Why Do Hemorrhoids Itch? What Causes the Uncomfortable Sensation and How To Stop It

If you’ve ever dealt with hemorrhoids, you may have noticed an unpleasant side effect: itching. This common symptom, sometimes called pruritus ani, can also come with burning, irritation or discomfort around your bottom.

But the reason hemorrhoids itch isn’t always as simple as it may seem. In many cases, the hemorrhoids themselves aren’t the main issue.

Colorectal surgeon Arielle Kanters, MD, explains why hemorrhoids itch, how to find relief and when it’s time to see a healthcare provider.

Why do hemorrhoids itch?

First of all, hemorrhoids themselves usually aren’t the problem. “Hemorrhoids are a consequence of something else going on,” clarifies Dr. Kanters. “If you treat the underlying issue, the itching often gets better.”

There are a few reasons why you might experience itching. Sometimes, it’s a mix of irritation, moisture and inflammation.

Dr. Kanters explains what might be going on.

Bowel habits and inflammation

Constipation, straining to poop or spending too much time on the toilet can put extra pressure on the veins in your anus. When there’s ongoing pressure, it can cause them to swell.

This swelling can trigger inflammation. That inflammation releases chemicals like histamine, which can cause an itchy feeling.

These habits are often the root cause behind hemorrhoid symptoms, says Dr. Kanters.

Moisture from mucus or seepage

Swollen or prolapsing hemorrhoids can leak mucus. At times, there may also be a small amount of stool (poop) leakage. That constant moisture can irritate your skin and lead to itching.

The skin around your butthole is very delicate — it can easily be damaged. It isn’t meant to have poop leakage and moisture sitting on it.

“When that area stays damp or irritated, the skin can start to break down. It’s kind of like a diaper rash,” says Dr. Kanter. It can lead to burning, stinging or itching.

Too much scratching or wiping

When something itches, your first instinct may be to scratch or wipe. But frequent or aggressive scratching or wiping can cause tiny tears in your skin.

That irritation can make itching worse. It can create a cycle of itching and wiping that’s hard to break.

Why does it feel worse at night?

Many people notice that hemorrhoid itching feels worse at night, and there are a couple of reasons why.

For one, you’re less aware of your habits when you’re tired or asleep. “During the day, you might stop yourself from scratching,” Dr. Kanters notes. “At night, that self-control goes down.”

Your muscles also relax when you sleep. This can lead to a little more moisture or mucus leaking in the area, which can trigger itching.

How to relieve the itching

Relief from hemorrhoid itching isn’t just about quick fixes. The most effective approach is to protect your skin and address the underlying cause.

Protect your skin with a barrier

Barrier creams can help shield irritated skin from moisture.

Dr. Kanters recommends zinc oxide over products like petroleum-based ointments or traditional hemorrhoid creams. Those can focus on shrinking swollen veins instead of protecting irritated skin.

“Zinc oxide acts like a liquid bandage,” she explains. “It protects your skin so moisture doesn’t keep irritating it.”

Use gentle, low-friction cleaning

Avoid using wipes. And steer clear of products like witch hazel or anything with fragrance or alcohol. These can dry out your skin and make irritation worse. Plus, they target the symptoms (like swelling) but not the underlying problem.

Instead, gentle rinsing (like with a bidet) and patting dry can help reduce irritation.

“You don’t need to over-clean the area,” Dr. Kanters stresses. “Doing less is often better.”

Keep it cool and dry

Scratching and wiping can make symptoms worse.

Cooling products that contain menthol can help calm itching. These ingredients work by interrupting the itch signal. It’s similar to how a minty lip balm can soothe chapped lips.

But keeping the area dry is key, too.

Tight clothing, sweating or prolonged moisture can all make symptoms worse. Reducing friction and keeping skin dry can help prevent irritation.

Improve your bowel habits

Long-term relief often comes from fixing what’s causing the irritation in the first place. A good first step may be to add a fiber supplement.

“Fiber is kind of the universal normalizer,” Dr. Kanters says. “It can help soften hard stools or bulk up loose ones, making bowel movements easier and cleaner.”

If you’re adding fiber, increase slowly and drink plenty of water (about 2 liters a day) to avoid gas or discomfort. Always talk with a provider before starting any kind of supplement.

Other ways to prevent hemorrhoids include:

• Avoid straining.
• Spend fewer than five minutes on the toilet.
• Don’t use your phone while you go.
• Consider a small footstool (like a Squatty Potty®), which can help support a more natural position for bowel movements.

When to see a provider about ongoing itching

Occasional itching is common. But if your symptoms don’t improve with basic care, it’s important to get checked.

“If you’ve tried the simple things and you’re still having symptoms, we need to know about that,” Dr. Kanters advises.

A provider should always evaluate persistent itching, skin irritation or bleeding. Symptoms that seem like hemorrhoids may be caused by something else, including skin conditions or more serious issues.

The key is not to ignore ongoing symptoms. Getting the right diagnosis can help you find the right treatment and rule out anything serious.