Some sexually transmitted infections (STIs), such as anal herpes or gonorrhea, can cause rectal itching. However, it is also possible that the itching results from other conditions, such as anal fissures or hemorrhoids.

In this article, we will discuss which STIs can cause rectal itching, and how to treat them. We also look at other conditions that can cause rectal itching.

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Gonorrhea is the result of the Neisseria gonorrhoeae bacteria.

According to the Centers for Disease Control and Prevention (CDC), gonorrhea is a very common STI, affecting around 1.14 million people in the United States every year.

People can contract it via sexual contact with the genitals, mouth, or anus of a person who has gonorrhea.

Symptoms of rectal gonorrhea include:

  • anal discharge
  • anal itching
  • soreness and bleeding
  • painful bowel movements

However, not everyone with rectal gonorrhea will have symptoms. That is why it is important to have regular STI screenings.

Learn more about gonorrhea here.

Treatment

Treatment for gonorrhea involves a combination of ceftriaxone and azithromycin, which are antibiotics.

It is important that a person abstains from sexual activity for 1 week after treatment. This helps prevent passing the infection on to others.

Anal herpes is the result of herpes simplex virus type 1 or herpes simplex virus type 2.

People can contract herpes if they come into contact with:

  • herpes lesions
  • mucosal surfaces, such as the vagina or rectum
  • genital and oral secretions

Symptoms of anal herpes include:

  • small blisters that burst, leaving inflamed and open sores
  • tingling, burning, or itching sensation
  • pain while urinating

The CDC note that most people who have herpes are asymptomatic, meaning that they do not have any symptoms. Others may only experience very mild symptoms.

If symptoms do appear, the first outbreak of herpes lasts for approximately 2–4 weeks, and a person may also experience flu-like symptoms.

Learn more about anal herpes here.

Treatment

To diagnose herpes, doctors will take a culture of a sore or perform a blood test.

There is currently no cure for herpes. However, doctors can prescribe antiviral medications.

These can shorten the amount of time an outbreak lasts and reduce the chance of passing this infection on to others.

Anal warts are the result of the human papillomavirus (HPV). One 2020 article notes that approximately 10% of people who have HPV will develop genital warts.

Symptoms of anal warts include:

  • individual or large masses of warts around the anal area
  • warts that may bleed
  • itching or discomfort

Learn more about anal warts here.

Treatment

There is no cure for anal warts. However, the article states that 80% of people will spontaneously clear the infection within 18–24 months.

A doctor can surgically remove the warts or prescribe topical agents.

Rectal itching may not be the result of an STI.

The following can also cause a person to experience an itchy anus. However, the list is not exhaustive, and therefore a person should contact a doctor if they are experiencing rectal itching.

Yeast infection

An anal yeast infection occurs when there is an overgrowth of the Candida bacteria.

One 2016 article notes that Candida infections are present in approximately 10% of those experiencing an itchy anus.

Although an anal yeast infection is not an STI, a person can transmit or develop it via anal sex without the use of a condom or other barrier method.

Alongside itching, a person may experience:

  • burning
  • anal discharge
  • flushed or irritated skin
  • soreness

Learn more about anal yeast infections here.

Hemorrhoids

Hemorrhoids, or piles, are swollen veins that appear inside and around the anus.

Symptoms of internal hemorrhoids include:

  • itching, bleeding, pain, or burning in the anus
  • mucous discharge from the anus
  • swelling

Learn more about hemorrhoids here.

Anal fissure

Anal fissures are tears in the skin in the rectum and anus. The United Kingdom’s National Health Service (NHS) note that the majority of cases typically occur due to constipation or large stools that tear the lining of the anal canal.

However, anal fissures may occasionally occur due to STIs, such as syphilis or herpes. This is because they can infect and damage the anal canal.

Some anal fissures can last for more than 6 weeks.

Symptoms of anal fissures include:

  • bleeding when passing a bowel movement
  • itching around the anus
  • intermittent pain while passing a bowel movement

Learn more about anal fissures here.

Pinworms

Pinworms are small thin white roundworms called Enterobius vermicularis. The CDC state that pinworm infection is the most common worm infection in the U.S.

People can contract pinworms after ingesting pinworm eggs. This can happen after swallowing the eggs that may be present on fingers, clothing, food, and other contaminated objects.

While a person sleeps, the female pinworm travels to the anal area and lays its eggs around the anus.

Symptoms can be mild, and some people do not experience any. However, the most common symptom is rectal itching. Other symptoms may include:

  • redness and swelling
  • watery diarrhea
  • abdominal pain

A person may also be able to see the worms and their eggs on the skin near the anus approximately 2–3 hours after a person falls asleep.

Learn more about pinworms here.

Irritants

Certain irritants can lead to skin conditions, such as eczema or psoriasis. This can lead to anal itching, inflammation, swelling, and pain.

The most common irritants that may cause anal itching include:

  • soaps
  • shampoos
  • recycled toilet paper
  • intimate hygiene wipes
  • certain foods, especially those that contain nickel

A person should always contact a doctor if they are concerned that they have contracted an STI.

However, according to the NHS, a person can try the following to provide relief from the itching:

  • gently washing and drying the anus after having a bowel movement, and before bed
  • wearing loose-fitting cotton underwear
  • bathing or showering in lukewarm water
  • eating plenty of fiber, such as fruit and vegetables and pasta
  • avoiding wiping after having a bowel movement, and instead washing with water or using moist toilet paper and patting dry
  • avoiding scratching on and around the anus
  • avoiding fragranced products, such as soaps
  • avoiding eating spicy food and drinking alcohol and caffeine

It is important to contact a doctor if a person is concerned that they have contracted an STI or if a sexual partner informs them that they have an STI.

People should also consult a doctor if any rectal itching does not resolve.

Several STIs can cause anal itching, such as herpes, anal warts, and gonorrhea. However, with medical treatment, people can manage the symptoms or cure the infection.

Rectal itching can also occur due to other conditions, such as anal fissures, irritants, or hemorrhoids.

Although a person may be able to manage the itching at home, it is important to contact a doctor if they are concerned or if the itching does not resolve.