Itchy Bottom: What Causes Anal Itching After 50 and What Actually Helps

Anal itching, called pruritus ani, affects about 1% to 5% of people and is especially common in midlife.¹ It tends to flare after a bowel movement and at bedtime.¹ Scratching damages the skin, which makes the itch worse, so breaking the cycle is the goal.

Common causes

A review sorted the causes into several groups.¹

• Bottom problems: hemorrhoids and anal fissures are the most common
• Skin conditions: contact dermatitis from products, psoriasis and lichen conditions
• Infection: yeast accounts for up to 15% of cases
• Moisture and irritation: leaking stool, sweat, chronic diarrhea, soap and too much scrubbing
• Foods and drinks: some people improve within two weeks of cutting tomatoes, chocolate, citrus, spicy foods, coffee (even decaf), tea, cola, beer or milk
• Health conditions: diabetes and thyroid problems
• For women: vaginal discharge, urine leaks and menopause

Up to three-quarters of cases have no clear cause.¹

What helps

The review recommends keeping the area clean, dry and gently treated:¹

• Rinse with plain water after a bowel movement instead of rubbing. A bidet set to warm water and low pressure works.¹
• Pat dry, or use a hair dryer on a cool setting.¹
• Skip soap and scrubbing on the area.
• Wear loose cotton underwear that absorbs sweat.¹
• Try cutting out suspect foods for two weeks.¹

A short course of a mild steroid cream can help, but long-term use can thin the skin and invite infection.¹ Check the label on any wipes or creams, since fragrances and numbing ingredients can cause reactions. Our guide to hemorrhoid cream labels explains what’s inside.

When to get checked

If itching hasn’t improved after two to three weeks of self-care, look for an underlying cause.¹ The review notes that longer-lasting itching and age over 50 were linked to a higher chance of finding a growth, so a colonoscopy may be advised.¹ Our articles on hemorrhoids, anal fissures and pad rash cover related issues.

Questions to ask

1. Could this be hemorrhoids, a fissure, yeast or a skin condition?
2. Are any of my products irritating the skin?
3. Do I need a colonoscopy or other tests?

Try: “I’ve had anal itching for six weeks, worse at night. I’ve switched to water and cotton, but it hasn’t stopped. Can you take a look?”

Bloated by Dinner includes a Belly Clock log and a Test-It list with a visit script. Use them to note foods, bowel habits and when the itching flares. See the book.