Hi doctor, i suffer from an itch in my ass and this is not because of worms. so please help me?

Hemorrhoids: If not pinworms, it may be hemorrhoids, even small ones. You should get it evaluated by your primary care doctor.

Depends: Approximately half of patents with pruritis ani have an underlying cause (hemorrhoids, fissure, fistula, anal warts, etc), ...Typically in the other half of patients there is no obvious underlying cause and treatment is then directed to avoiding trauma (excessive wiping/scratching) and short courses of steroid creams.