Causes of Nighttime Anal Itching

Anal itching, or pruritus ani, is a common condition that is typically worse at night. Accompanied by a strong urge to scratch the skin around the anus, this condition is caused by a variety of skin disorders, infections and an adverse environment that irritates the skin, according to the New York University Langone Medical Center.

Prolonged sitting on a daily basis may be one cause of itchiness. (Image: Stockbyte/Stockbyte/Getty Images)


Hemorrhoids are caused by swollen anal veins. Hemorrhoids may be located within the rectum or in the external anal region. Those that occur externally cause itching, pain and bright red blood in the stool. Conditions that predispose an individual to hemorrhoids include chronic constipation, a low-fiber diet, pregnancy, obesity, liver disease and prolonged sitting. According to the University of Maryland Medical Center, treatment for hemorrhoids includes application of creams containing lidocaine, which decreases pain; avoidance of scratching the area or using perfumes and scented creams; increasing fiber intake to relieve constipation; avoidance of putting pressure on the area; and sitting on an inflatable O-ring.


Eczema and dermatitis are two terms used interchangeably to describe a condition that causes itching, dry, red and flaking skin in response to an allergen that contacts the skin. The allergen could be soap, detergent, synthetic fabric, lotions or feminine hygiene products. Once the allergen contacts the skin, an allergic reaction occurs, causing adverse symptoms. Eczema is a chronic condition. The predisposition for an allergic reaction in response to an allergen is untreatable. However, sufferers may prevent the skin reaction by avoiding allergens, using oral antihistamines or administering a topical steroidal ointment to lessen inflammation, according to the Milton S. Hershey Medical Center.


Pinworms are tiny intestinal worms, acquired by coming in contact with pinworm eggs on infected people or objects. The condition is commonly observed in children, who unknowingly pick up pinworm eggs and ingest them. Mature female pinworms travel to the anus to deposit more eggs in the external anal area; this causes intense itching. A person who feels driven to scratch the area may carry pinworm eggs under the fingernails and thereby infect other persons. A pinworm infection is treatable with a single dose of albendazole or mebendazole. These are anti-parasitic medications, according to the University of Maryland Medical Center.

Other Causes

Anal itching is also caused by diarrhea, laxative use, birth control pills, perfumes, soaps, poor hygiene or excessive washing, according to the Langone Medical Center.

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