Butt Rashes: Causes, Diagnosis, and Treatment (2024)

There are many reasons why you may have a rash or sores on your butt. They may be due to the abrasion and irritation of the skin from wearing tight clothes or bicycle riding. It may also be caused by an allergic reaction, chemical irritant, or a viral, fungal, or bacterial skin infection. Scratching can make symptoms worse.

Many butt rashes and sores can be treated with over-the-counter (OTC) medications and home remedies.Others may require prescription drugs or specialist treatment by a healthcare provider like a dermatologist.

This article describes some of the more common causes of butt sores and rashes, including how they are diagnosed and treated.

What Does a Butt Rash Look Like?

A rash on the buttocks can differ in appearance. The rash may look like tiny bumps or blisters, raised welts, open sores, or dry, crusty lesions. They may be widespread or limited to a certain area. They may be itchy, painful, hot, prickly, or cause no notable symptoms at all.

The characteristics of the rash or sore can provide clues as to the cause.

There are different ways to describe a rash:

• Macules: Flat lesions less than10 millimeters (mm) in diameter
• Papules: Raised lesions less than 10 mm in diameter
• Plaques: Flat or raised lesions over10 mm that have a different texture to the surrounding skin
• Nodules: Firm lesions or bumps that extend into the lower layers of the skin
• Vesicles: Clear, fluid-filled blistersless than10 mm in diameter
• Bullae: Clear, fluid-filled blistersover10 mm in diameter
• Pustules: Vesicles that contain pus
• Urticaria; Raised welt with well-defined borders (also known as hives)
• Ulcers: An open sore that extends to underlying layers of the skin
  

Common Causes of a Butt Rash or Sore

The most common cause of a rash on the buttocks is skin irritation. But there are other causes like infections and abnormal immune reactions that can also cause butt sores and rashes.

Here are some of the more common causes of a butt rash or sore:

Contact Dermatitis

Contact dermatitis occurs when your skin comes in contact with a substance that irritates it and causes symptoms like redness, itching, or burning.

Substances that can cause contact dermatitis include:

• Soaps
• Shower gels
• Lotion
• Laundry detergent
• New underwear

Contact dermatitis can also occur if you are allergic to a substance.This kind of skin irritation is called allergic contact dermatitis.

Contact dermatitis usually causes intense itching, a red rash, and dry skin. You may also experience burning, stinging, hives, or blisters. Scratching often makes the symptoms worse.

The best way to heal a rash from contact dermatitis is to identify the irritant and avoid it. Home remedies, like a cool compress or oatmeal bath, may feel soothing and calm the redness and itching.

An OTC hydrocortisone cream could provide ease inflammation and itchiness, while an OTC antihistamine can provide relief from allergic contact dermatitis.

Eczema (Atopic Dermatitis)

Eczema, also known as atopic dermatitis, is a common skin condition that causes inflammation in the skin. The most common symptom is a red, itchy, inflamed rash. It’s also possible to experience cracked skin that “weeps” clear liquid.

Experts believe genetic and environmental factors cause eczema. Healthcare providers usually treat it with moisturizers or topical steroids.

Eczema is not contagious. If you tend to experience hay fever or asthma, you may be at greater risk of developing an eczema rash.

The treatment of eczema is similar to that of contact dermatitis. Avoid any irritants, and ease the pain and itching with cool compresses and hydrocortisone cream.

Yeast Infection

A yeast infection occurs when Candida grows at an out-of-control rate and causes an infection. Candida is a type of fungus that usually lives on the skin and in the body without causing any issues. When it overgrows, it causes an infection called candidiasis.

Yeast thrives in warm, moist places like skin folds. It can cause a fungal infection between the buttocks or on other parts of your body such as the groin and inner thighs. In addition, the heat and moisture that can form around the anus make it an ideal environment for yeast overgrowth.

Common yeast infection symptoms include redness and itching.

This infection can usually be treated with an OTC antifungal cream or ointment. Prescription topical and oral antifungals may be needed for severe infections.

Folliculitis (Butt Acne)

Folliculitis is a common skin infection that appears as pimple-like sores on the skin. If you have noticed acne on your butt that is not itchy, it could be folliculitis.

Folliculitis refers to an infection of the hair follicles. Once germs enter the follicle, an acne-like breakout occurs.

Acute folliculitis usually comes on quickly after the hair follicles have been damaged. If the skin is damp and hot, such as the skin around the anus, an infection can occur.

Possible causes include:

• Shaving
• Rubbing the skin
• Wearing tight clothing
• Skin folds rubbing together

If you have recently developed acne on your butt, review the activities you did before it occurred. For example, spending time in a hot tub or biking on a hot day can damage hair follicles and encourage bacteria growth.

Most cases of folliculitis go away on their own. Even so, using a warm compress a few times per day could help provide some relief and allow the hair follicles to soften. Once folliculitis clears, avoid shaving that area for at least a month.

