The Butthole Dialogues

May 1, 2012 6:04 PM

How to rectify (har har) anal itching.

I don't know what I've done to it, but my butthole is unhappy with me, and has been for almost a year. I'm a girl, and I've read very useful home remedies (here and elsewhere) for things like yeast infections, BV, so I'm wondering if anyone has any cool butthole itching hacks. For what it's worth, I've been diagnosed with internal hemorrhoids. But I don't bleed, ever, regardless of pooping action (I don't go very often, but when I do, I don't strain). And I use baby wipes, so there aren't gobs of poop hanging off my butt that's causing the itching, in case people were wondering.

I've tried all sorts of butt creams like Tuck's, Boudreaux's butt paste, weird chinese stuff from Amazon, hydrocortisone cream, proctofoam prescribed by my doctor, suppositories, and sitz baths. To my shame, I've put many a Q tip up there to try and get the medication of the day as far up as I can. I've thought about maybe using a syringe to squirt it up there but haven't gotten around to trying that yet. I've also used tea tree oil facial pads that sting horribly, but at least they stop the itching... for a little while. Not something I want to do long-term, to say the least.

Oh, I also tested for pinworms at one point hoping for an explanation, but it's not that either.

If anyone has any further ideas, I'd really appreciate it. If your butthole is shy and would like to contact my butthole confidentially, you can find her at: [e-mail]

Thank you!

posted by anonymous to Health & Fitness (28 answers total)

I'm not even remotely qualified to answer this, and I don't even have any experience to back it up (hah again) but this sounds like a job for medicated enemas. It's like the warm, gentle, liquidy version of trying to get the medication up in there by sticking q-tips in your butt.
posted by carsonb at 6:08 PM on May 1, 2012

I wonder if some of the external products you are using contain astringents that are exacerbating whatever irritation might be happening in that area. I'd try a soothing-only approach for a little while, including alcohol-free wipes (perhaps only moistened with things like glycerin or aloe, not anything like witch hazel) or perhaps a dry enema. Think moisture (including in your diet), not anything advertised as "pain relief."
posted by argonauta at 6:19 PM on May 1, 2012 [2 favorites]

Have you messed with your diet? Like, cut out dairy for a few weeks, cut out caffeine for a while, etc.? I would be very surprised to learn this didn't have something to do with either your diet or something else going on in your digestive system.

I assume, also, that you've already tried the classic "irritated skin" solutions (Dreft soap for your clothes, fragrance free everything, Desatin and Aquaphor, etc.) For a while as a kid I had horrific irritation on the bottoms of my feet that responded only to extreme avoidance of allergens and irritants (I had to wear only cotton clothing, only leather shoes, use baby soap, etc. - even on the rest of my body.) They thought that part of the reason it went away is that my body basically got a break from having to fight off whatever non-existent demons it thought it was defending the soles of my feet from. By "horrific" I mean "a fate so much worse than itching." But it itched, too.

Make sure that you try whatever it is that you're trying for a good long stretch of time, as well. Like, two to six weeks. Your skin is a fairly demanding and capricious organ - treat it like you would Britney Spears, with an excessive amount of sympathy and self-discipline.

(You should have seen a gastroenterologist and a dermatologist by now, BTW.)
posted by SMPA at 6:21 PM on May 1, 2012

I don't know what 'tested for pinworms' means, but my medically-unqualified guess is that a colonoscopy to definitely rule out pinworms and other things would be advisable.
posted by Mr. Justice at 6:22 PM on May 1, 2012

More generally, I would think a visit to a colorectal guy would be highly advisable.
posted by Mr. Justice at 6:23 PM on May 1, 2012

If it's been going on a year, see a specialist. Primary care doctors are absolutely awesome at first-line treatment, but if it's not working for you, try a gastroenterologist. I think it's a definite possibility that you have something specific going on other than the internal hemorrhoids. For instance, a child of mine had a diaper rash in a tiny ring around her anus that, when cultured, turned out to be a bacterial infection that needed antibiotic treatment, and the anti-fungals we'd been using after initial diagnosis by her pediatrician were just making it worse and more irritated. A few days of antibiotics, and all was well.

