AN ITCHY BUTT can be so uncomfortable in so many ways. There’s the issue of the itching. There’s the issue of not being able to figure out how to scratch it when your butthole itches in public. And there’s the issue of going to a doctor to ask the question, “Why does my anus itch?” (That last one shouldn’t be an issue, by the way. Doctors have heard it all before and can help you get to the bottom of your itchy butt).
“Anal itching is quite common, and for some people, it can feel incredibly frustrating,” says Mitchell Bernstein, M.D., an associate professor of surgery and director in the division of colon and rectal surgery at New York University Langone Health. “Some people even start scratching in their sleep, and of course, too much scratching just makes it worse.”
The ailment is technically known as pruritus ani, meaning “itchy anus” in Latin. (Talk about a straightforward translation.) When experiencing an itchy butt, some people have “primary” pruritus ani, which means their butt is itchy for no apparent or underlying reason. However, others have “secondary” pruritus ani, which means the itch comes from a condition like hemorrhoids, anal fissures, bacterial infections, or something else.
While experiencing an itchy butt can happen at any age and at any time, you might notice anal itching gets worse after you reach the age of 40.
If you find yourself dealing with an itchy butt crack, you are likely going to hope it’ll go away on its own. Generally, it needs some help. There are some issues in the list below that you can take care of on your own, and there are some ways to get immediate relief for that itchy butt. But you’ll want to call a doctor for some of the more complicated ones. Here’s what might be up down there and how to soothe your seat fast.
1. Anal Itching Cause: You’re Not Wiping Enough
Slacking on your hygiene can irritate the skin and cause itching due to flecks of fecal matter remaining on your anus. Even though you’ve been doing it for years, you might not be wiping enough after you use the toilet.
“How someone wipes and the quality of toilet paper makes a huge difference,” explains Evan Goldstein, D.O., of Bespoke Surgical in New York City. “Not wiping enough leaves residual excrement in a place that already does not get much sun or air, and also retains moisture. Plus, stools are laden with bacteria and you can imagine how it can fester, causing the symptoms of an itchy butt and beyond.”
If there’s poop hanging around in your crack, get in the shower and wash your butt. Don’t just stand there and let the water run between your cheeks: Use body wash or soap and a hand-held shower head, if you have one. Look for soaps or body washes labeled “sensitive” or “gentle” when it comes to cleaning below the waist.
2. Anal Itching Cause: You’re Wiping Too Much
Okay, so to avoid an itchy butt, you definitely want to make sure you are wiping enough, but you also want to make sure you are not wiping too much, as this can also cause an itchy anus and an itchy butt.
As Dr. Goldtsein explains, it comes down to friction. “The more we wipe, the more friction there is. The harder we wipe, the more friction there is. The rougher the toilet paper we use, the more friction there is. All this friction causes irritation, microtears, and, yes, a potentially itchy butt.” Easily crumbled toilet paper can leave bits trapped in the anal skin, and that can be irritating as well.
If you think you may be going a little too hard with the toilet paper, you may want to consider alternative ways to clean yourself—like a bidet. (Just dry off adequately afterward.) If you don’t have one of those, try cleaning yourself in the shower instead of plowing through a whole roll of TP.
Flushable wipes seem like an easy solution, but the chemicals in them can irritate some people, making the problem worse, some doctors say. “They can also leave unnecessary moisture in between your cheeks, which leaves you with swamp ass and even infections over time,” Dr. Goldstein says. So it may be better to stick to good hygiene practices instead.
3. Anal Itching Cause: STIs
Another potential reason your butt is itchy is from sexually transmitted infections, particularly herpes, gonorrhea, and chlamydia, according to Ehsan Ali, M.D., primary care physician in Beverly Hills, California.
These STIs are fairly common, and rates are going up. They are especially seen in people who engage in anal sex without condoms, Dr. Ali says.
When they occur, they cause inflammation in the rectal area, and that can prompt itching. With herpes or HPV, warts may also appear, which can cause further burning and an itchy butt. Any of these STIs may also prompt discharge, or penile and testicular pain, and a rash.
If you suspect STIs might be the culprit, get tested. There are at-home tests you can take, but you might want to see a doctor from the start. A medical pro can treat the issue right away, and that can usually clear up the symptoms and stop the itch.
4. Anal Itching Cause: Eczema
Sometimes, the compulsion to scratch down below can come from eczema, a skin condition characterized by a red, scaly rash that can come with a really persistent itch.
The exact cause of eczema is unknown, but it has been linked to an overactive response by the immune system and can be triggered by allergies or asthma, says Alan Parks, M.D., dermatologist and founder of DermWarehouse.
