A scratchy butt could be caused by many factors, from hemorrhoids to pinworms to improper wiping. Here's how to figure out the source of the itch and how to treat it. 

By Emily Elveru
Updated: May 13, 2019
Pixabay/mintchipdesigns

If your child keep scratching his butt, you might assume that he isn’t wiping well enough. But pinworms (yep, worms) are the most notorious reason for a constant itchy heinie.

Pinworms are often spread in day-care or classroom settings where 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 his anus, which causes irritation. If you notice he’s itchy only at night, the simplest way to diagnose him is to shine a light down there and look. If you see little white strings, he’s got pinworms. Luckily, there are a number of medications that will get rid of pinworms. (Ask your doctor which to use.)

No worms in sight? The butt scratching could be due to something else, like hemorrhoids—small, usually external anal outpouchings that look like grapes and arise from constipation or straining while pooping. Apply hydrocortisone cream to the area two times a day for a week and offer fiber supplements to get things moving.

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.

Leftover poop from incomplete wiping can lead to itchiness too. If you suspect (or know) that’s an issue, consider using baby wipes until your kid is more skilled with regular toilet paper. Give him 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. 

Source: Ari Brown, M.D., Parents advisor and a pediatrician in Austin, Texas.

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