Overview

Itching bottom (pruritus ani)

Pruritus ani is a common condition of continual itching or irritation around the anus (bottom). 

The main symptom is an urge to scratch your anus, which might be difficult to resist. This can lead to skin damage and possible infection in that area. 

Causes

It has many possible different causes, including piles (haemorrhoids) and certain skin conditions. 

The most common cause is a minor leakage (soiling) from the anus. If small amounts of poo (stool) or liquid mucus leak from the anus, this can irritate the delicate skin around the anus.

Treatment

Pruritus ani can be difficult to treat, and it might take many months of gentle care to improve the symptoms. 

Do

  • keep the area as clean as possible
  • use moist toilet paper or non-alcoholic wet wips to clean your bottom after going for a poo
  • talk to your nurse or doctor if you have a problem with leakage
  • wear loose cotton underwear and change daily
  • wash underwear with non-biological washing powder
  • increase the amount of fibre in your diet to soften your poo
  • drink plenty of water

Don't

  • do not scratch the area, even if you feel you need to
  • do not wipe your bottom too much with dry toilet paper
  • do not put anything in your bath water such as bath salts, bath oil and bubble bath
  • do not use any creams, deodorants, talcum powder and antiseptics on your bottom, unless it's treatment a doctor suggested
  • do not wear man-made fabric
  • do not wear tights, tight trousers or jeans, or G-string knickers
  • do not sit down on plastic chairs for long periods of time
  • do not strain (push down) when you go to the toilet

Tips for keeping the area clean

Carefully wash and gently dry the area at least once a day, or after each time you have a poo

Some people find that cold water is more soothing than warm water. It is better to use water on your hand rather than a flannel. 

You might find sitting on the edge of the bath and using a shower head makes washing easier.

Wash without soap, as soap can sting. A good alternative to soap is a light emollient such as aqueous cream, Zerocream® and Aquamax®. You can buy them from a pharmacy.

If you are out or at work, take a small plastic bottle of water into the toilet to wash your bottom after going for a poo. Non-alcoholic wet wipes can also be used when you are not at home.

If you have a problem with leakage from the anus, put a small amount of damp cotton wool on your fingertip and to gently clean into the anus. This will make sure there is no residue left behind. If your leakage continues after wiping, a small plug of cotton wool in the anus might stop the poo coming out to irritate the skin. Please talk to your nurse or doctor about this.

Dry the area by gently patting with a soft towel or tissue. Avoid rubbing. If you are very sore you might find that using a hairdryer on a low setting is the most comfortable way of drying the area. 

NHS website has more advice about the causes of an itchy bottom what to do if it doesn’t get better.

Resource number: 0677/VER5
Last reviewed: April 2022
Next review: April 2025

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