Dealing with the embarrassment and irritation of pain in the well, you-know-what? We've got all the possible culprits, plus solutions to help you get some relief.
That Itch You Can't Scratch
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Got an itch you can't scratch, at least not in public? Fortunately, pruritis ani—the medical name for anal itching—affects only 1 to 5 percent of the general population. Still, those low numbers aren't too reassuring when you're the one with an itchy butt.
The frustration is that scratching the itch only makes matters worse, and can quickly put you in an endless itch-scratch cycle, says Roberta L. Muldoon, M.D., a spokesperson for the American Society of Colon and Rectal Surgeons. That's because "when you scratch the anal area, you tend to break the skin and cause little superficial abrasions, which then begin to itch, so you scratch even more," she says. To nip this problem in the butt—bud!—here are some common reasons your derriere might itch, plus your fix to find some much-needed relief. (Next up: What's Causing My Itchy Vagina?)
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The culprit: A fungal infection on the butt generally comes from two possibilities: an overgrowth of the yeast that is normally found in the bowels and on the perianal skin, or fungus that has spread along the skin from a different area of the body, says Cynthia Bailey, M.D., a board-certified dermatologist and founder of DrBaileySkinCare.com. The yeast-type infection usually only shows up around the anus. In addition to being extremely itchy, you may notice redness and pimple-like bumps. If it's fungus that has spread from elsewhere (which can happen by touching an infected area and then touching your backside), you'll usually see signs of it in the form of athlete's foot or toenail fungus, and it will manifest itself in a dry, itchy, scaly rash that can affect both the buttocks and the anus, Bailey explains.
The fix: To treat a fungal infection on the butt and ease itching, the first step is to keep the area clean and dry since fungi love warm, dark, moist environments, Bailey says. An over-the-counter antifungal cream can cure the infection on the skin, or your doctor can prescribe an oral medication to kill the yeast on the skin and balance the yeast in the bowels. (Psst: The 5 Biggest Yeast Infection Myths—Debunked)
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The culprit: This may come as a shock to you, but everyone has hemorrhoids. Hemorrhoids are the pillow-like cushions of blood vessels just inside the rectum. They're actually part of our normal anatomy, Muldoon explains. Hemorrhoids only become a problem when they get enlarged or inflamed (you may feel a lump in the area). Then they can cause anal itching, pain, and bleeding during bowel movements. Chronic constipation or diarrhea, straining during bowel movements, and spending long amounts of time on the toilet are some of the reasons hemorrhoids may start to swell. (More here: Why Am I Pooping Blood?)
The fix: Don't jump to self-treat. "If you're experiencing bleeding or feel a mass back there, don't assume it's hemorrhoids—get it checked out to make sure it's not something else more serious, like colon or rectal cancer, which can have the same symptoms," Muldoon says. Once your doc confirms it really is a hemorrhoid issue, turn to fiber. Muldoon recommends a high-fiber diet, ranging from 25 to 35 grams per day, to make your stool softer and easier to pass. This reduces pressure on the hemorrhoids. To reduce swelling and relieve your symptoms, up your water intake to prevent constipation (exercise can also help with that!), don't strain during bowel movements, and take frequent sitz baths (you can do this by sitting in a couple of inches of warm water—just enough to cover your hips—in your bathtub for about 10 minutes, or you can go to the drugstore or a medical supply store and get a special sitz bath that fits over your toilet.) Your doctor might also give you hydrocortisone suppositories or topical medications to help calm the hemorrhoids down, Muldoon says. If home treatment doesn't work, or hemorrhoids are severe, special treatments or surgery may be used as a last resort.
Your Hygiene Habits
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The culprit: Sorry, but your itchiness may actually be because you just aren't wiping well enough. If you don't clean properly after a bowel movement, fecal material left behind can cause irritation, which can manifest in itching or burning, Bailey says.
The fix: Use either soap and water, wet tissue paper, or alcohol- and fragrance-free moist wipes after a bowel movement. If you find you have to wipe a lot, eat more fiber to add bulk to your stools so they're easier to clean. Shower daily, using a washcloth with mild soap and warm water, and be sure to rinse well afterwards since soap left in the area can also cause irritation and itching. Once you're done, pat dry with a towel. "If you're prone to getting yeast infections in the area, you may need to use a hair dryer on cool to get it really dry," adds Bailey. That's not to say you should go overboard. Being overzealous or aggressive with your wiping or cleaning, or using fancy cleansers, can irritate the anal skin and cause small abrasions, which means more itching, Muldoon says.
