A Bump Between the Buttocks: Identifying the Cause and Knowing What to Do

A pimple between the buttocks is not like other pimples. The gluteal cleft is a closed, warm, and moist fold where the skin rubs against itself all day long: lesions that appear there are nothing like those on the rest of the buttocks. Folliculitis, pilonidal cysts, Verneuil’s disease, or intertrigo—each requires a different treatment. And one rule applies above all else: a painful lesion near the anus or at the bottom of the cleft always warrants a visit to the doctor.

For the skin on the buttocks itself, a body treatment for blemishes helps with daily care; but deep within the crease, the situation is different. Here’s how to identify each cause, relieve it, and prevent it from recurring.

The gluteal cleft: a unique area

Three factors set this skin fold apart from the rest of the skin on the buttocks. It is occluded, without ventilation, and in a state of constant maceration. It is warm and moist, creating an ideal environment for bacteria or yeast. And it is hairy, with often coarse hairs that easily penetrate the skin at the base of the fold. As a result, common skin imperfections—comedones, blackheads, and folliculitis—are rare there. Instead, the conditions found there tend to involve inflammation of one or more hair follicles and intertrigo.

The Six Causes of a Pimple Between the Buttocks

• Folliculitis: inflammation of the hair follicle, caused by bacteria (staphylococcus) or, in some cases, a fungus. Small, red bumps centered around a hair, which are tender and may sometimes itch. Moisture makes the condition worse.
• A boil: a deep, red, hot, and very painful form of folliculitis that forms a white head of pus. Discussed in detail in the section on painful buttock pimples
• Pilonidal cyst: the most common cause of the gluteal cleft. A cavity at the top of the cleft, near the tailbone, formed around hairs embedded under the skin. It may remain asymptomatic for years, then suddenly become infected.
• Verneuil's disease (hidradenitis suppurativa): painful, recurrent nodules in skin folds, often diagnosed years too late—even though early treatment makes all the difference.
• Intertrigo: irritation or a fungal infection at the base of a skin fold, caused by maceration. It is more of a red, oozing, itchy lesion than an actual pimple, and is common in the summer.
• Ingrown hairs: After shaving or waxing, a hair grows back under the skin and forms a small, painful red bump. Tips for getting rid of them without damaging the skin.

As for the factors common to the entire buttocks—friction, sweating, and hygiene—all of them are detailed in the section on the causes of pimples on the buttocks.

There are two situations that require immediate medical attention: a perianal abscess (near the anus, warm, very painful, often accompanied by a fever), which requires surgery and can develop into a fistula; and any unusual growth or lesion in the area, which should be examined. These conditions are not treated with cosmetic procedures.

Recognizing a Pilonidal cyst

This is a diagnosis you shouldn't overlook, because it isn't treated like a pimple. Warning signs to watch for:

• A location at the top of the crease, near the tailbone—not on the buttock.
• A small dimple or a visible opening from which hairs sometimes grow.
• A swelling that grows larger, turns red, becomes warm and painful, makes it impossible to sit, and oozes pus.
• A recurrence in the same place—that's typical.

Pilonidal cysts mainly affect young men who are hairy, overweight, or spend long hours sitting. A clinical examination is usually sufficient for diagnosis, and treatment involves surgery if an abscess develops: no cream will cure it.

What to Do—and, Most Importantly, What Not to Do

You should never lance a boil between the buttocks. Squeezing it pushes the infection deeper, can make it worse, and leaves a scar. In an area that isn't well ventilated and is close to the anus, the risk of complications is higher than elsewhere.

• Gently clean the area morning and night with mild, unscented soap, making sure to rinse the crease thoroughly.
• Dry thoroughly by patting: this is the most effective method, since residual moisture keeps the wound from healing.
• Apply a warm compress for ten minutes, three times a day, to a maturing boil to speed up drainage.
• A mild topical antiseptic for use on broken skin, when used as directed.
• Avoid friction: wear cotton, nothing tight, and spend as little time as possible sitting on the area.
• Do not apply salicylic acid, exfoliants, or essential oils to an open wound, in a skin fold, or near mucous membranes: these active ingredients are intended for preventive use on the skin of the buttocks, not in the crease.

When to See a Doctor or Dermatologist

In this area, the threshold for seeking medical attention is lower than elsewhere. Seek medical advice if the pimple is painful and swollen, if there is pus or a fever, if the redness spreads, if the lesion is near the anus, if it recurs in the same spot, if there is discharge, or if you have diabetes, are immunocompromised, or are taking medication that weakens your immune system.

The doctor performs a clinical examination and tailors the treatment: antiseptic, topical or systemic antibiotics, antifungal medication if the cause is fungal, incision and drainage of an abscess, surgery for a pilonidal cyst, and sometimes laser hair removal for recurrent folliculitis. None of these treatments can be improvised, and none can be adapted from a prescription intended for the face.

Preventing the development of rashes between the buttocks

• Always dry the groin area thoroughly after a shower, bath, or swim, and change your clothes immediately after exercising.
• Wear cotton and breathable fabrics every day, and avoid tight-fitting and synthetic clothing.
• Space out or adjust how often you shave the area: shaving too frequently can lead to ingrown hairs and pilonidal cysts. Gentle exfoliation two days beforehand helps prevent hair from growing back under the skin.
• Moisturize the skin around the crease without occluding the underlying skin to maintain an effective hydrolipidic film.
• Getting up regularly when you have a sedentary job: a simple habit that's worth more than any product.

When applied to the skin of the buttocks, Fesse Time (lactic acid) can also be used to treat body acne. For the intimate area and surrounding mucous membranes, South Beauty soothes and protects.

FAQ

This article is published for informational purposes only; it is not a substitute for medical advice.