Rashes are kind of the worst, no matter where they are on your body—but getting one on your butt? That’s a whole ‘nother level of misery. (Have you ever discreetly scratched a butt itch in public? No, because you can’t.)
Inconvenience aside, they’re also a little concerning. Sure, that small bump on your butt could just be a pimple, but what if it’s a bit more serious—say, a little bigger and redder and kind of painful? Can you treat it with an over-the-counter cream, or do you need to make an appointment with your doc? Don’t stress just yet—I’ve got your butt rash guide.
Check out these signs of the most common rear-end rashes—along with their treatments—to help you decide.
1. If the rash is: wrinkled and smudgy
It’s probably: cutaneous t-cell lymphoma.
“A lot of people miss this diagnosis. I see it all the time. They call it eczema, they call it dry skin, and it’s not,” says Adam Friedman, MD, FAAD, professor of dermatology at GW School of Medicine and Health Sciences. Cutaneous t-cell lymphoma is a type of skin cancer, relating to abnormal immune cells called lymphocytes. And this condition has a predilection for areas that are covered.
So if you see wrinkled, smudgy kind of rashes on your skin, you should talk to your derm ASAP. While this cancer isn’t super common, Dr. Friedman says it can turn into a more serious health situation when not treated.
2. If the rash is: itchy, shiny white and near the anus
It’s probably: lichen sclerosis.
This one involves the perianal area. According to Dr. Friedman, it’s thought to be an autoimmune disease where the immune system is attacking the skin, thinning its top layer, and thickening the bottom part where your hair follicles and sweat glands are.
“This condition is exquisitely itchy,” he says. It’s usually treated aggressively with steroids. And if left untreated, the disease can quickly turn into squamous cell carcinoma, another skin cancer type.
You want to look out for a kind of shiny, white-appearing rash in the anal area. When active, Dr. Friedman says, the edges of the rash will sometimes turn purple.
Again, a biopsy is needed to diagnose this disease, so if you’re starting to see a similar rash, give your doc a call ASAP.
3. If the rash is: flesh-colored dry bumps that turn red from inflammation
It’s probably: keratosis pilaris
Have you never heard of it before? Don’t worry; it’s a relatively harmless rash. Go ahead and touch your butt. Do the bumps back there feel like sandpaper? If so, you might have keratosis pilaris caused when excess skin grows over where a hair follicle would usually come out. People often experience keratosis pilaris on the back of their arm and thighs, but it can occur on the butt.
If you think you’re suffering from keratosis, head to your closest drug store. You’re going to want to buy something known as a keratolytic, a kind of therapy that treats excess skin. Just make sure yours contains ingredients like urea and ammonia lactate.
4. If the rash is: a cluster of painful or burning red bumps and blisters
It’s probably: a herpes outbreak.
Herpes is typically thought of as something that can only affect your mouth and genitals, but it can crop up on your butt, too, says Joshua Zeichner, MD, director of cosmetic and clinical research in dermatology at Mount Sinai Hospital.
When the virus flares up—due to stress or illnesses that weaken your immune system—it can come to the skin’s surface, causing a rash, explains Dr. Zeichner. The rash will probably go away on its own in about a week, but it’s contagious through direct contact, so it’s best to avoid getting too intimate. You can also try an OTC cold-sore medication or see your dermatologist for a prescription antiviral to clear up the outbreak faster, says Dr. Zeichner.
5. If the rash is: a red circle with a white scaly ring around it
It’s probably: a fungal infection.
If you’ve ever picked up athlete’s foot (aka ringworm or tinea corporis) from your gym’s locker room, you’ve seen this fungus before—and, yeah, it can show up on your butt, too.
It thrives in hot, humid environments, so working out in the summertime (or sitting around in sweaty workout clothes or steam rooms) increases your risk, says Dr. Zeichner. He recommends treating the rash ASAP with an athlete’s foot cream, so it doesn’t spread; apply it twice a day for one to two weeks and see your doctor if it doesn’t go away.
6. If the rash is: unbearably itchy and around the anus
It’s probably: pinworm.
This is a kind of rash that would take place in your gluteal crack or perianal area. But it actually stems from an intestinal worm infection. “The worm comes out of the anus and implants eggs into skin folds,” Dr. Friedman says—and this causes severe itch.
In order to find out if you have a pinworm, a dermatologist would take tape, put it on your perianal area, and pull it off. What’s left on the tape will be examined using a microscope—and that’s where they’ll be able to see the pinworms and treat you with an anti-parasite medication.
7. If the rash is: red with tender, pimple-like bumps
It’s probably: folliculitis.
