Why Does My Kid Keep Scratching Their Butt?

Your child keeps scratching their butt—what's up with that? If you already know that pinworms (yep, worms) are a notorious reason for a constantly itchy heinie in kids, you might be freaking out a little. While you'll definitely want to rule them out, there are actually plenty of other reasons for a child to have an itchy bottom that aren't worms.

Keep reading to learn about common reasons your child is itching their bum and how to resolve the problem.

Common Reasons for an Itchy Butt in Kids

So your kid is constantly scratching their bottom, which probably means they have an itchy bum—and that's unpleasant for everyone. To stop the itch, you'll need to identify the problem. Here are some of the most common reasons kids get an itchy butt.

Pinworms

Pinworms are often spread in daycare or classroom settings where young kids share mats or toys. The tiny parasites can hang out in your child's rectum during the day and come out at night to lay eggs on the outside of their anus, which causes irritation.

If you notice that your child is only itchy at night, the simplest way to diagnose them is to shine a light down there and look. If you see little white strings, you've got a pinworm problem. Luckily, pinworms are very common and easy to treat.

According to the Centers for Disease Control and Prevention (CDC), pinworms can easily be treated with medication. There are both prescription and over-the-counter medications, so you'll want to consult a health care provider about which one will be best for your child. Typically, your child will be given a single dose and a follow-up dose around two weeks later to clear up the pinworms.

Yeast infection

According to Boston's Children's Hospital, candidiasis, which is a yeast infection caused by a fungus known as Candida, can happen almost anywhere on the body, including inside the vagina and anus. Sometimes, the fungus can overgrow in the intestines, causing an infection, which can appear in the anus—hence the itchy bottom.

Signs of an anal yeast infection include:

• Persistent itchiness
• Red, irritated skin
• Pain or bleeding from scratching
• Possibly discharge

Vaginal and anal yeast infections can be easily treated with medicated suppositories. Talk to a health care provider about possible causes and prevention, as an overgrowth of candidiasis could be a sign of an underlying condition such as diabetes, a compromised immune system, or other illness.

Hemorrhoids

Hemorrhoids don't just affect adults; kids can get them too. Little research has been done on kids and hemorrhoids, and what we know about the causes and treatment of hemorrhoids is largely from adult studies, but constipation and the resulting straining while pooping is one common cause.

Hemorrhoids can cause pain and irritation around the anus but they can also be extremely itchy, which might explain all the scratching. If you think your child has hemorrhoids, talk to a health care provider for diagnosis and treatment, particularly if your child has chronic constipation and hemorrhoid symptoms.

A health care provider may recommend applying hydrocortisone cream to the area and offering extra fiber to get things moving if constipation is the likely culprit. You can also look at your child's diet and lifestyle to find ways to increase water, fiber, and exercise.

Perianal strep infection

Strep throat can also cause skin irritation in the anus and vagina. Most children will have other symptoms of the illness, like fever, sore throat, or loss of appetite, but a wicked red rash could be the only sign, so it's worth a doctor's visit.

According to the National Library of Medicine, perianal streptococcal cellulitis is an infection of the anal area that is caused by the same streptococcal bacteria that causes strep throat. If a child touches their mouth or nose during a strep throat infection, they can then pass that bacteria to their bottom when wiping after going to the bathroom.

Symptoms of an anal infection include:

• Redness around the anus
• Fever
• Bleeding during bowel movement
• Itching

A strep infection of the anus requires a diagnosis and treatment from a health care provider. Your child will likely be prescribed a 10-day antibiotic treatment as well as mupirocin, an antibacterial topical cream to help soothe the area.

Incomplete or over wiping

Leftover poop from incomplete wiping can lead to itchiness too. If you suspect (or know) that's an issue for your child, consider going back to the basics of toilet hygiene. Depending on their age, you might consider assisting in the bathroom until you're confident in their wiping skills. You might also consider re-introducing baby wipes until your kid is more skilled with regular toilet paper.

But some kids are really, really good at wiping and can inadvertently over-wipe, causing dry, itchy skin around the anus. Either way, they'll need some coaching to get the process figured out and avoid the itchy bum.

Atopic dermatitis or eczema

According to the National Eczema Association (NEA), atopic dermatitis is a common form of eczema that's caused by an overactive immune system. This skin condition affects more than 31 million people and is often first spotted and diagnosed in childhood. Since eczema can occur anywhere on the body, it is not unusual to find patches of affected skin around the anus.

Symptoms of atopic dermatitis include:

• Red, patchy, dry skin
• Rashes that weep, ooze, or bleed when scratched
• Affected skin that's thickened or hardened
  

Talk to your child's doctor about effective treatments to help manage eczema. The NEA suggests these safe, at-home remedies to soothe an eczema itch temporarily:

• Oatmeal baths
• Cold compresses
• Skin cleansers with a low pH
• Soft, breathable clothing

Other possible causes

Sometimes kids (and adults, for that matter), can get an itchy butt for some pretty random reasons. If you've ruled out pinworms, infections, hemorrhoids, and incomplete wiping (to name a few), consider these other possible causes for an itchy derrière:

• Foods such as caffeine, citrus, chocolate, and spicy foods
• Skin tags and anal fissures
• Diarrhea
• Fecal incontinence
• Dampness from sweat or sitting in wet clothes or a bathing suit (aka "swamp butt")
• Chafing from tight clothes or "wedgies"
• Allergic reactions to detergent, soaps, or lotions

What Makes an Itchy Butt Worse?

The first thing to do when your child has an itchy bottom is to assess and address the root cause. Not only is an itchy bottom incredibly uncomfortable, but it could be a sign of something more serious.

To keep your child's itchy butt from feeling worse, avoid tight or damp clothes, excessive heat, and known allergens. If the itchiness persists, consult a health care provider.

To prevent your child from spreading germs and turning that itchy bottom into a bigger problem, give them this refresher course in proper hygiene: Always wash your hands after touching private parts, and if you really need to scratch, grab a wipe or a tissue—and then wash your hands again.

When To Call the Doctor

An itchy anus is not considered a medical emergency, but if you see any bleeding, call your doctor to rule out gastrointestinal bleeding or other problems. Your child's doctor can help you identify the cause of the itchiness and tell you about prevention and treatments.