Oh, another thing -- maybe, as argonauta suggests, you're dried out down there... but just as possibly, all those products are actually holding moisture, and you've got fungal action. When we thought our daughter had a fungal diaper rash, we were literally rinsing and then blow-drying her anus with every diaper change. Weird, but apparently very helpful with fungal things.
posted by palliser at 6:27 PM on May 1, 2012 [2 favorites]

Try different laundry detergent — or use less detergent. Sometimes fragrances and soap residues can be irritating.
posted by Blazecock Pileon at 6:31 PM on May 1, 2012

This seems obvious, but you have tried preparation H with an internal applicator, right? Because that's probably more effective than a syringe or a q-tip.
posted by PhoBWanKenobi at 6:33 PM on May 1, 2012

Have you tried using a soap for sensitive skin? My boyfriend also has internal hemorrhoids and occasionally bleeds, but doesn't have the itching issues, and he uses Dove Sensitive Skin on his erm sensitive parts.
posted by jabes at 6:40 PM on May 1, 2012

Since you mention internal hemorrhoids and irregularity, try increasing your fiber intake -- couldn't hurt, might help!
posted by SweetTeaAndABiscuit at 6:43 PM on May 1, 2012

A second on the fiber - 2-3 doses of psyllium powder per day can do wonders.

This is a clue: "I don't go very often". Bulk up. You'll pass more, and your problem may resolve.
posted by yclipse at 6:48 PM on May 1, 2012

I don't know what 'tested for pinworms' means, but my medically-unqualified guess is that a colonoscopy to definitely rule out pinworms and other things would be advisable.

Pinworms are visible to the naked eye. "Testing" for them usually involves applying clear tape to the rectum, lifting it off, and observing to see if any worms are present. A colonoscopy would be highly, highly unnecessary.

If you're going to increase fiber, which is a reasonable suggestion, make sure to increase your fluid intake, too. Otherwise, you could become constipated, which may lead to straining...which of course will only make things worse.

This is really delicate skin, and some of the products you've used are pretty astringent, as others have mentioned. I would make an appointment with a proctologist or other specialist and use Tuck's (or another product with witch-hazel) in the meantime.

A sitz bath could help relieve symptoms, but it's time consuming - it's usually recommended that you soak at least 10-15 minutes. If things are extremely uncomfortable, though, you could try it as a stop-gap measure. I wouldn't ever use soap, not even something marketed for sensitive skin.

Make sure your skin is totally dry after sitting in the sitz bath or using a baby wipe. You can blot with a towel or use a hair dry on the low or cool setting. If the skin is too dry or cracked, you can apply a thin layer of petroleum jelly (on skin only - NOT on the anus or inside the rectum).
posted by pecanpies at 7:09 PM on May 1, 2012

Definitely sounds like it's time to see a specialist.

In the mean time, in the realm of self-care: Fiber is great, sitz baths are also great. (just soaking your butt in warm water - it gets blood flowing to that area and helps encourage healing. it also helps keep things clean and soothed.) and if you can afford it (many basic models are under $50 or $100), get a bolt-on bidet for your toilet. I had some unhappy butt experiences due to some (now resolved) digestive issues, and getting a bidet did a lot to keep my butt happier. Much less chafing and irritation, and now I always feel not-quite-totally-clean if i poop anywhere besides home.
posted by rmd1023 at 7:10 PM on May 1, 2012 [1 favorite]

As palliser suggested, perhaps it is not a matter of things being too dry, but of things being too moist.

Do you wear cotton underpants - all cotton, not just cotton crotch? And change them daily? If you don't, try that. I have had ... itching issues ... in the past, and making sure I always wear cotton undies, and NOTHING of any non-cotton variety (even tights or pantyhose) makes a big difference. And then no undies at night - I wear loose PJ pants, usually. This lets things air out overnight, and helps as well.

Don't use baby wipes. Cottonelle moist wipes, followed by a patting off with dry tissue to make sure things aren't left damp, are your best bet to make sure things are clean and dry when you've managed to poop.

Good luck. I hope you find a solution. The misery of an itchy butt is just no good at all.
posted by Lulu's Pink Converse at 7:15 PM on May 1, 2012

Yeah, if this has been a constant thing that's been ongoing for a year then I would see a doctor about it. That said, when I have occasional itchiness I find a little antibiotic ointment (not cream, ointment) soothes things nicely. But that's just for the every-once-in-a-while irritation thing, not for a year's worth of continuous burning bunghole. Go see a doctor.
posted by Scientist at 7:24 PM on May 1, 2012

Don't use any wipes! I started using Cottonelle wipes and found out the hard way. My butt was really itchy, which was never a problem I had before, and it didn't take long to trace it back to regularly using the wipes. They mess up my pH balance, or some such. Stop using any wipes, cream or medication for a week and I bet the problem goes away.
posted by catatethebird at 7:27 PM on May 1, 2012

It is likely that you have a severe case of contact dermatitis from the wipes. Check the ingredients in your wipes and if you see methylchloroisothiazolinone or methylisothiazolinone STOP USING THEM IMMEDIATELY and your problem should clear up without any further intervention. (WARNING: VERY angry anus pictures in link so NSFW).
posted by wherever, whatever at 7:32 PM on May 1, 2012

Do you eat a lot of salty foods? I get bad itch from too much salty fun, especially salted nuts.
posted by a humble nudibranch at 7:34 PM on May 1, 2012

And on re-reading your question, I want to reiterate, I really bet it's the wipes!
posted by catatethebird at 7:36 PM on May 1, 2012

(You should have seen a gastroenterologist and a dermatologist by now, BTW.) Yes

I don't know what 'tested for pinworms' means, but my medically-unqualified guess is that a colonoscopy to definitely rule out pinworms and other things would be advisable. No.


