Why does haemorrhoids cause anal itching, and how can I treat it?

In general, surgery is recommended for cases not responding to other non-surgical treatment methods such as oral medication, local therapy or band ligation. In cases with advanced grade or severe disturbing symptoms including recurrent bleeding, constant pain or discomfort due to thromobosis, surgery may be advised as a more definitive treatment method. Just as an aside, rubber band ligation is not suitable for all cases. External piles should not be treated with band ligation due to the rich nerve supply around the anal skin. Doing so can be too painful for anyone to bear.

May I ask if are there any concomitant vaginal discharge or bowel symptoms? The complaint of just isolated itch alone is a little unusual, especially if there are no skin changes. In essence you would need it to be looked at by a doctor, and two main conditions excluded – either pinworms or lichen sclerosus. If both are ruled out by the doctor, then you might want to consider perhaps a short course of topical corticosteroids eg mometasone cream.