Bottom
Itchy bottom
An irritating itch around the back passage — often worse at night — that is usually caused by skin irritation, piles, threadworms or a skin condition, and is rarely serious, but which with bleeding, a lump or a change in bowel habit needs checking.
Education and reference only. This explains the common causes of itchy bottom and the warning signs that need urgent help, in plain language — it is not a diagnosis or a substitute for advice from a clinician. If you feel very unwell or are worried, seek medical help.
Quick answer
What is itchy bottom?
An itchy bottom, or itching around the anus, is a common and often embarrassing complaint that most people are reluctant to mention but which is usually straightforward to explain. The delicate skin around the back passage is easily irritated, and itching can be set off by moisture, sweating, over-vigorous wiping, soaps and wipes, or leakage of mucus from piles.
- Get urgent help: Seek a prompt appointment if itching comes with bleeding from the back passage, a lump, or a persistent change in your bowel habit, which need checking to exclude anal or bowel cancer. Get assessed for itching with significant pain, a discharge of pus, or a fever, which may indicate an infection or abscess.
- Self-care: Gentle skin care usually settles an itchy bottom.
About itchy bottom
An itchy bottom, or itching around the anus, is a common and often embarrassing complaint that most people are reluctant to mention but which is usually straightforward to explain. The delicate skin around the back passage is easily irritated, and itching can be set off by moisture, sweating, over-vigorous wiping, soaps and wipes, or leakage of mucus from piles. In children especially, but also in adults, threadworms are a frequent cause and classically itch most at night when the worms are active. Skin conditions such as eczema, psoriasis and fungal infections can affect this area, and inflammation of the back passage can cause itching too. Scratching damages the skin and makes the itch worse, setting up a cycle. While the cause is usually harmless, persistent itching with bleeding, a lump, a discharge or a change in bowel habit should be assessed, because these can occasionally signal something more serious.
When to get help
Call 999 or go to A&E if itchy bottom comes with any of these warning signs:
- Seek a prompt appointment if itching comes with bleeding from the back passage, a lump, or a persistent change in your bowel habit, which need checking to exclude anal or bowel cancer.
- Get assessed for itching with significant pain, a discharge of pus, or a fever, which may indicate an infection or abscess.
- Arrange review if the itch is severe, persistent or not improving despite careful self-care.
- See a doctor if the skin around the anus is becoming raw, broken or thickened, or if there is a spreading rash.
When to see a doctor
An itchy bottom is usually harmless and often settles with simple skin care, so you can start there or ask a pharmacist for advice. See a doctor if the itch is severe, persistent or keeps returning, if careful self-care over a couple of weeks has not helped, or if the skin is becoming raw, thickened or infected. Importantly, do not put off seeking help if there is bleeding from the back passage, a new lump, a discharge, or a lasting change in your bowel habit, as these features need assessment to rule out a more serious cause even though the explanation is usually benign.
Not sure how urgent it is? It is always OK to call NHS 111 for advice, day or night.
What can cause it
Common causes of itchy bottom
Itchy bottom has many possible causes. Each links to a full, plain-language guide to that condition — what it is, how it's treated and when to seek help.
What helps
Self-care and what you can do
Gentle skin care usually settles an itchy bottom. Keep the area clean and dry, washing with water and patting — not rubbing — dry, and avoid perfumed soaps, wet wipes and talc, which often irritate. After opening your bowels, wipe gently or use plain water rather than scrubbing. Wear loose, breathable cotton underwear and avoid getting too hot and sweaty. Resist the strong urge to scratch, as this damages the skin and prolongs the itch; keeping fingernails short and wearing cotton gloves at night can help break the cycle. If threadworms are suspected, especially in a household with children, treat the whole household and wash bedding and nightclothes. If the itch persists despite these measures, see a pharmacist or doctor.
Answers
Itchy bottom: frequently asked questions
Why is my bottom itchier at night?
Night-time itching around the anus is classic for threadworms, which come to the skin to lay eggs in the small hours. Warmth in bed and fewer distractions can also make any anal itch feel more intense at night.
Can wiping too hard cause an itchy bottom?
Yes. Over-vigorous wiping, perfumed soaps and wet wipes all irritate the delicate skin around the anus and are common causes of itching. Gentle cleaning with water and patting dry usually helps.
When should I see a doctor about an itchy bottom?
See a doctor if the itch is severe or persistent, has not settled with careful self-care, or comes with bleeding, a lump, a discharge, or a change in bowel habit, as these need checking to exclude a more serious cause.
Will scratching make it worse?
Yes. Scratching damages the skin and sets up a cycle in which the itch returns more strongly. Keeping nails short, resisting the urge to scratch, and treating the underlying cause help break this cycle.
Sources
Where this is drawn from
- NICE CKS: Itchy bottom (pruritus ani).
- Guts UK: anal and bowel symptoms.
Related symptoms
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