Itchy bum in men: common causes and what helps

An itchy bum is common, and men get it more than women. NICE's guidance for GPs says pruritus ani, the medical name for an itchy bottom, is about four times more common in men than in women, and most common between the ages of 40 and 60. It's thought to affect up to 5% of people, though the true figure isn't known and may be higher, as not everyone with it sees a doctor.

The NHS says it's unusual for an itchy bottom to be caused by something serious, and you can often ease it yourself.

Why is my bum itchy?

Causes of an itchy anus include tiny traces of poo or sweat irritating the skin, products such as wet wipes and perfumes, piles, threadworms, skin conditions and infections. The NHS says there isn't always a clear cause, and an itch that settles quickly may have been down to something like sweating a lot in hot weather.

• Tiny traces of poo. The Association of Coloproctology of Great Britain and Ireland (ACPGBI) says the most common cause is a minor leak of poo or mucus (slime) from the anus, which irritates the delicate skin around it. NICE adds that both too much and too little cleaning can make things worse.
• Sweat. The skin there is often damp with sweat, and the Primary Care Dermatology Society (PCDS) says sitting for a long time or wearing tight underwear can irritate it further. NICE's guidance also mentions exercise and cycling.
• Things you put on the skin. PCDS says the skin around the bottom is easily irritated by wet wipes, soaps, perfumes and antiseptics, and some people react to fragrance in toilet paper, or to local anaesthetics or preservatives in creams for piles. The NHS also lists side effects of long-term medicine, including steroid creams, antibiotics, some gels and ointments for piles or fissures, and peppermint oil.
• Piles or a fissure. An itchy anus is one of the NHS's listed symptoms of piles, along with bright red blood after you poo, and NICE lists an anal fissure among the causes too.
• Threadworms, especially if the itch is worse at night (more on that below).
• Skin conditions such as eczema or psoriasis, particularly if you itch elsewhere on your body too.
• Infections. The NHS lists a fungal infection or a sexually transmitted infection (STI) when there are sores, swelling or irritation. PCDS names thrush (a Candida yeast infection), and NHS inform names genital warts and ringworm.
• Food and drink. The NHS says to avoid food or drink that makes the itching worse, such as caffeine, alcohol, citrus fruit or spicy food. ACPGBI singles out lager and flat beers, and NICE suggests keeping a diary to spot what sets it off. PCDS says an itchy bottom isn't caused by a food allergy.

Rarely, the NHS says, an itchy bottom can be a sign of a condition such as diabetes or anal cancer, so it's important to get it checked by a GP.

Itchy bottom: other symptoms and possible causes

	Possible cause.	Who can help.
Worse at night, with worms in your poo that look like small pieces of thread	Threadworms, especially in children	A pharmacist: medicine for everyone in the household aged 2 and over
Bright red blood when you poo	Piles (haemorrhoids)	A GP, to check the bleeding
Poo leaking, or pooing you cannot control	Diarrhoea or bowel incontinence	A GP
Sores, swelling or irritation	A fungal infection or a sexually transmitted infection (STI)	A GP or a sexual health clinic
Itching elsewhere on your body	A skin condition such as eczema or psoriasis	A GP
While using a medicine long term	Side effects of steroid creams, antibiotics, some gels and ointments for piles or fissures, or peppermint oil	A GP: tell them straight away if a medicine makes the itch worse

From the NHS. There is not always a clear cause; see a GP if you are worried or the itch keeps coming back.

How do you stop an itchy bum?

To ease an itchy bum, the NHS advises washing gently with water after a poo and before bed, patting dry, wearing loose cotton underwear, keeping cool and not scratching. NICE says more than 90% of people whose itch has no specific cause respond well to conservative treatment, which starts with these self-care steps.

Do:

• wash your anus gently with water after pooing and before bed; NICE suggests a shower jet or bidet where you can, and our guide to washing and drying after a poo shows how
• pat dry with a towel or cotton wool rather than rubbing; NICE says a hairdryer on a cool setting can also be used
• wear loose-fitting cotton underwear, and avoid clothes and bedding that make you overheat
• eat plenty of fibre, such as fruit, vegetables, wholegrain bread, pasta and cereal, to avoid constipation
• keep your fingernails short if you can't stop scratching

Don't:

• scratch, or wipe and rub too much, including with wet wipes; NICE adds alcohol-based disinfectants, and says not to leave bits of toilet paper on the skin
• strain when you go to the toilet
• use scented soaps, bubble bath, bath oil, perfumes or powders near your anus

If sweat is part of the problem, the bum-crack sections of our guides to sweaty balls and groin chafing cover staying fresh and stopping the rub.

