Rectal itching (pruritus) is usually not a sign of a serious disease. At first, the skin of the anal area may appear red. Itching and scratching may make the skin become thickened and white. Common causes of rectal itching include:
- Poor cleaning of the area after a bowel movement. Itching and discomfort may occur when pieces of stool become trapped in skin folds around the anus.
- Medicines, especially medicines that cause diarrhea or constipation, such as antibiotics.
- Cleaning of the anus with very hot water and strong soaps. The anal area is normally oily, and this barrier protects against the irritation of bowel movements. Repeated cleaning or showering will remove these oils and can lead to a cycle of itching and scratching that can be hard to stop.
- The use of scented toilet paper, scented soap, or ointments (such as those that contain benzocaine).
- A generalized dry skin condition that affects the entire body. This condition is more common in older adults. For more information, see the topic Dry Skin and Itching.
- Hemorrhoids. Hemorrhoids are enlarged veins near the lower end of the rectum or outside the anus. For more information, see the topic Hemorrhoids.
- An infection of the anus or rectum, which may be caused by viruses (such as genital warts), bacteria, pinworms, scabies, fungus, yeast, or parasites. Pinworms are the most common cause of anal itching in children. For more information, see the topics Pinworms, Scabies, or Genital Warts (Human Papillomavirus).
- Certain foods, such as coffee, tea, cola, alcoholic beverages, chocolate, tomatoes, spicy foods, and large amounts of vitamin C.
Home treatment for rectal itching depends on the cause of the itching.
Treat causes of anal itching
Try these home treatment measures for the following causes of anal itching:
- Poor hygiene. Clean the area gently with water-moistened cotton balls, a warm washcloth, or premoistened towelettes, such as Tucks or "baby wipes." A mild ointment, such as A+D Ointment or Desitin, can be applied lightly to help soothe the skin and protect it against further irritation.
- Scented or colored toilet paper or scented soaps.
- Buy white, unscented toilet paper.
- Do not use scented soaps, which can irritate skin.
- Apply an ointment that contains 1% hydrocortisone. Do not use other steroid creams on this sensitive area of your body; skin damage can occur. Hydrocortisone cream should not be used for longer than 7 to 10 days without talking with your doctor. Note: Do not use the cream on children younger than age 2 unless your doctor tells you to. Do not use in the rectal or vaginal area in children younger than age 12 unless your doctor tells you to.
- Reactions to topical creams. Apply an ointment that contains 1% hydrocortisone. Do not use other steroid creams on this sensitive area of your body; skin damage can occur. Hydrocortisone cream should not be used for longer than 7 to 10 days without talking with your health professional. Do not use creams or ointments, such as Benadryl cream, that contain antihistamines.
- Excessive sweating. For anal itching caused by excessive sweating, avoid wearing tight-fitting underwear and wear cotton, rather than synthetic, undergarments. You may use talcum powder to absorb moisture, but do not use cornstarch. Cornstarch may cause a skin infection. Dry your rectal area with a hair dryer set on the low setting before applying talcum powder.
To control itching
To control itching, try the following:
- Break the itch-scratch cycle, because further scratching leads to more itching. Take an oral antihistamine at night to help lessen your nighttime itching. Don't give antihistamines to your child unless you've checked with the doctor first.
- Take a warm sitz bath, three times each day and after each bowel movement. Following the bath, dry the anus carefully. You may wish to use a hair dryer set on low.
- Avoid foods that can increase rectal itching, such as coffee, tea, cola, alcoholic beverages, chocolate, tomatoes, spicy foods, and excessive amounts of vitamin C, for a minimum of 2 weeks. Gradually add the items back to your diet, one item at a time, to help determine the cause of the itching.
- Trim your fingernails short if you find yourself scratching irritated skin at night. Wear cotton gloves or socks on your hands at night to help stop the unconscious scratching that can occur while you sleep.
- Control your stress. Being under stress and feeling anxious or worried can cause some people to experience skin itching. If you find you are scratching your anal area when you are anxious, try to take relaxation breaks throughout the day, especially before bedtime.
To prevent rectal problems:
- Use white, unscented toilet paper.
- Do not use scented soaps, such as Irish Spring and Coast, which can irritate skin.
- Practice good hygiene. Gently wipe the area with toilet paper after each bowel movement. If irritation starts, use water-soaked cotton balls to clean the area and then pat the area dry with dry cotton balls. Premoistened pads, such as Tucks or "baby wipes," may be less irritating.
- Do not sit on the toilet for long periods of time.
- Eat a high-fiber diet that includes plenty of fruits and vegetables, and bran cereal every day.
- Avoid foods that can cause rectal problems. Examples of such foods include:
- Regular or diet cola.
- Beer and other alcoholic beverages.
- Dairy products.
- Any other items that you know cause you to have gas or indigestion