Dr Phil: Anal itching (video)

As my consultant used to say, the anus, when it's working properly, can tell the difference between a solid, a liquid and a gas: generally, you know what's coming. It's a fine piece of machinery and you want to look after it. So, why does it itch? It can itch for two reasons.

 

Washing too little or too much. It can itch because you don't wash it enough, little bits of particle (you know what I'm talking about) get caught in the folds, they hang around there and lead to a bit of itching. But, rather perversely, it can also itch if you wash it too much. People get down there, get scrupulous with their anal hygiene, and use detergents, Domestos, wire brushes, they use all sorts of things to punish their anus. So, rule number one, love your anus. If you are going to wash it you only need to wash it with salt water or just ordinary water, maybe two or three times a day. If you're posh enough to have a bidet you can use one of those, otherwise squat delicately over the bath, being careful not to fall in, maybe use the showerhead, and just wash those little particles away. Some doctors are quite keen on aqueous cream, which is a very simple cream you can buy over the counter: that doesn't have anything in it that's going to irritate the anus but you'll find a lot of creams like Germolene, Vaseline, or any disinfecting creams can actually make anal itching worse.

 

Threadworms. So, what if it's more than just a few bits of poo stuck in your crevices? Another common cause of anal itching, particularly in children, are threadworms. These are fantastic little creatures are about a centimetre long, white little slimy worms and they're very, very clever. They live in the gut and come out at night, or the lady worm does, and lays its eggs around the rim of the anal margin, making it intensely itchy. So what do you do in the morning? You wake up with an itchy bum, scratch it, get the eggs under your fingernails, and later in the day you put your fingers in your mouth and the eggs get back into the gut, hatch again and the cycle repeats every 6 weeks or so. As Dr Dog said in one of my favourite books, never scratch your bum and suck your thumb. There is something you can take for threadworm, available over the counter, mebendazole. You've got to take 2 or 3 doses maybe a month apart if you want to wipe it out completely, and you probably have to give everyone in your family a dose too. Some people just say well, let it be, it will die out anyway after 6 weeks or so, but a hot wash for all of your bed linen and your towels should sort it out.

 

Try not to scratch. Other causes of anal itching, rather perversely, are scratching. People get the itch and they scratch, whether it's caused by threadworm or by something else, and the scratching then makes it worse, you must never, ever scratch your bum if you can avoid it. Wear light cotton pants. Some people put a little dab of talcum powder on a cotton wool ball, just place it nicely between the cheeks and that just seems to take the edge off things.

 

The three degrees of piles. If you can feel a lump or something you don't think should be there, it might be haemorrhoids (piles). Aren't they wonderful, haemorrhoids. They come in three degrees, a bit like the group. They're not varicose veins, they're just like fleshy pads around the anus that help tell you whether it's a solid, a liquid or a gas, and if those pads get swollen, sometimes you get a little bit of leakage that makes things itch, and sometimes the pads themselves can drop down. So your first degree piles stay up and don't cause you any problems, second degree pop down but go in again fairly quickly, third degree come all the way down and are quite hard to push in. Fourth degree, that's not going anywhere, but nobody talks about the fourth degree. A bit like Diana Ross.

 

See your doctor. If you feel lumps, that probably is something to show to a doctor. If you get any bleeding, that's also something to show to a doctor. But in the first instance, try plenty of washing in salt water. Visit our section on Seeing your doctor about an anal problem.
 

Written by: Dr Phil Hammond
Edited by: Dr Phil Hammond
Last updated: Tuesday, April 5th 2011

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Comments on this article

Posted by Optional on 13/06/2011 at 09:49

This has been most phenomenal to me and tanks to this site. I had always taught the itches around ma anus and some of da signs of piles was going to kill me one day, but i feel relieved now having read about it in this article by Dr. Am really grateful

Posted by John on 30/03/2011 at 11:48

I have just stated with an anal itch and of course you scretch it. Having read the article on anal itching I wont be scratching again. It was very helpful in helping me understand th evarious causes of itching. I'm now working on getting rid of the itching once and for all. Thank you very much!!

