Health A to Z
Itchy bottom (pruritus ani) is characterised by a strong urge to scratch the skin around your anus.
The anus is the opening at the lower end of the digestive system, where solid waste leaves your body.
As itchy bottom is a symptom rather than a condition itself, many cases have an underlying cause, for example:
In children, an itchy bottom is often caused by threadworms.
But not all cases of itchy bottom have an identifiable cause.
An itchy bottom can be made worse by:
Read more about the causes of itchy bottom.
See your GP if you've had an itchy bottom for more than a few days, so they can try to find the cause. They may ask about:
Your GP will usually want to examine the skin around your anus and may ask to carry out a digital rectal examination (DRE) to rule out more serious underlying conditions.
You may feel awkward, but it's nothing to be embarrassed or worried about, as this is one of the most common examinations GPs carry out.
If necessary, you may be referred to a specialist for further investigation and treatment.
An itchy bottom is usually easy to treat at home. Some ways of easing an itchy bottom include:
Your GP can prescribe creams or ointments to help relieve your symptoms while the above self-care measures are taking effect. Check with your GP or pharmacist about how long you should use them for.
If your itchy bottom is caused by an underlying condition, such as a bacterial infection or piles, it will also need to be treated.
Read more about treating an itchy bottom.
Frequently scratching your bottom may damage or tear the delicate skin around your anus. This may lead to problems such as:
The earlier these complications are diagnosed and treated, the quicker you'll recover. You should visit your GP if the skin around your anus changes or feels painful.
If the cause of your itchy bottom can't be identified and treated, it may last for long periods of time (known as chronic itchy bottom). This may cause you to feel embarrassed, anxious or depressed.
As the urge to scratch is often worse at night, your sleep may also be disturbed, leaving you feeling tired during the day.
Speak to your GP if your itchy bottom is making you anxious or depressed, or if it's significantly affecting your sleep.
The cause of itchy bottom isn't always known. However, it can sometimes be a symptom of another problem or underlying condition.
An itchy bottom may be a sign that your body is trying to deal with an infection. The infection may be:
An itchy bottom can sometimes be a symptom of a sexually transmitted infection (STI).
If you've had unprotected sex and think you could have an STI, visit your local sexual health clinic. They can offer advice and provide testing and treatment.
Gastrointestinal conditions affect your digestive tract (your mouth, throat, stomach, intestines and anus).
Gastrointestinal conditions that may cause an itchy bottom include:
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:
Systemic conditions affect your whole body and can sometimes make your bottom feel itchy. Systemic conditions include:
Some types of medication, including those applied directly to your skin (topical), may make your bottom feel itchy.
For example, if you use a cream to treat haemorrhoids, it may irritate the sensitive skin around your anus and make the itching worse.
Some topical medicines may also cause contact dermatitis (red, itchy skin) if used for long periods.
Medicines that may cause an itchy bottom or make your symptoms worse include:
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.
Most cases of itchy bottom aren't caused by cancer, but it's important that your GP rules out all possibilities.
Possible symptoms of anal cancer include:
Possible symptoms of bowel cancer include:
Treatment for itchy bottom usually involves following simple self-care measures for a few months. If necessary, medication may be prescribed to help ease the symptoms.
If you still have an itchy bottom after two months, or if it returns, you may need to follow this self-care advice for longer.
If you have an itchy bottom, you should keep your bottom as clean and dry as possible.
The best way to do this is to use water to gently clean your anus and the surrounding skin. Clean your bottom in this way after every bowel movement and before going to bed each night.
You can use soap to clean your bottom, but make sure it's mild and unperfumed so it causes less irritation to your skin. Wash all of the soap away afterwards.
After washing, gently dry your bottom. Avoid rubbing the area vigorously, as this may irritate your skin. Instead, gently pat the skin dry using a soft towel. You can also dry your bottom using a hairdryer on a low heat setting.
When you're away from home, you can use damp toilet paper after passing stools, before gently patting your bottom dry.
If you have a tendency to sweat, or if your bottom becomes very moist, putting a cotton tissue in your underwear will help absorb the moisture around your anal area.
As well as keeping your bottom clean and dry, there are a number of other self-care measures you can undertake. For example, you should:
It may be difficult, but you should try to resist the urge to scratch your bottom, as scratching will only make the problem worse.
Some foods may make your itchy bottom worse. If the urge to scratch your bottom is greater after eating certain foods, try cutting them out of your diet completely or reducing the amount you eat.
Foods that may make your itchy bottom worse include:
Your GP may recommend that you follow a diet that keeps your stools regular and well-formed.
This means your stools won't be loose (runny), but you won't need to strain when you go to the toilet.
Loose stools can irritate your anus. Straining to pass hard stools may cause haemorrhoids (piles) to develop. Piles are swellings that contain enlarged and swollen blood vessels in and around your anus.
Including more fibre in your diet will make your stools softer and easier to pass. Fibre can be found in:
Read more about why fibre is important.
While waiting for the above self-care measures to take effect, your GP may prescribe medication to help ease your itchy bottom.
However, you shouldn't use topical treatments (those applied directly to your skin) for more than two weeks, because they may start to harm your skin if used for long periods.
Your GP may prescribe an ointment or cream to soothe the skin around your anus. You'll usually have to apply it in the morning and at night, as well as after each bowel movement.
If the skin around your anus is sore and inflamed due to itching, your GP may prescribe a mild topical corticosteroid (an ointment that contains steroids). Applying this directly to the affected area will help relieve the inflammation and ease the urge to scratch.
In most cases, using a topical corticosteroid will help ease the itch. However, it can sometimes make the itching worse. Speak to your GP immediately if your itchy bottom gets worse after using topical corticosteroids.
If your sleep is disturbed due to itching at night, using an antihistamine may help.
Antihistamines are medicines that work by counteracting the action of histamine (a chemical released during an allergic reaction). Some antihistamines also have a sedating effect (they make you drowsy).
Your GP may prescribe chlorphenamine or hydroxyzine. These should be taken at night and shouldn't be used for longer than two weeks, because after this time the sedating effect may no longer work.
You need to be aware that sedating antihistamines can affect your ability to drive or operate machinery, and the sedating effect may be stronger if you drink alcohol.
When diagnosing itchy bottom, your GP will try to determine an underlying cause.
If they identify the cause, such as a bacterial infection or skin condition, it will also need to be treated for your itchy bottom to be properly managed.
For example, a bacterial infection may need to be treated with antibiotics. If the underlying cause is left untreated, your itchy bottom may return.
An itchy bottom in children is often caused by worms. If treatment for worms is recommended, other family members with the same symptom should also be treated.
Go back to your GP if your itchy bottom doesn't improve after following self-care measures, such as keeping your bottom clean and dry, and using medication to provide relief from the itching.
Your GP may then refer you to a dermatologist (a specialist in treating skin conditions) or a colorectal surgeon (who specialises in conditions that affect the large intestine and anus).