Hi, The cause for pruritus ani could be many. It could be due to fungal infection, worm infestation, sweat, stool incontinence, stool deposits due to improper maintenance of hygiene, diarrhoea, increased anal discharge, haemorrhoids, fissures, sometimes it is psychogenic etc To treat the condition Maintain hygiene, clean the area properly and keep it dry Rule out the underlying cause If due to worms deworming with medication is required If cause is stool incontinence, fissure, haemorrhoids , a consultation with surgeon to suggest appropriate treatment is required If its fungal infection usually application of a antifungal cream and dusting with antifungal powder helps. The bleeding in your case could be due to erosions from constant scratching. To treat the area empirically now, take anti histaminics like cetirizine, clean and dry the area apply a steroid antibiotic antifungal cream ( you can mix flutivate cream with candid cream and apply)for few days. However take a doctor s appointment to look for specific cause. Take care.