Itching around the anal area with red rashes is commonly caused by worm infestation (especially pinworms), fungal infection, or local skin irritation due to sweat, poor hygiene, or tight clothing. The sensation of something moving is often reported in worm infections, especially at night. For treatment, a doctor may prescribe a deworming medicine such as albendazole (usually a single dose, sometimes repeated after 2 weeks) if worms are suspected, along with maintaining strict hygiene like washing hands regularly, keeping nails short, changing and washing undergarments daily, and cleaning the anal area gently with water and keeping it dry. If there is a rash or fungal infection, an antifungal cream may be needed. Avoid scratching as it can worsen irritation and infection. If symptoms persist, worsen, or if there is severe itching, pain, or discharge, it is important to consult a doctor for proper examination and treatment.