The condition can also crop up with external factors like changes in weather or exposure to household products like soap or detergent.
Stress can also be a factor, and can also cause the problem to worsen. When you get tense, your body issues a protective response by increasing inflammation. That can cause a flare-up of itching wherever you have eczema, including itching in your butt crack.
Dr. Parks notes that the problem is usually treated with topical steroid creams, which tend to take care of the itching fairly rapidly because they lower inflammation—unlike other medicated creams that may increase it and make itching worse.
5. Anal Itching Cause: Fungal Infections
That’s right—the one place where you would least like to have fungus is where you can get a bunch of it.
Actually, we all have fungus living on our skin, says Dr. Parks, but where it thrives the most is in warm, moist, airless areas. Like in your underwear.
The body is usually adept at fighting off the invaders, but if you’ve been sick lately, overstressed, or if your butt sweats a lot, the fungus may linger. This may cause an area of redness and inflammation around the anus, similar to eczema.
In that case, your doctor will likely treat you with a topical or oral anti-fungal medicine. In the meantime, you can also shop around for a better pair of underwear.
6. Anal Itching Cause: Your Laundry Detergent
If there’s an itchy rash on your behind, it could be from the laundry detergent you used to wash your underwear. “With any products that are going on our skin, we need to make sure we do not have any sensitivities to the ingredient,” says Dr. Goldstein. It doesn’t matter that the skin is on our butthole, it still can react the same way as the skin on our legs or chest.
The irritating chemicals found in laundry detergent can lead to contact dermatitis, a skin condition that causes a red rash and mild to severe itching. The reaction may be more severe in spots where your clothing gets damp with sweat—such as your butt and groin.
You can help prevent contact dermatitis by switching to a fragrance- or dye-free detergent.
7. Anal Itching Cause: No-Breathe Clothing
If sweat can’t get out, you can end up with swamp butt (aka “swamp ass”), and ultimately, an itchy butt. When sweat accumulates, moisture-loving bacteria and fungus breed there (see fungus, above).
“It is so multifactorial, but moisture gets trapped in between the cheeks throughout the day. Then, you have got old or dirty underwear or clothing, and finally, the potential friction from exercise, sitting, and other parts of our day, and you can see how this can become a compounding situation,” notes Dr. Goldstein.
“I find a lot of people don’t shower at night—they hop right into bed after spending an entire day running around, living their life, pooping, sweating, and getting dirty. Whether or not they change their underwear before heading to bed, they are still taking all that grime and dirt with them, under sheets and blankets that do not breathe either. It is a nidus for infections and irritations,” he says.
Lots of manufacturers feel your pain (and itching). Many workout clothing brands and even standard clothing brands make underwear options that wick sweat away from your butt, starving out those itch-producing germs.
8. Anal Itching Cause: Hemorrhoids
By the time we hit age 50, about half the population of the U.S. will experience symptoms of hemorrhoids, and itching is one of them, along with pain and bleeding.
Hemorrhoids are basically bulgy blood vessels either inside the lower rectum or right outside the anus (known to doctors as “external hemorrhoids,” known to you as the ones that generally bother you more).
They’re linked to chronic constipation and long bouts of sitting on the toilet, which can allow blood to pool in vessels there and cause the ballooning. Fiber, of course, is one solution to taming the problem that can cause an itchy butt (check out these high-fiber foods you should be eating). Another classic for finding relief is sitting in a warm bath for 10 to 15 minutes. Doctors recommend these sitz baths three times a day, especially right after a bowel movement (which has the potential to be pretty inconvenient).
If you’re interested in an OTC option, Dr. Goldstein says there are many over-the-counter lotions and suppositories, like PreparationH and Calmol-4. “You can also introduce stool softeners, like Colace because you want to keep your stool soft and bowel movements easy.”
Also, do not sit too long on the toilet, notes Dr. Goldstein. This draws all the blood to that area, which can create or exacerbate hemorrhoids.
“I recommend people try these at-home remedies first and see if things improve over the next 3 to 5 days, which they often do. However, if things persist, it is time to see a doctor, who can prescribe more specific medications and treatments. Sometimes, people think it is a hemorrhoid, but it turns out to be another common anal ailment that needs different modalities of treatment,” he says.
9. Anal Itching Cause: Your Pooping Habits
How often you poop and the form it takes could irritate the skin of your anus, causing an itchy butt, according to the Cleveland Clinic.
When you’re constipated, you might strain to poop, and long-term, that can damage the skin around your anus and make it itchy. Chronic constipation also elevates the pressures in your anus and increases the likelihood of hemorrhoids or anal fissures.
