemicals in some foods, such as those found in spices and hot sauces. Similarly, some foods may directly or indirectly irritate your anus as they exit your colon. Common culprits include chocolate, alcohol, tomatoes and citrus fruits. Consuming certain beverages, including milk or caffeinated drinks, may cause some people to experience diarrhea followed by anal itching.
- Medications. Anal itching may be a side effect of certain medications, including some antibiotics, that can cause frequent diarrhea.
- Infections. Sexually transmitted diseases may also involve the anus and can cause anal itching. In children, the parasite that causes pinworms can cause persistent anal itching. Adults in the same household can also be infected. Other parasites may cause similar itching.
- Anal tumors. Rarely, benign or cancerous tumors in or around the anus may be a cause of anal itching.
- Other causes. Anal itching may be related to anxiety or stress. Sometimes, the cause is undetermined.
Contributing to the problem
Although anal itching is almost never a problem of cleanliness, your own actions may contribute to the problem.
- Scratching. Whatever the cause of anal itching, your natural reaction is to scratch the area. But scratching worsens the problem by removing superficial layers of skin.
- Excessive washing. The natural tendency in response to an irritation is to wash the area frequently with soap and a washcloth. However, excessive washing can aggravate the condition by removing your skin's natural protective oils.
References
- Breen E, et al. Approach to the patient with anal pruritus. http://www.uptodate.com/home/index.html. Accessed March 24, 2010.
- Pruritus ani. American Society of Colon and Rectal Surgeons. http://www.fascrs.org/patients/conditions/pruritus_ani/. Accessed March 30, 2010.
- Pfenninger J, et al. Common anorectal conditions: Part I symptoms and complaints. American Family Physician. 2001;63:2391. http://www.aafp.org/afp/20010615/2391.html. Accessed March 30, 2010.
- Pruritis ani. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec02/ch020/ch020j.html?qt=Pruritus%20Ani&alt=sh#sec02-ch020-ch020h-1370. Assessed March 30, 2010.
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