Posted by Optional on 09/03/2011 at 02:06

I have very sensitive and itch skin around my anus I seen to many doctor used four deferent cream I had no relief and it worse when I am active, and after used the toilet it's not going away and i feel helpless what should I do.

Posted by Optional on 28/02/2011 at 10:16

Perianal problem. About 5-7 years ago I felt that I pulled out a hair with the toilet paper. It was sore. I dabbed some TCP on it and left it at that. I did not take much notice after that except I did notice something, what felt like a pimple, developed at the site. I was aware that it remained permanently, but it was not a problem. I suppose it must have become bigger - it is hard to say as I never looked at it in the mirror until two years ago, but most of it is under the skin (no discolouration of skin)and probably the shape of a flattened orange pip half inch long. Whatever it is, it is extremely hard and sharp like a piece of plastic pointed at both ends. I can bend it if I use two hands. I feel I could push it through the skin and take it out if I tried. There is no soreness except from the thing trying to cut its way out if I sit on a bicycle. I have discounted a cancer as it has been there too long and is a mobile object that can be slid from side to side. Anyone heard of this please?

Posted by blahblah on 09/02/2011 at 12:51

how much salt needed ?

Posted by Optional on 26/01/2011 at 03:31

Very down to earth and informative. Thank you Dr Phil.

Posted by Optional on 23/01/2011 at 09:42

Dr phil,i think dat i hv a third degree piles..prob is that im also sufferin from a cold right now and weneva i cough,it hurts down there..it hs bin 2days since da piles appeared,hw lng is it goin 2 takes until im bck 2 normal

Posted by keith on 02/01/2011 at 04:35

I have been scratching my bum nightly for 3 months straight. I bought some tucks to use just before going to bed. I have in the past been diagnosed with fissures, and hemorrhoids. The nightly itch has subsided but now I have a sharp pain that comes and goes once every hour or so and last for about 3 seconds. I'm afraid this may be something serious

Posted by Optional steve on 08/12/2010 at 01:48

taking meds that cause farts and ok during day going to bed is when it itches

Posted by Optional on 19/09/2010 at 08:22

This site has given me some great tips and i will try them. fingers crossed they work, can't go on like this much longer!

Posted by Optional on 07/09/2010 at 01:49

I got a problem... there's an itching but constantly on one side. It presents itself as some kind of rash. It is never any side except for the left side by the anus. I find it quite shameful, as I don't know what the cause is.

Posted by Optional on 13/08/2010 at 05:20

thats the itchy arse solved, then. What do you recommend for sore ribs caused by laughing at the itchy arse video?

Posted by Jason on 16/06/2010 at 02:38

Hello Dr. Phil, thanks alot for this wonderful Health information. I am indeed very grateful. I have been experiencing this Pile stuff for sometime now, suspected it though, but a little bit confused. I just saw my doctor quite some days ago and he gave me some prescriptions, which i have adhered strictly to. So Dr. please is there any other thing i can add to make this pile disappear completely in addition to the doctor's prescription? I think mine is a second degree pile. Thanks for your support i am indeed very grateful. Looking forward to hearing from you.

Posted by Optional on 18/05/2010 at 03:28

ive had anal itching for near on two years i hardly sleep. saw dr when it first occured i was not examined just told it was possible piles. ive taken countless threadworm tablets i thought maybe that was the problem but it was not.countless things i have tried but to no avail.I dread being examined but it now is getting me down after such a long time.I just hope i wont be fobbed off by my doctor again.

Posted by lyndsey on 16/02/2010 at 12:13

aswell as the above i get discomfort at the base of my spine/lower back which often coincides with when i have opened my bowels. It comes and goes. it almost feels like a numbness in my spine i also get a tingling sensation in the anus which also comes and goes aswell. I do suffer with piles afew times a year one will protrude and i use cream to shrink it untill it goes back up. Is this all related??