Definition

• Itching of the anus
• Occurs on a repeated basis

Health Information

Causes

• There are many causes of itching around the anus.
• The most common cause is stool that has been left on the skin. Stool contains chemicals and germs that can cause itchy skin rashes.
• A bubble bath and other soaps can also cause an itchy bottom.
• Pinworms are tiny, harmless worms that live in the colon (large bowel).
• They are a less common cause than irritation from soap or stool.

Care Advice

1. Overview:
   • There are many causes of itching around the anus. Some are more common than pinworms.
   • The most common cause is stool that has been left on the skin.
   • Treat the common causes.
   • If the changes don’t get rid of the anal itching, get a pinworm test.
   • Here is some care advice that should help.
2. Anal Cleansing:
   • Try to keep stool off the skin around the anus
   • After wiping off stool with toilet tissue, cleanse the skin with warm water. Do not use soap.
   • A bubble bath can also cause an itchy bottom. Children with dry skin are at special risk. Avoid bubble bath or sitting in any soapy bath water.
3. Steroid Cream:
   • For itching, wash the skin around the anus with warm water.
   • For severe itch, use 1% hydrocortisone cream 2 times per day.
   • Use for 1 or 2 days. No prescription is needed.
4. Look for Pinworms:
   • Examine the area around your child’s anus, using a flashlight.
   • Look for a ¼-inch (6 mm), white, threadlike worm that moves. (If it doesn’t wiggle, it’s probably lint or a thread.)
   • The worm may be seen around the anus or on the child’s bottom.
   • Rarely, the pinworm is seen on the surface of a stool.
   • Do this a few hours after your child goes to bed. Check him 2 nights in a row.
   • Also, check him first thing in the morning for 2 days.
5. Scotch Tape Test:
   • If no adult pinworm is seen, call your doctor’s office. Ask for instructions on doing a Scotch-tape test for pinworm eggs. You can also use the technique below:
   • Take a piece of clear Scotch tape (with the sticky side down). Touch it to the skin on both sides of the anus. Do this in the morning soon after your child has awakened. Also, do this before any bath or shower.
   • Put the sticky tape side that touched the skin on a slide. If you don’t have a slide, put it on a second piece of tape.
   • Do it 2 mornings in a row.
   • Bring the 2 samples in to be looked at under a microscope.
6. What to Expect:
   • Anal itching should be better in 2 days.
   • Itching should be gone by 1 week or less.

Call Your Doctor If

• Pinworm is seen
• The skin around the anus gets red or tender (could be Strep)
• Anal itching lasts more than 1 week
• You think your child needs to be seen
• Your child becomes worse

Author: Barton Schmitt MD, FAAP

Copyright 2000-2020 Schmitt Pediatric Guidelines LLC

Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it. The information contained in this handout should not be used as a substitute for the medical care and advice of your pediatrician. Listing of any resources does not imply an endorsement.

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