well, I used to notice it just at night, but over time now, without much improvement, it is during the day as well. I went to a colo-rectal doctor yesterday and she says it's puritius ani. She doesn't think it's pinworms becasue I've been on the strong medication and it didn't improve. I do have some hemmoroids, but this would not cause this kind of itch, but could contribute to it not really being able to clear up. I now have to treat this like an allergy, elimating caffiene, tomatoes, citrus etc... I am not convinced, but will go along with it for now. She says in any case, this puritius ani is hard to treat.