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8 Causes of Pruritus Ani

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  • Post last modified:September 26, 2023

Got an urge you can’t scratch, at least not in public? Maybe you’re scratching wayyy down low, spot an itchy rash on your rear crack or rear cheeks, or have itchy lumps on your butt. Fortunately, pruritis ani — the medical term for anal itching — affects only 1 to 5 percent of the general population. Still, those low numbers aren’t too comforting when you’re the one with an itchy rear.

Even less comforting? The fact that scratching a butt itch likely only makes things worse, and can quickly put you in an endless itch-scratch cycle, says Roberta L. Muldoon, M.D., an assistant professor of colon and rectal surgery at the Vanderbilt University Medical Center. That’s because “when you scratch the anal area, you tend to break the skin and cause little superficial abrasions, which then begin to itch, so you scratch even more,” she says. To solve this problem, here are some common reasons you might have an itchy rear, plus your solution to find some much-needed relief.

Fungal Infection

A fungal infection on the rear generally comes from two possibilities: an overgrowth of the yeast that’s normally found in the intestines and on the perianal skin (aka the skin immediately surrounding the anus), or fungus that has spread along the skin from a different area of the body, says Cynthia Bailey, M.D., a board-certified dermatologist based in California.

The yeast-type infection usually only shows up around the anus, and in addition to being extremely itchy, you may notice redness and pimple-like lumps. If it’s fungus that has spread from elsewhere (which can happen by touching an infected area and then touching your backside), you’ll usually see signs of it in the form of athlete’s foot or toenail fungus, and it will manifest itself in a dry, itchy, scaly rash that can affect both the buttocks and the anus, explains Dr. Bailey.

The solution: To treat a fungal infection on the rear and ease itching, the first step is to keep the area clean and dry since fungi love warm, dark, moist environments, says Dr. Bailey. An over-the-counter antifungal cream can cure the infection on the skin, or your doctor can prescribe an oral medication to kill the yeast on the skin and balance the yeast in the intestines.


This may come as a surprise, but everyone has hemorrhoids. Hemorrhoids are the pillow-like cushions of blood vessels just inside the rectum, and they’re actually part of normal human anatomy, explains Dr.

Muldoon. Piles only become an issue when they become bigger or irritated (in such cases, you might experience a lump in the region). At that point, they can lead to anal scratching, agony, and bleeding while passing stool. Prolonged blockage or loose bowels, exertion while defecating, and extended time spent on the toilet are a few of the factors that can cause piles to begin swelling.

The solution: Refrain from self-treating. “If you’re encountering bleeding or sense a lump down there, don’t assume it’s hemorrhoids — have it examined to ensure it’s not something more serious, like colon or rectal cancer, which can exhibit similar symptoms,” advises Dr. Muldoon. Once your physician confirms it is indeed a hemorrhoid issue, turn to fiber. Try adopting a high-fiber diet, ranging from 25 to 35 grams per day, to make your stool softer and easier to pass, recommends Dr. Muldoon. This alleviates pressure on the hemorrhoids.

To decrease swelling and alleviate your symptoms, increase your hydration level to prevent constipation (exercise can also aid in that!), avoid straining during bowel movements, and take frequent sitz baths (you can do this by sitting in a couple of inches of warm water — just enough to cover your hips — in your bathtub for about 10 minutes, or you can go to the drugstore or a medical supply store and acquire a special sitz bath that fits over your toilet.) Your physician might also prescribe hydrocortisone suppositories or topical medications to help alleviate the hemorrhoids, notes Dr. Muldoon. If home remedies fail or the hemorrhoids are severe, specialized treatments or surgery may be considered as a last option.

Your Cleanliness Practices

Is your upper buttock crevice sore and itchy? Apologies, but your butt itch may actually be due to inadequate wiping. If you don’t cleanse thoroughly after a bowel movement, residual fecal matter can cause irritation, which can manifest as anal itching or burning, notes Dr. Bailey.

The solution: Use either soap and water, moist tissue paper, or alcohol- and fragrance-free moist wipes after a bowel movement. If you find yourself wiping excessively, increase your fiber intake to add bulk to your stools so they’re easier to clean. Shower daily, employing a washcloth with mild soap and warm water, and ensure thorough rinsing afterward since soap residue in the area can also cause irritation and anal itching. Afterward, pat dry with a towel. “If you’re prone to getting yeast infections in the area, you may need to utilize a hair dryer on cool setting to ensure thorough drying,” adds Dr. Bailey.

That’s not to say you should go overboard. Being excessively vigorous or forceful with your wiping or cleansing, or using extravagant cleansers, can irritate the anal skin and lead to minor abrasions, resulting in more butt itching, says Dr. Muldoon.