“Any local trauma (there are many culprits) can potentially lead to bleeding, pain, and—you guessed it—an itchy butt,” says Dr. Goldstein. If you constantly find yourself constipated, add these foods to your next grocery run or try these tricks.
On the other hand, diarrhea, especially when it persists, might irritate anal skin, too. Diarrhea is caustic to the anal tissue,” explains Dr. Goldstein. “And if someone goes multiple times a day, you can understand how irritation is inevitable.”
However, Dr. Goldstein explains that anal tissue is not strong and tough enough to withstand this constant trauma. “Micro tears happen and then this spirals into an itchy butt and beyond.”
While a high-fiber diet can keep you more regular, if you’re having ongoing watery stools or struggling to go at all, it’s a good idea to check in with your doctor. They can check for certain gastrointestinal illnesses that might need more treatment.
10. Anal Itching Cause: Pinworms
Also known as threadworms, pinworms are tiny white or light gray parasitic worms that live in the intestines and rectums of infected people. Pinworms can lay their eggs around the anus, which can cause itching and irritation, according to the Cleveland Clinic.
Pinworms are common in children, but anyone of any age can get them. You can get them when you come in contact with someone who has the worms, scratches their anus, and transfers them to you. The eggs travel through your digestive system, hatch in your intestines, and move to your anus to lay more eggs. So if you need yet another reason to wash your hands after using the restroom or touching your butt, this is it.
While it sounds horrific, the good news is pinworms typically don’t cause serious illness, just usually severe and annoying itching. But they do have to be treated with prescription anti-parasitic medication.
Dr. Goldstein says OTC options are also readily available at your local pharmacy. “Treatment is easy and effective and usually consists of a two-dose regimen to get rid of everything.” However, seeing your doctor is always a safe bet to make sure the diagnosis is accurate, as well as to make sure you have an appropriate treatment plan in place, he notes.
11. Anal Itching Cause: Anal Fissures
Anal fissures are small tears in the lining of your anus, right on the rim of your butthole. They can be caused by straining to have a bowel movement, long periods of diarrhea, anal sex, anal stretching, or inserting objects in your anus, according to the Cleveland Clinic.
Along with an itchy butt, anal fissures cause pain, blood on the surface of your stool, blood on toilet paper, and visible tears in the anus.
Treating anal fissures involves reducing the trauma and pressure to your anal area, such as by ensuring stools are softened, soaking in a sitz bath, avoiding straining, and keeping the area lubricated.
12. Anal Itching Cause: The Foods You Eat
It may be surprising, but what you eat and drink can make your butt itch, too. Spicy foods, caffeinated beverages, carbonated drinks, dairy products, alcohol, citrus, and tomatoes are some items that can irritate the anus, according to Harvard Medical School.
“Everyone’s body—and digestive systems—are different, so it is important to avoid foods and drinks that you know cause intestinal distress,” says Dr. Goldstein.
You might notice that the anal itching starts about 24 to 36 hours after consuming these foods and drinks. That’s how long it takes them to move through your digestive tract.
What Should You Do About Anal Itching?
No matter what the issue, if your itchy butt continues for longer than a couple of weeks and your tweaks to hygiene and diet aren’t working, see a doctor.
They will help determine what’s causing it, which will guide your treatment options. Treatments for anal itching can include prescription or over-the-counter creams and ointments, antibiotics, antifungal medications, and others.
There is also a chance that the itching can be much more serious, such as a symptom of anal cancer or even colon cancer (get to know the other symptoms of colon cancer here). But Dr. Bernstein says that if you only have an itchy butt, the risk of cancer is low—cancer tends to come with bleeding, not just itching.
If you want to start incorporating some general lifestyle tips to avoid anal itching causes, Dr. Goldstein says nighttime showering and scrubbing is something everyone should be adding to their daily routine.
“Most people do not really think about treating our cheeks (and what is in between) with the same kind of care we do with the rest of our bodies,” he says. Get rid of the sweat that has accumulated throughout the day. Sleep naked or in loose-fitting clothing that allows your butt to breathe. Remember to change your sheets often and adjust your bedding to match the season. Also, wear fresh underwear each day (and after working out), and invest in new pairs each year or any time you notice degradation. Look for ones with breathable fabrics or quick-dry technology. An itchy butt is annoying, but you don’t have to live with it.
Elizabeth Millard is a freelance writer focusing on health, wellness, fitness, and food.
Ashley Martens is a Wellness Writer based in Chicago, Illinois. With a digital marketing background and her knowledge of general nutrition and a lifelong passion for all things health and wellness, Ashley covers topics that can help people live happier and healthier lives.