If it's been going on a year, see a specialist. Absolutely.

This is embarrassing for you but not for a doctor. We all have butts and sometimes things go wrong with them. That's what doctors are for. There are specialties that revolve only around things like this. In fact, there are a couple that may be able to help your problem specifically. Either a gastroenterologist, a colorectal surgeon, or a dermatologist can help. Talk to your PCP and get a referral. It could be your hemorrhoids. It could be pinworms. It could be an allergy to wipes or detergent or something else. Hell, it could be an STD. Stop guessing and see a specialist. Good luck
posted by karlos at 7:46 PM on May 1, 2012

Coffee has oils in it that are not digested, and can itch up your butt when they come out the other end. Try cutting coffee out and see if that helps. But my bet is on the wipes. If you have to use them, try the most unscented, un-everything kind you can find.

Good luck!
posted by amcm at 7:47 PM on May 1, 2012

Stop using wipes, as others suggest, and stop using soap completely. This is advice given to a friend from a colorectal surgeon, who said that soap causes almost all the causes of dermatitis he sees. Warm water will get you cleaner than you think. Give your honey a break from anything but water for a couple of weeks and see how you feel. You can also ask for a scrip for some cortisone cream if it is in fact some kind of dermatitis.
posted by Addlepated at 8:07 PM on May 1, 2012

Definitely see a doctor about it. But in the meantime, do you use any scented bath products? Scented lotions? Fabric softener? I have very sensitive skin that is prone to INSANE BOUTS OF ITCHING (and eventually peeling and bleeding) if I use scented products very much. I use Dove unscented soap to wash and that's it. Also, try to keep your shampoo and conditioner from...trickling down the lane (if you know what I mean) when you rinse it out. My doctor recommended using Neutrogena shampoo and conditioner. I did some research on unscented shampoos and conditioners and found some for online order but never tried them.

Also, per my doctor's recommendation, I use only the Free & Clear detergents, NO fabric softener, and I double-rinse all my underwear and towels. You know, wash the load once normally, the do the rinse/spin cycle again. It's annoying but it has DEFINITELY helped. I hope you feel better soon.
posted by Aquifer at 9:02 PM on May 1, 2012

I get itchy if I am even mildly constipated. For a week or 2, add 1 or 2 glasses of water a day to your diet, and some fiber. Several dried apricots a bowl of oatmeal, an orange or apple, plenty of veggies, or some toasted bran sprinkled in your salad. Fiber's really good for you, so even if it doesn't solve the itch, it's no-risk.
posted by theora55 at 11:30 PM on May 1, 2012

Seconding all the remarks on diet. My knowledge is not first hand, however, a good friend was a vegan naturopathic doctor who swore that many problems with the digestive tract can be traced back to diet.

He specifically mentioned fats, oils, salt, sugar, and alcohol. I also remember him saying that it's not the class of those things but specifics. Some people have poor reactions to white sugar but not brown sugar. Some people have digestive problems with spirits but not wine. Some people are fine with olive oil but not with vegetable or peanut oils.

Same guy inspired a pretty healthy habit of a high-fibre diet in myself. "You don't want chemicals and fats sitting there do you? You have to get them out man. They're not going to get themselves out are they." I take psyllium husk capsules if a day does not include high-fibre food. If traveling and eating oily, low-fibre meals? Unhappiness and stagnation. As if the digestive is the equivalent of depressed.

Food for butt, so to speak.

And of course, see a doctor.
posted by nickrussell at 2:58 AM on May 2, 2012

Take baths instead of showers, every day.
posted by mareli at 5:39 AM on May 2, 2012

And I use baby wipes, so there aren't gobs of poop hanging off my butt that's causing the itching, in case people were wondering.

Do not use baby wipes, which may well be irritating your problem with the perfumes and the chemicals. If you feel compelled to wet wipe, use Tuck's Medicated Pads, or make your own with witch hazel. You can even keep them in the freezer if you like.
posted by DarlingBri at 6:23 AM on May 2, 2012

When my kids were little and had a similar problem, the doctor suggested it was a symptom of a food allergy. It seems more likely that the wipes, soap, detergent, etc, might be causing your specific problem, but if resolving those doesn't fix it, consider allergies.
posted by instamatic at 7:54 AM on May 2, 2012