Anal itching, also referred to as pruritus ani, is a rash or irritation of the skin just outside of the anal opening. Usually raw and chapped, small ulcers or sores may also be present on the skin. This can cause severe itching, burning and even pain. Dry toilet paper cannot remove all of this stool material. Therefore, it leaves a thin layer on the anal skin which dries and irritates the skin. This dryness and irritation of the anal skin can be made worse by soaps and vigorous washing. Anal itching can be very painful and uncomfortable, often lasting for long periods of time.

An anal fissure is a tear in the lining of the lower rectum anus. It can itch and cause pain. You may notice bright red blood on toilet paper after you wipe. A fissure may form if you are constipated and try to pass a large, hard stool or if you do not relax your anal muscles during a bowel movement.

And they will just think it is a consequence of having sex. People should know that anal fissures can be treated and that there are things you can do to help heal them. They can bleed—a lot.