Why Do Hemorrhoids Cause Itching?

Medically reviewed by: Gary H. Hoffman, MD

Anal itching, or pruritus ani, is a common complaint. We see patients all the time who believe they have hemorrhoids because of the severe itching and need to scratch the tender skin around their anus. Some have already tried to treat their self-diagnosed hemorrhoids, and seen little relief. Often, this is because piles are not the cause of the itching. Other times, they do suffer from a hemorrhoid, but need additional treatment to stop their symptoms.

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If you suffer from pruritus ani, it is important to talk to us about your symptoms. This is especially true if you also see blood on your stool, toilet paper, or underwear. Hemorrhoids can certainly cause these symptoms, but so can other more serious health concerns. We can evaluate your condition, ensure you receive the right diagnosis, and put you on a treatment plan that offers relief and healing.

Why Do Hemorrhoids Cause Itching?

External hemorrhoids cause painful burning, and can also itch. But when patients report severe itching, we usually expect to see a prolapsing internal hemorrhoid. When a hemorrhoid slips through the anus, it brings with it mucus that can irritate the sensitive skin around the anus. This irritation can cause the kind of activity-limiting itching many of our patients describe.

When the hemorrhoid remains prolapsed, the anal mucosa continue to produce mucus and the irritation continues. In addition, stool can mix with the mucus and leak out of the anus. This coats the skin around the anal opening, causing even more irritation.

If you suffer from a prolapsed hemorrhoids, we have both non-surgical and surgical treatments that can offer relief. Correcting the hemorrhoid will stop the itching, as well as your other symptoms.

What Are Some Other Possible Causes of Anal Itching?

Sometimes, we see patients who believe they have hemorrhoids who actually suffer from another health condition. Other possible causes of anal itching may include:

Issues with Personal Care

The skin around the anus is particularly sensitive to products with perfumes and dyes, and may be easily irritated. Using too many products, or the wrong products, can cause irritation. Too little self-care can cause itching, as well, of course. Using allergen-free soap or wipes designed for sensitive skin to gently clean the area allows the skin to heal and the itching to subside.

Sexually Transmitted Infections

Some sexually transmitted diseases that affect the area around the anus can cause severe itching. This may include herpes, genital warts, syphilis, and other infections. Some of these STDs can be tentatively diagnosed with a physical exam, but most require a blood test to confirm.

Other Infections

Fungal and yeast infections are both relatively common. Women with yeast infections often experience itching around the anus, and either gender can suffer from a fungal infection in the area. Both are easily treatable with the right diagnosis.


Pinworm infections can cause ongoing anal itching until you receive a proper diagnosis and begin treatment. Female pinworms lay eggs just outside the anus at night, leaving the host waking up to itching and irritation. Other parasites may cause itching in the same way.

Skin Conditions

Sometimes a systemic skin condition can affect the area around the anus, causing symptoms. This may includes psoriasis, hives, contact dermatitis, poison oak or poison ivy. Treating the skin condition generally brings relief from the itching, as well.

Other Medical Conditions

Pruritus ani can be a side effect of a number of other medical conditions, as well. This might include disorders that cause chronic diarrhea, precancerous lesions, and anal tumors. Diabetes and immune system disorders may also raise your risk. For this reason, it is important to see a doctor for an accurate diagnosis before you attempt to treat your anal itching at home.

How Can I Stop Pruritus Ani?

Anal itching usually disappears when the underlying cause is treated. If we discover hemorrhoids are the cause of your pruritus ani, we may be able to prescribe an ointment or hydrocortisone cream that will temporarily relieve the itching while you heal. Witch hazel pads may also bring some relief while you wait on other treatments to work.

If you have a prolapsed hemorrhoid, we may need to discuss procedure for prolapse and hemorrhoids (PPH). This quick procedure is almost as effective as a traditional hemorrhoidectomy, but you can heal much faster. As soon as we treat your hemorrhoid, your symptoms should disappear.

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