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The culprit: Working up a sweat is always a good thing, of course, but it could be the reason for your itchy butt. Remember, moisture promotes the growth of yeast and other fungi. So if you're sitting in your sweaty leggings for long periods of time, it can lead to a fungal infection between the cheeks. (See: 8 Exercise-Induced Skin Afflictions.)
The fix: To prevent this from happening in the first place, make it a habit to get out of your wet workout clothes as soon as you're done with your sweat session. Shower with mild soap and warm water, rinse well, and then dry carefully, paying special attention to your bum (and other folds of the body). If it's the round part of your butt that's itching for a scratching, your laundry detergent may be to blame. "When you're sweating, any detergent residue on your clothing is going to become liquid and get on your skin, causing itching," Bailey says. Rinse your workout clothing twice to get out all of the residue and skip the fabric softener, she says.
A Skin Disorder
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The culprit: Skin problems like psoriasis can affect anyone—Kim Kardashian suffers from the condition. It usually appears on the elbows, knees, or scalp, but some people have what's known as inverse psoriasis, in which the plaques show up in the folds of the skin, like between the butt cheeks. Another skin condition that can present itself on the tush is eczema. Also known as dermatitis, eczema causes dry, itchy skin and rashes. The type that is more likely to appear in the perianal area is contact eczema, or allergic eczema, which occurs when your butt comes into contact with an allergen or irritant, Bailey explains. The reaction can be triggered by dyes, fragrances, and other additives in toilet paper, soaps, perfumes, lotions, clothing, and moist wipes.
The fix: If you believe psoriasis is the cause of your itchy butt, you'll need to see your dermatologist for a prescription steroid cream. Once the psoriasis is under control, the itching should subside. To ease itching caused by allergic eczema, first narrow down what's causing the irritation and then stop using it, Bailey says. Once you eliminate the offending product, you should see (and feel) an improvement in symptoms. Applying a thin layer of OTC hydrocortisone cream for a few days (two to three times a day) may also help.
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The culprit: Yes, it is possible to get herpes on the bottom. Herpes, caused by the herpes simplex virus, is a sexually transmitted disease (STD). It can cause painful blistering sores in the vagina, on the labia, or the area around the rectum (usually on one side only) which can last for days, says Jocelyn B. Craig, M.D., medical director of the Center for Women's Pelvic Health at Long Beach Memorial Medical Center in California. Before the blisters appear, some people feel what's known as a prodrome, an early warning signal that may include itching, pain, or tingling. "This can be experienced as anal itching as the virus can irritate the nerves around the rectum," Craig says.
The fix: Unfortunately, there's no cure for herpes. The virus remains in the nerves near your spine and can be re-activated later, causing repeated outbreaks. However, your doctor can prescribe an oral or topical antiviral medication to reduce symptoms and shorten the length of the outbreak.
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The culprit: Although the world may call it "butt acne," unlike the pimples that pop up on your face, itchy bumps on your cheeks aren't actually caused by clogged pores. Instead, they are due to what's known as folliculitis, which occurs when a hair follicle gets infected by bacteria or becomes inflamed—usually from friction due to sweating and clothing rubbing against the area, Bailey says. (More on "exercise booty" here.)
The fix: If you're prone to bouts of folliculitis, be sure to wear lightweight, loose-fitting clothes when it's hot and humid, change out of sweaty workout clothing as soon as you're done working out, and generally keep the area clean and dry, she says. While folliculitis usually goes away on its own, you can help it along by using a benzoyl peroxide cleanser, Bailey suggests. A word of warning: Benzoyl peroxide does bleach fabrics, so she recommends using it at night before going to bed (and wearing white underwear). A derm can also prescribe you an oral or topical antibiotic.
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The culprit: "Citrus, chocolate, coffee, tea, and alcohol are some foods and beverages that are believed to cause anal itching," Muldoon says. While it's not known exactly why, one possible theory is that they can decrease the muscle tone of your sphincter, causing a little bit of fecal leakage, which then irritates the skin, Muldoon says. Yikes.
The fix: To find out which item, if any, might be causing your itchy butt, you may need to go through a process of elimination. Remove one item at a time from your diet for a couple of weeks to see if symptoms improve. (While you may not be willing to give up your coffee or wine habit for good, in Muldoon's experience, avoiding these specific beverages often does improve the itching. Sorry!)