Itchy bottom
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.
Causes of itchy bottom
As itchy bottom is a symptom rather than a condition itself, many cases have an underlying cause, for example:
a bacterial infection – such as those that cause streptococcal infections
a skin condition – such as atopic eczema, where the skin becomes red, dry and flaky
haemorrhoids (piles) – swellings that contain enlarged and swollen blood vessels in and around the anus
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:
heat
woollen clothing or blankets
moisture
soiling yourself
Read more about the causes of itchy bottom.
When to see your GP
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:
how often you wash and whether you use creams, powders or soaps around your anus
the duration and pattern of your itching – such as whether your symptoms are worse at night or after eating certain foods
other symptoms – such as bleeding or other discharge from your anus
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.
Treating itchy bottom
An itchy bottom is usually easy to treat at home. Some ways of easing an itchy bottom include:
keeping your bottom clean and dry
avoid using scented soaps
use soft toilet tissue
avoid scratching
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.
Complications of itchy bottom
Frequently scratching your bottom may damage or tear the delicate skin around your anus. This may lead to problems such as:
thick and leathery skin (lichenification)
sore and broken down skin (ulceration)
the top layer of skin being worn away (excoriation)
infection
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.