Butt Rashes: Causes, Diagnosis, and Treatment

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Rashes are uncomfortable no matter where they occur, but there’s something especially upsetting about discovering a new butt rash. It’s common to put off treating it for fear of having to see the doctor. Fortunately, there are plenty of common reasons and simple treatments for skin rashes that appear on the buttocks. 

Skin irritation or infection can lead to an itchy rash, and scratching the itch can worsen the irritation. Many types of butt rashes can be safely treated at home with over-the-counter medications or home remedies. And if you do need to see your doctor, try not to worry; they have seen it all before. 

woman holding her butt

Rattankun Thongbun / Getty Images

Common Causes

The most common causes of butt rash usually start with skin irritation. Sometimes a small cut, new laundry detergent, moisture, sitting, or sweating can irritate the skin, and then scratching leads to redness and more itching. 

Contact Dermatitis

Contact dermatitis occurs when your skin comes in contact with a substance that irritates the skin and causes symptoms like redness, itching, or burning. Possible substances that could cause a rash on your butt include soaps, shower gels, lotion, laundry detergent, or new underwear. Contact dermatitis can also occur if you are allergic to a substance. 

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

The best way to heal a rash from contact dermatitis is to figure out which substance is irritating your skin and remove it from your routine. In the meantime, do your best to avoid scratching and try a home remedy to calm down the redness and itching. A cool compress or oatmeal bath may feel soothing to your skin. An over-the-counter hydrocortisone cream could also provide some much-needed relief. 

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. Eczema is believed to be caused by a mix of genetic and environmental factors. It’s usually treated with moisturizers or topical steroids. 

Eczema is not contagious and cannot be spread. If you tend to experience hay fever or asthma, you may be more at risk of developing an eczema rash on your skin.

The treatment for eczema is similar to that for contact dermatitis. Avoid any irritants, and ease the pain and itching with cool compresses and a hydrocortisone cream. If you don’t notice any improvement after trying home remedies, see your dermatologist. 

Yeast Infection

A yeast infection occurs when the yeast Candida grows at an out-of-control rate and causes an infection. This yeast usually lives on the skin and in the body without causing any issues. However, when it starts to overgrow, it can lead to an itchy, uncomfortable infection.

Yeast thrives in warm, moist places like skin folds, so it’s not uncommon to experience a yeast infection near or around the anus. The heat and moisture that can generate around the anus make it an ideal environment for yeast overgrowth. It’s estimated that up to 40% of cases of anal itching can be attributed to a yeast infection. 

Common yeast infection symptoms include redness and itching. This infection requires an antifungal medication to be treated. See your doctor if you believe that you’ve developed a yeast infection on your butt. Your doctor will be able to diagnose your condition and prescribe the right antifungal treatment. 

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 grease or dirt enters the follicle, an acne-like breakout occurs.

Acute folliculitis usually comes on quickly after the hair follicles have been damaged. Possible causes of damage include shaving, rubbing the skin, wearing tight clothing, or skin folds rubbing together. If the skin is damp and hot, such as the skin around the anus, an infection can occur. 

If you have recently developed acne on your butt, think about the activities you did before it occurred. Spending time in a hot tub or biking on a hot day can damage the hair follicles and encourage bacteria growth in the hair follicles. Folliculitis may be itchy and slightly painful. 

Fortunately, most cases of folliculitis go away on their own when you have a healthy immune system. Using a warm compress a few times per day could help provide some relief and allow the hair follicles to soften. Once folliculitis on the butt clears up, 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 that 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 tinea cruris. 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. Ringworm can often be treated at home with over-the-counter antifungal creams. If you don’t notice any relief after using the cream as directed, see your doctor for testing and treatment. 

Miliaria (Heat Rash)

If your butt rash came on after spending the day outdoors in the heat and humidity, you may have heat rash. Heat rash is common in the groin area, including the buttocks, and 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, first move indoors or to a cooler area. Change out of sweaty clothes and do your best to keep the area clean and dry. Applying a small amount of powder may help with the itching. Steer clear of any lotions or ointments since these products will only add more moisture and make heat rash worse.

Heat rash usually resolves on its own. If you begin to experience other symptoms of being out in the heat like muscle cramps, exhaustion, nausea, or dizziness, move to a cooler area right away to rest and rehydrate. 

Genital Herpes

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

Herpes sores usually appear as blisters on the lower back or buttocks and around the anus; they may also present around the mouth or genitals. When the blisters break, they leave open, painful sores.

Herpes is contagious, especially when someone has open blisters. Only a doctor can diagnose herpes. While there is no cure, the condition can be managed. 

Hemorrhoids

Hemorrhoids can sometimes be mistaken as a rash on the butt. This common condition is not a rash at all, but swollen veins, similar to varicose veins. Internal hemorrhoids are located inside the rectum and cannot be seen from outside the body. External hemorrhoids, on the other hand, appear around the anus and may feel like a rash. 

Hemorrhoids can cause intense itching, as well as pain, discomfort, and bleeding. They are often the result of straining to have a bowel movement. To help prevent hemorrhoids, prevent constipation with plenty of water and fiber in your diet. Opt for fresh fruits and vegetables often, as well as whole grains. Physical activity can also help prevent constipation, which puts pressure on the veins in and around the anus. 

Pinworm

A less common cause of butt rashes is pinworm, 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. The itching is caused when the female worm lays her eggs in the skin. As awful as this sounds, it is relatively easy to treat. Your doctor will usually prescribe either mebendazole, pyrantel pamoate, or albendazole to both kill the pinworm and prevent future infections. 