To help prevent folliculitis on the butt, avoid tight underwear and clothing, especially when it is hot and humid out. If you choose to shave the area, use a quality moisturizing shaving cream and shave with the grain to avoid damaging the hair follicles.

Ringworm

Another fungal infection that can cause a butt rash is tinea cruris, also known as ringworm. Jock itch is a common infection caused by ringworm. Because this fungus thrives in warm, moist environments, the groin area is a common site of an infection.

A fungal infection around the anus can cause both itching and pain. The rash is usually red and raised in the shape of a circle or ring.

It’s more common to experience ringworm in warm weather when sweat and moisture are more likely to get trapped in the skin folds. You can often treat ringworm at home with OTC antifungal creams.

Heat Rash

If your butt rash came on after spending the day outdoors in the heat and humidity, you might have miliaria (heat rash).

Heat rash is common in the groin area and buttocks. It looks like clusters of bright red pimples or small blisters. Heat rash forms in areas of the body that can trap heat and moisture.

To treat heat rash:

• Moving indoors or to a cooler area.
• Changing out of sweaty clothes.
• Keeping the site clean and dry.
• Applying a small amount of baby powder to help ease the itching.

Heat rash usually resolves on its own. However, if you begin to experience other symptoms of heat exhaustion like muscle cramps, exhaustion, nausea, or dizziness, move to a cooler area to rest and rehydrate.

Genital Herpes

Genital herpes is a sexually transmitted infection caused by the herpes simplex virus. Many people with herpes have no symptoms, while others experience recurrent outbreaks with open sores.

Herpes lesions can appear as blisters on the lower back or buttocks and around the anus. Blisters may also develop around the mouth or genitals. When the blisters break open, they leave painful, ulcerative sores.

Herpes is contagious, especially when someone has open blisters. Only a healthcare provider can diagnose herpes. While there is no cure for herpes, the condition can be managed with antiviral drugs.

Hemorrhoids

People sometimes mistake hemorrhoids for a rash on the butt. However, this common condition is not a rash but is caused by swollen veins (similar to varicose veins) in and around the anus. They are often the result of straining to have a bowel movement.

Internal hemorrhoids are located inside the rectum, and you cannot see them. On the other hand, external hemorrhoids appear around the anus and may feel and look like a rash.

Hemorrhoids can cause intense itching and pain, discomfort, and bleeding.

OTC hemorrhoid creams can help ease the swelling, pain, and itching. Increasing your intake of dietary fiber can make stools softer, reducing stress during bowel movements as the hemorrhoid heals.

Severe cases may need specialist treatments like rubber band ligation in which the hemorrhoid is tied off to reduce blood flow and shrink the swollen vessel.

Pilonidal Cyst

A pilonidal cyst is a small, fluid-filled pocket that forms just above the cleft of the buttocks.

The cyst is characterized by a noticeable lump or bump on the skin. The bump can be small like a pimple or much larger and can cause pain when sitting or bending over. It can also make the top of your butt crack sore and itchy.

A pilonidal cyst may be accompanied by redness, swelling, and drainage of pus or blood. Sometimes there are no symptoms other than the lump itself.

The cysts don't usually need treatment, but if you have one that is irritated or painful, see your healthcare provider. In such cases, the cyst can bedrained after numbing the skin with alocal anesthetic,

Pinworm

Pinworm is a parasitic infection caused by the roundworm Enterobius vermicularis. While it can affect anyone, pinworm is more common in young children, people who live in institutional settings, and anyone who lives with someone with a pinworm infection.

Pinworm causes mild itching in and around the anus, and some people have no symptoms at all. However, when the worm lays eggs in the skin, it causes itching.

To diagnose pinworm, your healthcare provider may apply a piece of transparent tape to the anus. They will then examine the tape under a microscope for evidence of pinworm eggs.

As concerning as pinworm sounds, it is relatively easy to treat. Your healthcare provider will usually prescribe anti-parasitic drugs like mebendazole, pyrantel pamoate, or albendazole to kill the worm and prevent future infections.

Psoriasis

Psoriasis is a chronic autoimmune condition that occurs when the body makes new skin cells too quickly. Rather than sloughing off like normal, old skin cells accumulate and form dry, itchy plaques on the skin. It is possible to experience psoriasis patches on the butt or groin area.

The most common type of psoriasis, plaque psoriasis, presents as thick, raised patches of dry skin. The patches are usually itchy and get worse with scratching.

The first line of treatment usually involves a steroid ointment. Severe cases may require oral or injected immunosuppressants like Cosentyx(secukinumab), Enbrel(etanercept), or Humira(adalimumab) that temper the overactive immune response.

Less Common Causes of a Rash on the Butt

While most cases of butt rash are common and easily treated, others are a bit more complex. The less common causes require a visit to a healthcare provider and prescription treatment.

Keratosis Pilaris

Keratosis pilaris, sometimes referred to as “chicken skin,” is a benign skin condition that causes tiny, red bumps on the skin. These little bumps are plugs of dead skin cells and are usually dry and itchy. Keratosis pilaris is harmless and usually resolves on its own.

