Burning Sensation Around the Anus: Causes and Treatment

A burning sensation around the anus is an uncomfortable symptom that can have many different causes, such as hemorrhoids, anal tears, or irritation from traces of stool. Anal burning and itching can be painful and interfere with work or daily activities. It occurs in up to 5% of the population, affects men more than women, and is more commonly found in ages 40 to 60.

Treatments will depend on the cause but can include medications and lifestyle adjustments, such as eating more fiber and gentle washing.

This article discusses anal burning and itching causes, treatment, and prevention. It also will cover the symptoms and treatment options available.

Common Causes of Burning Anal Pain

There are several causes of anal burning. Here are common causes and information about each one.

Hemorrhoids (Piles)

Hemorrhoids, sometimes called piles, are a common condition. Approximately 50% of men and women will develop hemorrhoids by the time they are 50 years old.

Hemorrhoids are swollen veins in the anus and lower rectum. They can develop on the inside of the anus or the outside, around the anus. Hemorrhoids develop when there is too much pressure on the veins.

Hemorrhoid symptoms include pain, itching, burning, blood in the stool, and hard lumps around the anus.

Anyone can get hemorrhoids, but certain risk factors put a person at a greater risk. Here are the risk factors for hemorrhoids:

• Pregnancy
• Straining from heavy lifting
• Sitting on the toilet for long periods
• Family history of hemorrhoids
• Long-term diarrhea or constipation
• A person affected by obesity

Stool

Sometimes the cause of burning in and around the anus is caused by stool. After a bowel movement, if the stool isn't completely removed, it can irritate the skin.

For some people, liquid stool leaks out of the anus and causes burning and itching. This can happen in healthy people who drink a considerable amount of liquids.

Using toilet paper to remove stool isn't always effective. The toilet paper can spread the stool over the anus and surrounding skin. Instead, use toilet paper dampened with water to clean the anal area after a bowel movement.

Diet

A person's diet can cause anal burning and itching. The foods and drinks that tend to cause these symptoms include:

• Coffee
• Alcohol
• Tea
• Citrus fruit
• Chocolate
• Tomatoes
• Vitamin C tablets

It takes 24 to 36 hours for food to move through the digestive tract. As a result, it will take that long after eating or drinking something for it to cause anal burning or itching.

Anal Fissures

Anal fissures are tears, sores, or cracks in the anus. It happens when the anus is stretched past its capacity, usually because of hard constipated stool, and tears. Once an anal fissure starts it is prone to reinjury.

The symptoms associated with anal fissures are pain, burning, blood in the stool, and a cut or tear in the anus.

The greatest risk factor for developing an anal fissure is constipation. Hard, dry stool passing through the rectum and anus can stretch the skin too far and cause a tear. Other risk factors are:

• Low fiber diet
• Vaginal childbirth
• Diarrhea
• Anal trauma
• Inflammation in the anus
• Surgery in the anal area

Chemicals and Medications

The anal skin area is sensitive and can easily be injured. Using harsh chemicals and medications in the anal area can cause skin irritation and reactions. These irritants can include:

• Scented soap and lotion
• Dyes and perfumes in toilet paper
• Feminine hygiene sprays and deodorants
• Medicated talcum powders
• Perianal wipes that contain alcohol or astringents

Before using any over-the-counter (OTC) cream or lotion talk, to a healthcare provider. It can cause further anal irritation, burning, and itching.

Excessive Cleaning

One common cause of anal burning and itching is excessive anal cleaning. This tends to happen to people who feel unclean after a bowel movement and excessively wipe themselves. The vigorous scrubbing and use of medicated wipes irritate the anal area causing skin damage and removing the skin's natural barriers.

With the new burning and itching symptoms, some people begin to wipe and clean themselves even more, which creates a vicious cycle of skin irritation and excessive wiping.

Skin Conditions

Psoriasis and eczema are two skin conditions that can cause itching and burning around the anus.

Psoriasis is a chronic inflammatory disease that causes scaly patches on the skin. According to a 2016 study, 5% to 8% of people who went to their colon and rectal surgeon with rectal itching had psoriasis.

Eczema is a type of dermatitis that is caused by an allergic response. People with eczema may have dry, scaly skin that itches and burns. It can be caused by various allergens like soaps, lotions, and environmental factors.

Sexually Transmitted Infections

Sexually transmitted infections (STIs) of the anus and rectum can cause symptoms such as painful burning and itching. Other symptoms may include a feeling of needing to pass stool even when bowels are empty, bowel urgency, anal discharge, anal bleeding, or bumpy growths. STIs can also be asymptomatic (showing no symptoms).

STIs that can affect the anus and rectum include:

• Chlamydia
• Gonorrhea
• Anal herpes
• Human papillomavirus (HPV), or anal warts
• Syphilis
• Anal infections in those with human immunodeficiency virus (HIV)

Related Symptoms

Anal burning and itching are caused by various conditions and causes. They are often accompanied by other symptoms:

• Mild discomfort to severe burning and itching
• Pain in the anal area during bowel movements
• Bleeding from the anal area
• Diarrhea or constipation
• Anal seepage

Diagnosis

Anal itching and burning are diagnosed by a healthcare provider based on health history and symptom description. A rectal exam may be necessary to check for specific causes like hemorrhoids or anal fissures.

If an STI is suspected, a swab of the area may be done to test for infections.

Skin scrapings can be sent for evaluation if fungal infection is suspected.

Burning Anus Treatment

Treatment for anal itching and burning should focus on treating the underlying cause. Sometimes when the cause is not found, treating the symptoms becomes the focus.

Here are some of the common treatments for anal itching and burning:

• Clean the anal area with warm water and pat dry. Avoid rubbing to prevent skin irritation.
• Use a protective barrier like Vaseline or zinc oxide. This will protect the skin from stool irritation.
• Hydrocortisone cream can alleviate itching but shouldn't be used for the long term.
• An over-the-counter pain reliever such as ibuprofen or acetaminophen may help with pain
• Ice packs on the area may be soothing
• Wear loose cotton underwear

Treat any STIs with appropriate medications, such as antibiotics or antivirals.

If diarrhea or constipation is contributing to the irritation and burning, correcting these issues with your bowel movements can offer relief. Treatments may include:

• Increasing fiber in your diet through fruits, vegetables, beans and legumes, and whole grains
• Taking probiotic or fiber supplements
• Medications, such as laxatives for constipation or anti-diarrhea medications
  

Prevention

While not every case of anal burning and itching can be prevented, several prevention techniques can help decrease the chances of developing these symptoms:

• Avoid using scented soaps or lotions.
• Use a bidet or squirt bottle to clean the perianal area.
• Avoid scratching.
• Don't use prepared wipes or witch hazel pads.
• Only clean the anal area with warm water (can use moistened toilet paper and pat dry). Avoid rubbing the area to prevent skin irritation.
  

Summary

Anal burning and itching are symptoms that can be caused by several different conditions or sources. Once the cause the burning sensation is found, it can be removed, and treatment can begin. If the cause is unknown, treatment focuses on reducing the burning and itching as much as possible.

Many times anal burning and itching can be prevented. Avoid over-cleaning the anal area and correct any digestive problems like constipation or diarrhea.

A Word From Verywell

Discomfort in the anal region can be a difficult topic to discuss with your healthcare provider. Be assured that such discussions are very common, and what's most important is being properly evaluated, getting a correct diagnosis, and getting the right treatment.

— JAY N. YEPURI, MD, MEDICAL EXPERT BOARD