Hemorrhoids — also known as piles — are swollen and distended veins in the anus and lowest part of the rectum.
Hemorrhoids are traditionally associated with prolonged sitting on the toilet combined with straining during bowel movements. Hemorrhoids can be both painful and itchy.
Hemorrhoids are either external or internal. External hemorrhoids are found beneath the skin surrounding the anus while internal hemorrhoids are found inside the rectum.
Sometimes straining while using the bathroom pushes an internal hemorrhoid until it protrudes through the anus. When this happens it’s called a prolapsed internal hemorrhoid.
When an internal hemorrhoid prolapses it brings along mucus that can irritate the sensitive area around the anus causing itching. If the hemorrhoid stays prolapsed, mucus production continues and so does the itching.
If stool mixes with the mucus, that combination can make the irritation, and thus the itching, greater.
Anal itching is also referred to as pruritus ani which could be triggered by a number of conditions aside from hemorrhoids.
These other causes include:
- anal fissures
- yeast infection
- stool leakage
- sweat buildup
- genital warts
- pinworm infection
- hookworm infection
- body lice
You could also itch from poor hygiene or needing to do a better job keeping the anal area clean.
Conversely, if you overclean the area you can cause micro tears and cracks — along with dryness from the chemicals in wipes, cleansers, and creams — that can lead to itching.
If your itching is severe and you’re not sure if it’s hemorrhoids, see a doctor for evaluation.
Tips to avoid pruritus ani
- Use plain white toilet paper, avoiding the scented or printed varieties.
- Avoid chemically treated wipes.
- Wipe gently.
- Dry the area thoroughly after washing.
- Wear loose clothing.
- Wear cotton underwear.
The first step in easing the itch is to stop scratching. Aggressive scratching can further damage the area and make the problem worse.
According to the American Society of Colon and Rectal Surgeons, sometimes the desire to scratch is so intense that many people scratch when they sleep. To avoid damaging scratching while sleeping some people wear soft cotton gloves to bed.
The next step is proper hygiene, keeping the area clean with mild, allergen-free soap and water.
After these important primary steps, some ways to reduce or eliminate anal area itching include:
A popular home remedy for itchy hemorrhoids is soaking either in a full tub or a sitz bath.
A sitz bath is a shallow basin that fits over your toilet. You can fill it with warm water — not hot — and sit on it, allowing the water to soak your anus. The warmth helps circulation and helps to relax and heal the area around your anus.
This is typically done two times a day.
Some natural healing advocates also suggest adding two to three tablespoons of baking soda or Epsom salts to the water in the sitz bath.
To numb the nerve endings and relieve the itch, your doctor might suggest applying cold compresses on your anal area or using an over-the-counter cream or ointment containing hydrocortisone and lidocaine. These can temporarily relieve the itching.
To reduce the itch, your doctor might recommend a topical protectant to use as a barrier between the irritated skin from further irritants such as stool.
Some products that are recommended to provide protection for perineal skin include:
Hemorrhoids can itch, but there may be other causes as well. If the itching is severe, you should seek an evaluation from your doctor.
There are a number of simple and effective ways to deal with the itch yourself, but if it’s a persistent problem that starts negatively impacting the quality of your life, you should talk to your doctor about dealing with the underlying cause as opposed to dealing with the symptom.