Most people call this “butt acne,” but that’s not entirely accurate, says Dr. Zeichner. Those pimple-like bumps are superficial infections of the hair follicles—otherwise known as folliculitis.
Mild cases may be helped by washing with antibacterial soap. Dr. Zeichner recommends washing with a surgical-grade cleanser like Hibiclens or an acne-treatment wash with benzoyl peroxide for recurring situations. To prevent future outbreaks, keep the skin clean and dry (especially after workouts) and wear breathable fabrics.
8. If the rash is: a beefy red color with puss-filled bumps
It’s probably: a yeast infection.
Most people consider yeast infections strictly vaginal. But this type of infection can occur in skin folds on the body (like the butt!).
What people don’t understand is that yeast is not the problem itself. “We have yeast everywhere, as it’s part of our microbiome,” Dr. Friedman says. What’s actually happening is that people are experiencing intertrigo or irritant dermatitis, inflammation of the skin in skin folds caused by poor hygiene and friction. Yeast (which is a fungus) may overgrow in the inflamed area, leading to infection.
Helpful clues: Look for a beefy, red, angry-looking rash on your butt, closer to your perianal area. You might see satellite pustules, or small pus-filled bumps situated slightly away from the main rash area.
As far as treatment goes, OTC ointments or creams for yeast infections should do the trick.
9. If the rash is: red plaques covered in white scales and located inside your butt crack
It’s probably: psoriasis.
In this chronic (and often genetic) condition, your body’s immune system “gets angry and attacks the skin,” says Dr. Zeichner. Psoriasis usually shows up on elbows and knees, but in between the butt cheeks is a familiar spot, too.
You can treat it with a 1 percent hydrocortisone cream, but prolonged use can damage your skin. If it’s not going away, check in with your doctor for a prescription-strength anti-inflammatory cream.
10. If the rash is: patchy and itchy, sometimes with tiny red bumps
It’s probably: eczema.
Eczema is an inflammatory skin condition that causes the skin to dry out and crack—often caused by genetics, irritants, or allergies. According to Dr. Zeichner, these microscopic cracks develop in the outer layer of skin, so the key to treatment is hydrating and repairing the skin barrier with moisturizers and anti-inflammatory creams.
Eczema on your butt may be caused by irritating fabrics, detergents, toilet paper, or cleansing wipes, so be mindful of what’s coming into contact with your skin back there.
11. If the rash is: super itchy and on your anus
It’s probably: hemorrhoids.
Straining during bowel movements (thanks, chronic constipation, or pregnancy) causes hemorrhoids, which are swollen and dilated blood vessels around your anus. These protrusions are itchy, painful, and hard to ignore.
They’re pretty standard and can be treated with OTC witch hazel pads or hemorrhoid ointments. Still, Dr. Zeichner recommends getting medical attention (or a G.I. evaluation) if they’re causing you to bleed during bowel movements—that’s something you never want to ignore.
12. If the rash is: red and itchy with acne-like bumps
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It’s probably: miliaria (aka heat rash)
Heat rash occurs when sweat-duct openings become blocked, which can happen when wearing tight-fitting clothing that traps in sweat and bacteria.
“That trapping results in an inflammatory response,” Dr. Friedman says. But don’t worry, heat rashes are easily treatable with a little OTC medication. Dr. Friedman recommends antibacterial washes or acne washes that contain benzoyl peroxide or salicylic acid. Pro tip: benzoyl peroxide can stain, so be careful when applying.
13. If the rash is: pink, swollen, and sometimes watery
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It’s probably: an allergic reaction.
Unlike a heat rash (which is often caused by irritation), other rashes are sparked by allergic reactions.
Here’s how to spot the difference: Irritant rashes are often itchy and hurt like crazy, Dr. Friedman says. The bumps will appear raised and tend to be a darker pink to red color. Rashes caused by an allergic reaction are often more swollen, pink, and maybe even watery. Head to your doctor’s office if you’re unsure what you’re dealing with, so they can provide the proper treatment or medication. Rashes are kind of the worst, no matter where they are on your body—but getting one on your butt? That’s a whole ‘nother level of misery. (Have you ever discreetly scratched a butt itch in public? No, because you can’t.)
Inconvenience aside, they’re also a little concerning. Sure, that small bump on your butt could just be a pimple, but what if it’s a bit more serious—say, a little bigger and redder and kind of painful? Can you treat it with an over-the-counter cream, or do you need to make an appointment with your doc? Don’t stress just yet—I’ve got your butt rash guide.
Check out these signs of the most common rear-end rashes and their treatments—to help you decide.
