Itchy bottom (pruritus ani)
Pruritus ani is a common condition of continual itching or irritation around the bottom (anus).
The main symptom is an urge to scratch your bottom, which might be difficult to resist. This can lead to skin damage and possible infection in that area.
Causes of an itchy bottom
There are many different causes of an itchy bottom.
- 90 out of 100 cases (90%) are caused by a minor leakage (soiling) from the bottom. If small amounts of poo (stool) or liquid mucus leak from the bottom, this can irritate the delicate skin around this area.
- Skin conditions such as dermatitis or psoriasis
- Piles or haemorrhoids (lumps inside and around your bottom) and some skin conditions.
- Colorectal cancer (may occur with altered bowel habits and rectal bleeding)
Treatment for an itchy bottom
Management of the cause where possible.
The condition pruritus ani can be difficult to treat. It might take many months of gentle care to improve your symptoms.
- keep the area as clean as possible
- use moist toilet paper or non-alcoholic wet wipes to clean your bottom after doing a poo
- talk to your nurse or doctor if you have a problem with leakage from the bottom
- wear loose cotton underwear and change it every day
- wash your underwear with non-biological washing powder (this does not contain substances called enzymes to break down dirt and is better for sensitive skin)
- eat more fibre in your diet to soften your poo (fibre is found in fruit, vegetables and wholegrain bread, pasta and cereal)
- drink plenty of water
- do not scratch the area, even if you feel that you need to do this
- 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 or bubble bath
- do not use any creams, deodorants, talcum powder or antiseptics on your bottom, unless this is treatment recommended by a doctor
- 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 your bottom clean
Carefully wash and gently dry your bottom at least 1 time each day, or after each time you do 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 it easier to wash your bottom if you sit on the edge of the bath and use a shower head.
It is best to wash your bottom without soap because this can sting. A good option is to use a light emollient (a cream or liquid that makes dry or sore skin softer or less painful). Examples are:
- aqueous cream
You can buy these products from a pharmacy.
If you have gone out or are at work, take a small plastic bottle of water into the toilet. You can use this to wash your bottom after doing a poo. When you are not at home, you can also use non-alcoholic wet wipes.
If you have a problem with leakage from the bottom, put a small amount of damp cotton wool on your fingertip. You can use this to clean gently into the bottom and make sure that small amounts of poo are not left behind.
If your leakage continues after wiping your bottom, a small plug of cotton wool in the bottom might help. This can stop the poo coming out to irritate your skin. Please talk to your nurse or doctor about this.
Dry your bottom by gently patting it with a soft towel or tissue. Avoid rubbing the area. If you are very sore, using a hairdryer on a low setting might be the most comfortable way to dry the area.
- Topical agent- mildly potent topical corticosteroid.
- Sedating anti-histamine- if your sleep is disturbed due to itching.
Referral to a specialist
We can refer you to a specialist if:
- a serious underlying cause is suspected.
- symptoms continue after self-care and conservative management.
The NHS website has more information about the causes of an itchy bottom and what to do if this does not get better.
National Institute for Health and Care Excellence (NICE) also has more information on treatment and causes.