Anal itching - Treatment

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.

Self-care for itchy bottom

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.

Keeping clean and dry

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.

Other self-care measures

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:

use soft toilet tissue
bath or shower daily
wear loose-fitting cotton underwear and change it daily
only put underwear on when your bottom is completely dry
avoid wearing tight clothing; women should wear stockings instead of tights
use a light duvet at night so you don't get too hot
avoid using scented soaps, bubble bath, perfumes or powders around your anus
keep your fingernails short to try to keep your skin being damaged from scratching
wear cotton gloves while sleeping so that you cause less damage to your skin if you scratch

It may be difficult, but you should try to resist the urge to scratch your bottom, as scratching will only make the problem worse.

Diet

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:

tomatoes
spicy foods
citrus fruits, such as oranges
nuts
chocolate
dairy products
coffee
excessive amounts of liquids, such as milk, beer or wine

Fibre

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:

grains – such as wholegrain bread
pulses – edible seeds that grow in a pod, such as peas, beans and lentils
oats – which are in some breakfast cereals
fruit and vegetables

Medication

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.

Soothing ointments

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.

Topical corticosteroids

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.

Antihistamines

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.

Treating an underlying cause

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.

Further treatment

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).