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My Child Is Scratching Their Bottom, But It's Not Worms - What Could Be Behind Anal Itching In Children.

  • Writer: Johanna
    Johanna
  • Jan 12
  • 3 min read

If your child keeps scratching their bottom, sits restlessly, or says that it "itches down there," many parents immediately have one thought:

"Please, no worms."


This concern is perfectly understandable. At the same time, medical experience offers some reassurance: in most cases, there is no serious underlying illness, and often no worms either.


Anal itching ( pruritus ani) is a common symptom in children and has many possible causes. This area of skin is particularly sensitive and reacts quickly to irritation, moisture, or minor changes.


Important: Itching is a signal from the body, not a diagnosis.



Itchy bottom scratching children
©Mylittlesprout


  1. The most common causes in children


    1. Remaining stool residue after using the toilet, or when small amounts leak unnoticed (stool smearing), retain stool


    2. Moist skin and friction


    3. Frequent or vigorous wiping


    4. Too much hygiene: moist toilet paper with fragrances; soaps or washes in the intimate area


    5. Constipation , hard stools, resulting in anal fissures - small tears in the mucous membrane.


    6. Irritant allergic contact dermatitis : caused by fragrances on toilet paper, personal care products, synthetic clothing, detergents, etc.


    7. Dietary causes: very spicy or heavily seasoned foods, acidic foods, citrus fruits, a diet high in sugar, which promotes diarrhea.


    8. Fungal infection (mycosis): Favored by persistent moisture, recent antibiotic therapy, and damaged or very sensitive skin. Typical symptoms include intensely reddened, sharply defined, often shiny skin with small red dots at the edge of the redness. Treatment involves targeted antifungal creams after medical evaluation.


    9. Skin diseases can also be involved, e.g., atopic dermatitis (eczema), perianal eczema. Typical symptoms include: redness, scaly or thickened skin, sometimes weeping sores.


    10. Rare : Psoriasis, Lichen sclerosus (Chronic skin disease)


    11. Psychological or emotional factors : Stress, tension, and pressure can intensify itching.


    12. Or could it be worms? >>>Read about worms in children here<<<




  1. What helps your child?


The goal is to protect and soothe the skin, not to over-care for it.

-Relieve skin - protect it - break the scratching cycle-


  • Less is often more here.

  • After a bowel movement, gently clean with lukewarm water.

  • Soft toilet paper or moist cotton wool for cleaning.

  • Allow skin to dry thoroughly or pat dry gently.

  • Loose cotton underwear

  • Keep nails short

  • Apply a thin layer of unscented protective cream once or twice a day >>>read more in the following section

  • Light cotton gloves may be worn at night.


    Avoid:

  • Fragrance in personal care products, no soap in the anal area

  • Moist toilet paper due to allergic reactions to chemical additives in the wipes

  • Bubble bath or intimate wash products

  • Spicy food, salty foods, nuts, chocolate, dairy products or citrus fruits, and, for older children, caffeinated and alcoholic drinks.



Keep an eye on bowel movements

  • Pay attention to soft, regular bowel movements

  • Drink enough fluids and promote exercise



  1. When is it advisable to use creams on children?


Applying creams can help if it's targeted, short-term, and uses the right products . Too much or the wrong kind of cream can worsen the itching .


Important: Always apply thinly! Thick layers clog the skin too much.


Creaming is especially recommended for:

  • irritated, dry or reddened skin

  • irritant dermatitis (e.g., caused by stool, moisture, friction)

  • small skin tears or incipient fissures

  • Itch-scratch cycle



Which creams are suitable?


a. Barrier creams – Well-documented and safe for children.


They protect the skin from moisture and irritants. Especially helpful for:

  • moisture

  • Slight fecal soiling

  • Irritated skin


Suitable ingredients include:

  • Zinc oxide (applied thinly)

  • Panthenol

  • Oily creams without fragrances



b. Moisturizing basic care


Useful for dry, sensitive skin.

Goal: To stabilize the skin barrier


Recommended are:

  • Unscented, hypoallergenic cream

  • The shortest possible list of ingredients



c. Creams with active ingredients - as recommended by a doctor


Can help with:

  • severe itching

  • inflamed skin

  • pronounced itch-scratch cycle



What should you avoid?


The following are not recommended :

  • Combination ointments “against everything”

  • Ointments containing fragrances or essential oils

  • Zinc in very thick, occlusive layers

  • frequent switching between different creams

  • long-term use of cortisone without medical supervision


Important: Some children have allergic reactions to creams, which can worsen the itching.



  1. When should you take your child to the doctor?

You should urgently clarify:

  • Blood in stool

  • purulent discharges

  • severely inflamed, thickened skin


A visit to the doctor is advisable if:

  • The itching persists for several days and no improvement occurs.

  • the redness is very pronounced, sharply defined, or painful

  • the skin visibly changes

  • Pain during bowel movements

  • Weeping, open, or worsening skin lesions develop.

  • Your child is clearly suffering or sleeping poorly

  • additional fever or feeling unwell may occur



Many parents are afraid of "doing something wrong". But when itching occurs, the following often applies:

Protect, calm, observe, and do not overtreat.





As of January 2026

Resources:




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