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Itchy bottom
Category: Digestive & Abdomen · All digestive symptoms
What it can feel like
An itchy bottom (pruritus ani) is itching around the anus, often worse at night or after opening the bowels. It is common and usually driven by a cycle of irritation, scratching and more irritation — but persistent itching deserves a look for treatable skin and bowel causes.
Possible causes
A symptom can have many causes, and most are not serious. The lists below group conditions this symptom can be associated with — common causes first. They are possibilities to discuss with a clinician, not a diagnosis.
Common causes
Itching can be associated with traces of stool irritating the skin, piles, a small anal tear, threadworms (especially in children), sweat and friction, and scented soaps, wipes or creams that irritate sensitive skin.
Other possible causes
Persistent itching can be associated with skin conditions such as eczema, psoriasis or lichen sclerosus, with infections including fungal infection, and rarely with changes in the skin around the anus that need biopsy.
Red flags — when to seek help promptly
- Itching with bleeding, pain or a lump
- Itching with a sore, ulcer or patch of skin that does not heal
- Itching with unintentional weight loss or change in bowel habit
- Itching in a child that is worst at night, affecting the whole household
What a clinician may do
A clinician will examine the skin around the anus and ask about bowel habit, leakage, products used and household symptoms. Treatment usually combines gentle skin care, treating any piles or infection, and specific creams or threadworm treatment where indicated.
Related guides on MedicalVideos.com
Frequently asked questions
Why is it worse at night?
Warmth, sweat and lying still increase awareness of itch, and some causes — threadworms in particular — are more active at night. Night-predominant itching in a child is a classic threadworm pattern and the whole household is usually treated.
Could my wet wipes be the problem?
Very possibly — fragrances and preservatives in wipes are common irritants for this delicate skin. Plain water washing, gentle patting dry and a simple barrier ointment are often the core of treatment.
Related symptoms — Digestive & Abdomen
Browse the I section of the A–Z list or return to the Symptoms A–Z hub.