To diagnose pinworm, your doctor will most likely use a piece of transparent tape to take a sample from around the anus. The tape is then examined for pinworm eggs under a microscope. 

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 patches on the skin. It is possible to experience psoriasis patches on the butt or in the 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.

If you suspect that you are experiencing psoriasis, see your dermatologist. They will help determine the right diagnosis and prescribe treatment. The first line of treatment usually involves a steroid ointment, with stronger options available if needed.

Less Common Causes

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 your dermatologist 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 tiny 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, then apply a quality moisturizer regularly to prevent dry skin. If self-care at home is not showing any results, see your dermatologist. 

Intertrigo

Intertrigo is a type of dermatitis caused by the skin rubbing against itself (such as the skin in a skinfold), leading to moisture and friction. Symptoms include inflammation, redness, and scaling. This may occur near the anus or between the buttocks and backs of thighs. Once the skin is irritated, a bacterial or fungal infection could occur. 

See your doctor if you’re concerned that you could be experiencing intertrigo. Treatment will depend on the extent of the skin irritation, as well as the type of infection. 

Shingles

Shingles is caused by the herpes zoster virus and 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 presents. The rash itself is made up of 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. 

See your doctor to find out if you have shingles and start treatment. To provide some relief from the rash, try over-the-counter pain medicines, cold compresses, oatmeal baths, and calamine lotion. Your doctor may also prescribe an antiviral medication to shorten its duration. 

Lichen Sclerosus

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

Lichen sclerosus can also lead to painful sex, urinary retention, and constipation. If you are concerned that you may be experiencing lichen sclerosus, see your doctor right away to start corticosteroid therapy and have regular appointments to monitor your condition. 

Cutaneous T-Cell Lymphoma

Cutaneous T-cell lymphoma is a rare type of blood cancer that first presents as a rash on areas of the body 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, one will develop flat patches of dry skin, followed by red, raised, itchy patches. As the cancer spreads, the patches of skin may turn into raised plaques and tumors that split open and look like sores. 

If you have been treating a rash that looks like eczema that isn’t improving, see your dermatologist. 

Home Remedies

The first step in treating a rash at home is also the hardest: stop scratching. Easier said than done is an understatement, but scratching further irritates the skin and causes the rash to become more intense. Choose home remedies that help soothe the itch, including:

  • Oatmeal bath
  • Cool compress
  • Calamine lotion
  • Fragrance-free moisturizer (test on a small patch of skin first)
  • 1% hydrocortisone cream

Help prevent skin irritation by using gentle soaps and lotions on your buttocks that do not contain artificial dyes or scents. Always wash new clothes and underwear before wearing them to wash away any residue from production or shipping. Opt for a gentle laundry detergent made for sensitive skin. 

If your rash is near your anus, keep that area clean and dry to help soothe the rash. Use a soft toilet paper to gently wipe after bowel movements. Do your best to avoid getting any stool in the rash, as this could cause more irritation.

Try to avoid rubbing too vigorously or scrubbing in the shower since this could lead to further irritation. After a shower, gently pat the rash dry and choose loose cotton underwear. 

If you’re concerned that you have been experiencing hemorrhoids, incorporate a fiber supplement into your diet to prevent constipation and straining. 

When to See a Doctor

Many butt rashes can be treated at home. However, if home remedies are not providing improvement after a few weeks, see your doctor. Call your doctor if you develop bleeding from the rectum or a fever in addition to a rash. Other signs that it’s time to see the doctor right away include:

  • The rash comes on suddenly and spreads quickly. 
  • The rash begins to blister and leaves open sores.
  • The rash becomes painful.
  • The rash has signs of infection, such as yellow or green pus, inflammation, crusting, or pain.

Diagnosis

Your doctor will begin by taking an extensive history from you about when the rash started, how it feels, what makes it worse or better, and what remedies you have already tried. They will then examine the rash. Your primary doctor may be able to determine the diagnosis, but if not, will most likely refer you to a dermatologist. 

At your first dermatology visit, the doctor will ask you questions about the rash and any new soaps or products that you have been using. Once your dermatologist examines the rash, they may order diagnostic tests. Many rashes can be diagnosed with a thorough history and physical exam. Others, however, may require lab tests. 

If your dermatologist suspects a fungal infection, they may obtain a fungal culture by scraping off part of the scaly rash and sending it to the lab for examination under a microscope. If your doctor suspects you have a pinworm infection, they will obtain a skin sample using a piece of transparent tape, then examine it under a microscope to look for pinworm eggs. 

Treatment

The treatment for a butt rash will depend on its cause. Your doctor may recommend starting with a steroid cream to help calm the inflammation and itching. Rashes caused by yeast or ringworm require antifungal medications. 

If your doctor prescribes a steroid like prednisone, be sure to take it exactly as directed. It’s common to want to cut back on the medication once the rash clears up, but doing so could lead to a rebound rash. This occurs when a steroid is abruptly stopped, and the rash comes back more intensely than before.

A Word From Verywell

A butt rash is a pain in the, well, you know. Fortunately, most cases of butt rash can be quickly and easily treated at home. Keep the area clean and dry to help prevent irritation. Soothe the itch with calamine lotion or oatmeal baths.

If home remedies are not helping, see your doctor. They will help you determine the cause of your rash, as well as an effective treatment. If your rash ever becomes painful or looks infected, see your dermatologist right away.

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