If small leaks of poo are behind the itch, though, ACPGBI says a high-fibre diet can make poo softer and more likely to leak, and that cutting down on bran cereals, beans, pulses and nuts may help. NICE aims for poo that is regular and formed, so if you're not sure which way to go, ask a GP.

ACPGBI says reducing the irritation may take many months of gentle care. NICE's guidance says it's reasonable to relax the routine gradually after 2 months once the itch has settled, and to start again if it comes back.

Why is my bum itchy at night?

An itch that is worse at night is typical of threadworms. NICE's guidance describes intense itching around the anus that is typically worse during the night, and the NHS says the worms usually come out at night. They look like small pieces of white thread, and you may see them in your poo.

Threadworms (pinworms) are common in children and spread easily, and adults catch them too: NICE says they most often affect children, the people they live with and people living in institutions. The worms lay eggs around the anus, which makes it itchy. The eggs stick to your fingers when you scratch and pass to anything you touch, and other people swallow them after touching those surfaces.

You can buy a medicine called mebendazole for threadworms from a pharmacy. The NHS says to treat everyone aged 2 and over in your household, even if they have no symptoms, and to tell the pharmacist if a child under 2 or anyone pregnant or breastfeeding needs treating, as the medicine might not be suitable and a GP may need to see them. The medicine kills the worms but not their eggs, which can live for up to 2 weeks outside the body, so the NHS says to keep up these habits for 2 weeks if you're taking the medicine (6 weeks if you're not):

• wash your hands and scrub under your fingernails, especially before eating and after using the toilet
• shower every morning
• keep your fingernails short, and don't bite them
• wash sleepwear, sheets and towels at a hot temperature every day for several days after treatment
• wear underwear at night and change it in the morning
• don't share towels or flannels, and don't shake out clothing or bedding

There's no need to stay off work.

How to stop an itchy anus at night

Not every night-time itch is worms: PCDS says the itch of pruritus ani can come at night and disturb your sleep. The NHS suggests keeping cool, keeping your nails short and wearing cotton gloves at night. NHS inform adds that the gloves stop you damaging your skin if you scratch in your sleep, and suggests a light duvet so you don't get too hot.

If the itch keeps waking you, see a GP. NICE's guidance says a GP can suggest a short course of a sedating antihistamine, which helps you sleep rather than easing the itch itself.

What can a pharmacist or GP do for an itchy bottom?

A pharmacist can often help with an itchy bottom, and you can ask if they have a private area to talk. The NHS says they can suggest creams and ointments you can buy to ease itching, such as steroid creams, and medicine if threadworms are the cause. Don't use steroid creams or ointments for longer than 1 week, the NHS warns, because they can irritate the skin and make things worse; get medical advice if the itch hasn't gone after a week.

A GP will try to work out the cause and may need to check your bottom (a rectal examination). NHS inform calls it one of the most common examinations GPs carry out. It says the GP may ask whether you use creams, powders or soaps around your bottom, how long you've had the itch, and whether it's worse at night or after certain foods.

Depending on the cause, the GP may suggest things to try yourself or prescribe stronger steroid creams or ointments. NICE's guidance adds a check-up within 6 weeks. If the itch doesn't settle, it says to consider blood tests and, if symptoms persist, a referral to a colorectal surgeon. Tell your GP straight away if a cream, ointment or other medicine makes the itching worse.

If you think an STI could be the cause, for example after unprotected sex, the NHS says you can go to a sexual health clinic instead. They can provide the same treatments as a GP, and many offer a walk-in service.

When should you see a GP about an itchy bottom?

See a GP if an itchy bottom isn't going away or keeps coming back. Pain, bleeding, leaking, a change in your bowel habits, itching elsewhere on your body or a change around your anus that isn't usual for you are reasons too. In the NHS's words, see a GP if:

• you have an itchy bottom that is not going away
• the itch keeps coming back
• you have pain in your bottom
• you have blood in your poo, which might be dark red or black
• you're bleeding or leaking liquid from your bottom
• you've noticed a change in your bowel habits
• you have an itchy bottom and feel itchy on other parts of your body
• you notice a change around your anus that is not usual for you

NHS inform in Scotland adds an itch that affects your sleep or makes you anxious or depressed.

For bleeding from the bottom, the NHS says to ask for an urgent GP appointment or get help from NHS 111 if your poo is black or dark red or you have bloody diarrhoea. Go to A&E or call 999 if you're bleeding non-stop or there's a lot of blood, for example the toilet water turns red or you see large blood clots.