Do you suffer from hemorrhoids? If so, you know how irritating it can be when they itch. Why do hemorrhoids itch in the first place? In this article, we will discuss the causes of itching hemorrhoids and offer some relief tips.
What are hemorrhoids?
Hemorrhoids, often referred to as piles, are swollen veins, which are found in the lower rectum and anus. Hemorrhoids are common, affecting around 1 in 20 US adults and up to 50% of over 50s. Pregnant women are also more susceptible to hemorrhoids. Up to 40% of women experience hemorrhoids during pregnancy. Hemorrhoids can develop inside the rectum, known as internal hemorrhoids, or outside of the anus, known as external hemorrhoids. The most common signs of piles include:
- Itching around the anus
- Painless bleeding from the rectum
- Protrusion through the anal opening
What causes hemorrhoid itching?
Some people experience an itchy anus when they have hemorrhoids. Itchiness usually occurs when there is an external hemorrhoid or an internal hemorrhoid that prolapses, causing it to push through the anus. Several factors can contribute to itching, including:
- Swelling – Hemorrhoids are swollen, distended veins. If you have hemorrhoids they can trigger an inflammatory reaction, which causes itching and irritation. Using anti-inflammatory treatments usually reduces swelling and associated symptoms, such as pain.
- Friction – Friction can cause itchiness if you have an external hemorrhoid or a prolapsed internal hemorrhoid, which comes into contact with toilet paper, clothing, towels or chemicals or objects that cause irritation.
- Skin tags – In some cases, external hemorrhoids can develop a blood clot, which leaves a skin tag once it has dissipated. If there is a skin tag, it can become itchy and irritated due to contact with materials or objects and scratching.
- Bowel movements – Going to the toilet can exacerbate symptoms. If you are constipated, this can cause pain and discomfort due to straining. If you have diarrhea, the skin around the hemorrhoid can become itchy and painful, especially if you are wiping frequently.
- Mucus production – The body produces mucus naturally. If mucus leaks when passing stools or wind, this can cause itchiness. It is fairly common to experience mucus discharge if you have hemorrhoids. When stools mix with mucus, itching tends to be more intense.
Is hemorrhoid itching worse at night?
It’s a common question. Why do hemorrhoids itch at night? Some people find that irritation is more severe at night. Often, this is because people scratch subconsciously during sleep. Scratching causes itchiness and it can also be painful.
If you have hemorrhoids and you find that itching is worse at night, it’s beneficial to try to minimize the impact of scratching by cutting your nails or wearing a very light pair of gloves or mittens while you sleep. Using treatments to reduce itchiness can also help to prevent scratching. Examples include antihistamine medication.
How to relieve hemorrhoid itching?
Hemorrhoids are common and they cause unpleasant symptoms, including pain, discomfort and itchiness. If irritation persists or becomes more severe, there are treatments available to target itchiness and relieve discomfort. Here are some effective ways to relieve hemorrhoid itching:
1. Preventing scratching
The American Society of Colon & Rectal Surgeons (ASCRS) recommends avoiding skin trauma to alleviate itching. The most important step to take is to prevent scratching and contact with the hemorrhoid. Some people scratch during the night while they sleep, which makes it difficult to eliminate behaviors and actions that exacerbate symptoms. If this is the case, it’s helpful to wear lightweight gloves during the night and ensure that your nails are short.
2. Practicing good hygiene
Practicing good hygiene is essential if you have hemorrhoids. Wash regularly and try to keep the skin around the anus as clean as possible. Wipe the perianal area with a damp, soft cloth or a sensitive baby wipe instead of using dry, coarse toilet paper. Once you have washed, gently pat the skin dry. It’s important to keep the skin dry.
3. Avoiding perfumed products
Scented skin and body care products can irritate the sensitive skin around the anus. Try to avoid perfumed soaps, lotions and toilet paper.
A warm bath can help to ease irritation and pain. You can use a Sitz bath, which is designed to sit on top of the toilet or tub to wash the lower part of the body, or bathe normally in a tub with a small amount of water. Make sure the water is not too hot, dry your body after bathing and use a soft towel. It’s helpful to bathe after each bowel movement if you’re prone to severe irritation.
Numbing the skin around the anus can help to alleviate itching. You can do this by using a cold compress or by applying numbing creams or gels that contain hydrocortisone or lidocaine. Ask your doctor for advice.
What else could be causing anal itching?
There are many other causes of anal itching in addition to hemorrhoids. Causes of pruritus ani (itchy anus) include:
- Anal fissures
- Poor hygiene
- Anal and genital warts
- Proctitis (swelling of the rectal lining)
- Fungal infections
- Skin conditions, including psoriasis
- Sensitivities to certain foods or products, such as coffee and dairy products
- Wearing tight underwear made from synthetic materials
- Excess moisture caused by sweating or discharge
When to see a doctor?
You should see a doctor if your symptoms are getting worse or your hemorrhoids are affecting your day-to-day life. If you’re in pain, or you experience severe irritation, there are treatment options available. Your doctor may also be able to recommend self-help techniques to try at home to ease itchiness. It’s advisable to see your doctor if you have symptoms for longer than 7-10 days or you get hemorrhoids frequently.
Get help from an online doctor
If you’re worried about hemorrhoids, or you need advice about how to deal with itchiness or pain, which is worse at night, you can get help from an online doctor. The services at DrHouse are convenient and accessible and you can see an online clinician in as little as 15 minutes!
Hemorrhoids are distended, swollen veins, which are found in the lower rectum and anus. They can be itchy and painful.
Many people find that itching is worse at night because they scratch subconsciously while they sleep. To ease itching and prevent scratching, it’s helpful to wear gloves and keep your nails short.
If you experience itching, bathe regularly, avoid scratching, use sensitive, non-perfumed skin care products, and wear loose, light clothing.
Seek advice from an online doctor if your symptoms don’t clear up after 7-10 days or you experience severe symptoms, such as intense itching and pain.
- Definition & Facts of Hemorrhoids, National Institude of Diabetes and Digestive and Kidney Diseases. Avialable from: https://www.niddk.nih.gov/health-information/digestive-diseases/hemorrhoids/definition-facts#
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- Riss, S., Weiser, F.A., Schwameis, K. et al. The prevalence of hemorrhoids in adults. Int J Colorectal Dis 27, 215–220 (2012). https://doi.org/10.1007/s00384-011-1316-3
- Pruritis Ani Expanded Version, American Society of Colon & Rectal Surgeons (ASCRS). Available from: https://fascrs.org/patients/diseases-and-conditions/a-z/pruritis-ani-expanded-version
- Causes of Anal Itching, WebMD. Available from: https://www.webmd.com/digestive-disorders/ss/slideshow-anal-itching
- Hemorrhoids and what to do about them, Harvard Health Publishing. Available from: https://www.health.harvard.edu/diseases-and-conditions/hemorrhoids_and_what_to_do_about_them
- Sandler RS, Peery AF. Rethinking What We Know About Hemorrhoids. Clin Gastroenterol Hepatol. 2019 Jan;17(1):8-15. doi: 10.1016/j.cgh.2018.03.020. Epub 2018 Mar 27. PMID: 29601902; PMCID: PMC7075634.