To treat keratosis pilaris, gently exfoliate your skin in the shower and then regularly apply a quality moisturizer to prevent dry skin. If self-care at home is not showing any results, see a healthcare provider or dermatologist.

Creams containing alpha hydroxy acid, lactic acid, salicylic acid or urea help loosen and remove dead skin cells. Creams derived from vitamin A called topical retinoids can help unblock blocked hair follicles.

Intertrigo

Intertrigo is dermatitis caused by the skin rubbing against itself, leading to moisture and friction. Symptoms include inflammation, redness, and scaling.

This condition may occur near the anus or between the buttocks and backs of the thighs. Once the skin is irritated, a secondary skin infection can occur as bacteria enter breaks in the skin.

The treatment will depend on the extent of the skin irritation and the type of infection you have. Many are treated with topical or oral antibiotics along with low-potency topical steroids.

Shingles

The herpes zoster virus causes shingles. It leads to a painful rash on one side of the body or face. Most people with shingles first notice pain, numbness, and tingling before the rash appears.

The shingles rash causes blisters that usually scab over in about seven to 10 days and clear up within four weeks. Other shingles symptoms include fever, headache, chills, and upset stomach.

Shingles need to be seen by a healthcare provider. Antiviral drugs like Zovirax (acyclovir), Valtrex (valacyclovir), or Famvir (famicyclovir) may be prescribed to reduce the severity and duration of the infection. OTC pain medicines and cold compresses can help ease the pain.

Lichen Sclerosus

Lichen sclerosus is a chronic condition that occurs most frequently in post-menopausal people. This rare disease causes thin, white skin patches around the genitals and anus. Other symptoms include redness, itching, and pain. These patches of skin may tear or bleed.

Lichen sclerosus can also lead to painful sex, urinary retention, and constipation. If you develop symptoms of lichen sclerosus, see a healthcare provider. They will likely start topical steroids to reduce inflammation along with itching and pain.

Cutaneous T-Cell Lymphoma

Cutaneous T-cell lymphoma is a rare type of blood cancer that first appears as a rash on body areas that don’t get much sunlight. Diagnosing it can be tricky since the rash resembles eczema.

The red rash is usually itchy at first. Over time, flat patches of dry skin develop, followed by red, raised, itchy patches of skin. As cancer spreads, the patches of skin may turn into raised plaques and tumors that split open and look like sores.

Depending on the stage of cancer, the treatment of cutaneous T-cell lymphoma may involve topical retinoids, photodynamic therapy. chemotherapy, radiation therapy, immunotherapy, and targeted therapy.

Treating a Rash on the Butt at Home

The first step in treating a rash at home is also the hardest: You need to stop scratching. Scratching further irritates the skin and causes the rash to become more intense.

Use home remedies that help soothe the itch, including:

• Oatmeal bath
• Cool compress
• Calamine lotion
• Fragrance-free moisturizer
• 1% hydrocortisone cream

In addition, you should:

• Keep the area clean and dry.
• Use a soft toilet paper.
• Avoid rubbing too vigorously or scrubbing in the shower.
• Gently pat the rash dry after a shower.
• Wear cotton underwear.
• Use gentle soaps and lotions.
• Avoid artificial dyes or scents.
• Wash new clothes and underwear before wearing them.
• Use a mild laundry detergent made for sensitive skin.

Diagnosis

A healthcare provider will begin by taking an extensive history from you. Be prepared to answer questions about the following:

• When did the rash start?
• What does it feel like?
• What makes it worse or better?
• What remedies you have already tried?

Your healthcare provider will then examine the rash. If they cannot determine the cause, they may refer you to a dermatologist.

Diagnosis may involve:

• A medical history and exam
• Culture of the rash to look for a bacterial, fungal, or viral infection
• KOH test to detect the presence of skin fungus
• Skin prick or patch testing to check for skin allergies
• Antinuclear antibody (ANA) blood test to check for autoimmune disease
• Skin biopsy to obtain a skin sample for evaluation in the lab
  

How to Prevent Butt Rash

Some types of butt rashes can't be prevented, but you can take steps to prevent those caused by friction or irritation. If you experience frequent rashes, try these tips:

• Use fragrance-free laundry detergent and body cleansers.
• Wear loose-fitting clothing made from breathable, moisture-wicking fabrics.
• Apply petroleum jelly or a light emollient lotion to help minimize friction.
• Use an antiperspirant to prevent sweating.
• Change out of sweaty clothes right away.

Summary

Butt rashes can be caused by common conditions like skin infections, hemorrhoids, allergies, irritants, heat, and autoimmune diseases like psoriasis. Less commonly, they may be caused by things like lichen sclerosus and cancer.

Many causes of butt rash can be treated at home with self-care or over-the-counter medications. If your rash doesn't respond to home care, see your healthcare provider. You may need prescription drugs or specialist procedures to help clear the rash.