Causes and Features of Anal Itching
Cause |
Common Features* |
Tests |
Anal or rectal disorders |
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Inflammatory bowel disease (such as Crohn disease) |
Discharge of pus Pain in the rectum (sometimes) and/or abdomen (often) Sometimes diarrhea |
Examination of the lower portion of the large intestine, the rectum, and the anus with an endoscope (sigmoidoscopy) or of the entire large intestine (colonoscopy) |
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Hemorrhoids (internal or external) |
With internal hemorrhoids, bleeding (a small amount of blood on toilet paper or in the toilet bowl) With external hemorrhoids, a painful, swollen lump on the anus |
A doctor's examination Usually examination of the rectum with an endoscope (anoscopy) or sigmoidoscopy |
Infections |
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Bacterial infection (caused by scratching) |
Inflamed, red area, sometimes visible scratching |
A doctor's examination |
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Yeast infection (Candida) |
A rash around the anus |
A doctor's examination Sometimes examination of a sample of skin scrapings under a microscope (to identify the fungus) |
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Usually in children Sometimes present in several family members |
Microscopic examination of transparent tape that was applied to the anal area to check for pinworm eggs |
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Intense itching, usually worse at night Possibly itching of other body areas Possibly pink, thin, slightly raised lines or bumps (burrows) on the affected areas |
A doctor’s examination Examination of skin scrapings |
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Cancer of the skin around the anus (perianal skin) |
Scaly or crusty area |
Examination of a tissue sample (biopsy) |
Skin disorders |
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An itchy, red, oozing, and crusty rash |
A doctor’s examination |
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Sometimes itchy or painful patches on the skin |
A doctor's examination |
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Drugs |
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Antibiotics |
Current or recent use of an antibiotic |
Elimination of the drug to see whether symptoms are relieved |
Foods and dietary supplements |
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Beer, caffeine, chocolate, hot peppers, milk products, nuts, tomato products, citrus fruits, spices, or vitamin C tablets |
Symptoms that occur after a substance is ingested |
Elimination of the substance from the diet to see whether symptoms are relieved |
Hygiene-related problems |
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Excessive sweating described by the person, particularly with wearing of tight and/or synthetic clothing |
Measures to limit sweating (such as wearing loose cotton underwear and changing underwear frequently) to see whether symptoms are relieved |
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Overly meticulous or aggressive cleansing of the anal area Poor cleansing |
Inappropriate cleansing practices described by the person |
A change in cleansing practices to see whether symptoms are relieved |
Skin irritants |
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Anesthetic preparations, ointments, soaps, and sanitary wipes |
Use of a possibly irritating substance described by the person |
Avoidance of the substance to see whether symptoms are relieved |
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* Features include symptoms and the results of the doctor's examination. Features mentioned are typical but not always present. |
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