Let’s not be coy here: Everyone has a butthole—and sometimes, buttholes get itchy.
But before digging into why your butthole gets itchy, let’s clarify one thing: I’m talking about your itchy anus in particular—not your entire butt. (It’s kind of an important distinction, says WH advisor Samantha Nazareth, MD, a gastroenterologist who practices in New York City.)
The irritation—technically known as pruritus ani, per the U.S. National Library of Medicine (NLM)—can occur inside the anus or the perianal area, which is essentially the skin surrounding the anal opening.
If you are experiencing anal itching (seriously, UGH), it’s pertinent that you don’t scratch yourself silly. While there’s nothing wrong with scratching an acute itch, such as a bug bite, constant or “chronic” scratching can feed into what pros call the “itch-scratch” cycle.
This causes more skin inflammation and thus worse itch, says Brian Kim, MD, co-director of the Center for the Study of Itch at Washington University School of Medicine. If you *must* scratch, be as gentle as possible and try to keep it to a minimum, says Dr. Kim.
Ok, but why is my butthole so itchy? The discomfort can happen due to a range of issues—and the key to eliminating anal itching is figuring out the underlying cause. (Keep calm, it’s usually not a big deal.) Read on to get to the bottom of your, err, bottom issues—and to find relief from anal itching both in the short term and long term.
1. You’re wiping all wrong.
Dr. Nazareth always asks her patients about their bathroom hygiene habits. Are you an aggressive wiper? Do you not feel clean unless you use wet wipes? “Too many of us are wiping ourselves to death with toilet paper and then using wet wipes afterward,” says Dr. Nazareth. Those practices are bound to cause irritation or even anal fissures (tiny cuts or tears). Your skin is super sensitive down there.
On the flip side, you might not be wiping enough—leftover poop in the anal area, along with extra moisture, is also recipe for irritation, says Dr. Nazareth.
The happy medium? “Ideally, if you’re at home, the best way is going into the tub or using a shower head to clean the area with the force of the water. No soap needed. Then pat dry the area. It’s the best way short of using a bidet,” says Dr. Nazareth. If you’re out and about at a friend’s house, say, and not in a stall, when nature calls, she recommends using a little warm water on the TP and going for the pat-dry afterward.
2. You’re fixated on having “good” hygiene.
Hey, I get it, we all can be a little Monica Geller-y at times. But obsessively cleaning your nether regions until they practically sparkle is not a good idea. In fact, it’s a fairly common culprit of an itchy butt, according to Dr. Kim.
Using things like topical alcohol swabs, wet wipes, scented soaps, and even a natural skin cleanser like witch hazel to keep the perianal area clean or to treat the already-present itchiness can cause irritation and even an allergic contact dermatitis, which is a developed hypersensitivity to an allergen, Dr. Kim explains. “This can further aggravate the itch because now you have two problems,” Dr. Kim says. Uh oh.
Bottom (sorry, had to) line here? Don’t be overly concerned with perfect hygiene—meaning skip the wet wipes, which contain chemicals that can cause allergic reactions, and using harsh or scented soaps, Dr. Kim says. And when it comes to shower time, Dr. Kim recommends simply using gentle soaps like unscented Dove soap or a Vanicream cleansing bar.
3. You have hemorrhoids.
Hemorrhoids are inflamed, swollen veins around your anus or in your lower rectum, according to the National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK). Typically, external hemorrhoids—ones that form under the skin and around the anus—are the cause for itching.
Constipation (a.k.a. difficulty passing bowel movements) is often the cause of hemorrhoids—you know, from the pushing and extra time spent on the toilet. “I often suggest the Squatty Potty to my hemorrhoids patients,” says Dr. Nazareth, which can help the passage of bowel movements. Another smart tip to avoid flare-ups? Getting enough fiber in your diet to make things flow a little more…smoothly.
4. You might have pinworms.
Okay, this is pretty unlikely, but it’s still possible. Pinworms are small parasites that can live in your colon and rectum, per the NLM. They’re spread by the fecal-oral route (yes, that’s exactly what it sounds like) either directly or indirectly (through contaminated clothing, bedding, food, etc.).
This infection is most common in children, and many people who are infected don’t have symptoms at all. If you have symptoms, they’re most commonly intense anal (or vaginal) itching that can interfere with daily life. But here’s the catch: “You won’t be able to diagnose this at home,” says Dr. Nazareth. “You must get checked by a doctor via a stool sample.”
As for treatment, mild infections can go away on their own, but medication is sometimes needed, per the NLM.
5. You have a yeast infection
Yep, these can happen anywhere—not just in your vagina. When a fungus called candida (the scientific name for yeast, which naturally occurs inside your body) grows at a quicker rate than usual (usually caused by antibiotics or a weakened immune system), it can cause an infection of the area, according to the CDC. Sitting in sweaty workout clothes (guilty) can create a yeast-friendly environment too, says Dr. Nazareth.
Your best defense is to get out of those sweat-soaked clothes and shower post-workout. Already have a yeast infection that brought on anal itching? Dr. Nazareth suggests opting for an anti-fungal ointment or wearing loose clothing at home. “Ideally, don’t wear underwear at all and choose some loose-fitting pants to let things air out in their ‘natural’ state,” she says.
6. You might have—gulp!—scabies.
This is another rare one, but you might as well know what scabies are, right? They’re a parasite—like pinworms—that burrow into the outer layer of your skin and lay eggs there, says Dr. Nazareth. But scabies will itch everywhere, *not* just your butt (whew).
General Health Magazine 