Both internal and external hemorrhoids can cause serious itching and burning in the anal area, but why this should be remains a mystery to many people.

External hemorrhoids are a bit easier to answer, after all they're quite near a sensitive band of nerves, but how do hemorrhoids that are inside the body cause itching and burning on the outside? Hemorrhoids as a whole cause these symptoms both directly, due to their very existence and behaviour, and indirectly through other biological reactions.

Hemorrhoids cause itching and burning directly when they become inflamed.

When inflammation occurs anywhere in the body, the blood vessels swell up, lymph fluid fills and swells intercellular spaces, pain nerves fire, and immune cells launch at the area in question trying to solve the problem. If tissue is irritated too much by just about anything, from abrasion to bacterial attack, inflammation is usually the body's first line of defense.

In addition to creating a hostile environment for a bacterial or viral invader, it serves to alert the brain that something is wrong and damage has occurred.

While this is a good thing for our continued survival because we wouldn't live very long if we didn't know when we'd hurt ourselves, inflammation can easily be too much of a good thing. Once you know that an area of the body needs attention, it would be nice if you could turn the pain off. Fortunately, medications exist that allow you to do just that.

For a problem with an external hemorrhoid, many of the hemorrhoidal creams on the market today contain a topical anesthetic that will block pain within minutes. If it's an internal hemorrhoid causing the problem, ibuprofen tablets or capsules are the best because ibuprofen serves as both a painkiller and an anti-inflammatory.

Multiple indirect causes of itching due to hemorrhoids also exist.

Internal hemorrhoids can irritate the mucus membrane lining the anal canal into producing excess mucus in order to lubricate the area. This mucus escapes the anal sphincter, gets onto the skin surrounding it on the outside, and dries there. This both dries out and irritates the area.

In addition, the demand that an inflamed internal hemorrhoid puts upon the surrounding blood vessels can cause feelings of itching and burning as more blood moves faster, causing minute swelling throughout the entire area.

Finally, a sufficiently large internal hemorrhoid can cause extremely low-grade fecal incontinence, which of course causes itching and burning both from the fecal matter drying on external skin and the possible rash and infection that fecal incontinence can bring.

External hemorrhoids indirectly cause itching and burning through different means.

Of course, when an external hemorrhoid gets inflamed it hurts, itches, and burns directly.

However, if we give in to the urge to scratch or scrub, we upset the delicate balance of the skin surrounding the anal sphincter. There are several oil producing glands within that skin that normally serve to clean and lubricate the area. If we, through scratching, scrubbing, or applying harsh chemicals strip away those natural oils, itching is pretty much a foregone conclusion. In addition, by stripping those oils away we open ourselves to surface infections, which only makes the problem worse and sets up a vicious cycle.

The best solutions to itching and burning around the anal area are to take frequent sitz-baths in warm, plain water, use a soothing cream containing cocoa butter or a similar moisturizer, pat the area gently with either a medicated pad or plain, soft moistened toilet paper, and wear loose fitting cotton underwear. Loose cotton underwear will serve to wick excessive mucus or incontinence away from delicate skin without rubbing or scratching.

In addition, avoid harsh cleansers, soaps, or chemicals of any kind. Only use medicated pads and creams specifically formulated for this area of the body.

While you can't use external hemorrhoid creams inside the body, if an internal hemorrhoid is causing external irritation, one of the external hemorrhoid creams that has combines a moisturizer with a topical anesthetic may provide relief from the external itching and burning.

If hemorrhoid symptoms do not get better within a week, or if you can't manage to control them enough to proceed with a fairly normal day, you may need to see a doctor.

That being said, there is no reason to suffer horrendous symptoms that interfere with your daily activities due to hemorrhoids. By getting a sound education on hemorrhoidal cause and effect and applying that knowledge together with common sense, you can get on with life.