Your Perspiration

Working up a sweat is always beneficial, of course, but it could also be the cause of your itchy butt. Remember, moisture encourages the growth of yeast and other fungi. So if you’re sitting in your sweaty leggings for extended periods of time, it can lead to a fungal infection (and itching) between the buttocks.

The solution: To prevent this from occurring in the first place, make it a routine to change out of your damp workout clothes as soon as you complete your exercise session.

Cleanse your body with a gentle cleanser and lukewarm water, thoroughly wash away any residue, and subsequently pat dry with caution, focusing specifically on your posterior (as well as other creases on the body).

If your buttocks are itchy, your laundry detergent might be the culprit. “When you’re perspiring, any residue from the detergent on your clothes will liquefy and come into contact with your skin, leading to itching,” explains Dr. Bailey. Rinse your workout attire twice to remove all residue and avoid using fabric softener, she suggests.

A Skin Condition

Skin issues like psoriasis can affect anyone. It typically appears on the elbows, knees, or scalp, but some individuals experience what’s referred to as inverse psoriasis, where plaques develop in skin folds…such as between the buttocks and in the buttock crease. It can lead to itching, discomfort, and a reddish rash, so if the top of your butt crack is sore and itchy, it could be the issue.

Another skin condition that may manifest on the buttocks is eczema. Also known as dermatitis, eczema causes dry, pruritic skin and rashes. The type more likely to appear in the perianal area is contact eczema or allergic eczema, which occurs when your buttocks come into contact with an allergen or irritant, as explained by Dr. Bailey. The reaction can be triggered by dyes, fragrances, and other additives in toilet paper, soaps, perfumes, lotions, clothing, and moist wipes — and yes, it can cause plenty of buttock itching.

The solution: If you suspect psoriasis is the cause of your itchy buttocks, you’ll need to consult your dermatologist for a prescription steroid cream. Once the psoriasis is managed, the itching should alleviate. To relieve itching caused by allergic eczema, first determine the source of irritation and discontinue its use, advises Dr. Bailey. After eliminating the problematic product, you should notice an improvement in your itchy buttocks and other symptoms. Applying a thin layer of OTC hydrocortisone cream for a few days (two to three times daily) may also provide relief.


Sorry to inform you, but it is indeed possible to contract herpes on your posterior. Herpes, caused by the herpes simplex virus, is a sexually transmitted infection. It can result in painful blistering sores in the vagina, on the labia, or in the area surrounding the rectum (usually on one side only), which can persist for several days, notes Jocelyn B

Craig, M.D., medical director of the Center for Women’s Pelvic Health at Long Beach Memorial Medical Center in California. Prior to the appearance of blisters, certain individuals experience what is referred to as a prodrome, a preliminary cautionary indication that may comprise of itching, discomfort, or tingling. “This sensation can manifest as itching in the anal region due to the virus causing irritation to the nerves surrounding the rectum,” remarks Dr. Craig.

The solution: Unfortunately, there is no remedy for herpes. The virus remains in the nerves near your spine and can be reactivated later, resulting in recurring outbreaks. However, your doctor can prescribe an oral or topical antiviral medication to alleviate symptoms and shorten the duration of the outbreak.

Having Folliculitis

The world may refer to it as “butt acne,” but unlike the pimples that appear on your face, itchy bumps on your buttocks are not caused by blocked pores. Instead, they are the result of folliculitis, which occurs when a hair follicle becomes infected by bacteria or becomes inflamed – usually due to friction caused by sweating and clothing rubbing against the area, as explained by Dr. Bailey.

The solution: If you are prone to bouts of folliculitis (which can occur anywhere in your pubic area), it is advisable to wear lightweight, loose-fitting garments when it is hot and humid, change out of sweaty workout clothes immediately after exercising, and keep the area clean and dry in general, as suggested by Dr. Bailey. While folliculitis typically resolves on its own, you can assist the healing process by using a benzoyl peroxide cleanser, she remarks. A word of caution: Benzoyl peroxide can bleach fabrics, so consider using it at night before going to bed (and wearing white underwear), according to Dr. Bailey. A dermatologist can also prescribe an oral or topical antibiotic if necessary.

Your Eating Plan

“Citrus fruits, chocolate, coffee, tea, and alcohol are some of the food and drinks thought to cause anal itching,” states Dr. Muldoon. Although the exact reason is unknown, one possible theory is that they may reduce the muscle tone of your sphincter, resulting in a small amount of fecal leakage. This then irritates the skin and causes itching in the buttocks area. Yikes.

The solution: To determine if any specific item is causing your itchy butt, you may need to eliminate items from your diet one by one for a couple of weeks and observe if the symptoms improve. Dr. Muldoon has found that avoiding these specific beverages often improves buttock itching, although you may not be willing to give up coffee or wine permanently. Sorry!