Sores on the buttocks usually come from infected hair follicles, friction, or moisture trapped against the skin. The buttocks have a high density of hair follicles, sit against surfaces for long stretches, and stay warm and humid, making the area especially prone to breakdowns. Most causes are common and treatable, but a few deserve closer attention.
Folliculitis: The Most Common Cause
Folliculitis is inflammation of hair follicles, and it’s the reason behind most buttock bumps and sores. It typically looks like a cluster of small red or white-tipped bumps, similar to a pimple breakout. The usual culprit is Staphylococcus aureus, a bacterium that lives on everyone’s skin and takes advantage when a follicle gets damaged by friction, sweat, or shaving.
A yeast-driven form called pityrosporum folliculitis can look similar but tends to be intensely itchy and doesn’t respond to antibacterial treatments. Another variant, sometimes called hot tub folliculitis, is caused by Pseudomonas bacteria found in poorly chlorinated pools, hot tubs, or water slides. That version usually appears a day or two after exposure and clears on its own within a week.
Mild folliculitis often resolves with basic hygiene: washing with a benzoyl peroxide cleanser for five to seven days, keeping the area dry, and avoiding tight clothing. If it doesn’t clear within a week or two, a topical antibiotic may be needed. For people who get repeated flare-ups, the bacteria sometimes live inside the nose and recolonize the skin. A short course of a prescription antibacterial ointment applied to the nostrils can break that cycle.
Boils and Abscesses
When a follicle infection goes deeper, it can turn into a boil (furuncle), a painful, swollen lump filled with pus. Several boils that merge together form a carbuncle. The buttocks are one of the most common sites for boils because of the constant pressure and friction from sitting.
Small boils sometimes drain and heal on their own. Larger ones, particularly anything over about half a centimeter, may need to be drained by a provider. Boils have a frustrating tendency to come back. People with recurring boils can reduce flare-ups by washing daily with an antiseptic soap containing chlorhexidine, managing underlying risk factors like obesity or diabetes, and avoiding carrying items like wallets in back pockets that create pressure points.
Hidradenitis Suppurativa
If your buttock sores keep coming back as deep, painful lumps that linger for weeks and eventually drain blood or pus, you may be dealing with hidradenitis suppurativa (HS). This chronic inflammatory condition targets areas where skin rubs together: the armpits, groin, buttocks, and under the breasts. It’s not caused by poor hygiene.
Early HS can look a lot like ordinary folliculitis or boils, which is why it’s frequently misdiagnosed for years. The key differences are depth and behavior. Folliculitis bumps sit at the surface, respond to antibiotics, and clear up. HS lumps are deeper, feel like pea-sized nodules under the skin, and return in the same areas. Over time, HS can form tunnels (sinus tracts) beneath the skin that connect separate lumps and ooze chronically. These tunnels heal very slowly, if at all.
HS affects an estimated 1 to 4 percent of the population and tends to start after puberty. If this description matches your experience, getting an accurate diagnosis early matters because treatment options work better before tunneling develops.
Herpes Simplex Virus
Herpes isn’t limited to the genitals. The same virus can cause clusters of small, painful blisters on the buttocks, thighs, or around the anus. These blisters rupture into shallow ulcers, then scab over and heal, typically within two to three weeks for a first outbreak and faster for recurrences.
A hallmark of buttock herpes is prodromal symptoms: tingling, shooting pain, or an aching sensation in the legs, hips, or buttocks in the hours or days before sores appear. The pattern of recurring sores in the same spot, preceded by that tingling warning, is a strong signal. A provider can confirm the diagnosis with a swab or blood test, and antiviral medication shortens outbreaks and reduces how often they happen.
Friction and Moisture Rashes
Intertrigo is a rash that develops wherever skin folds trap heat and moisture, and the crease between the buttocks is a prime location. It starts as redness and irritation from friction alone, but that damaged skin quickly becomes a breeding ground for secondary infections. The most common invader is Candida, a yeast that thrives in warm, moist environments. A Candida-infected intertrigo rash typically has a bright red center with smaller “satellite” spots around the edges, and it may develop a foul smell or produce discharge.
Keeping the area clean and dry is the foundation of treatment. After bathing, dry the skin thoroughly, especially in folds. Moisture-wicking underwear helps more than cotton in high-friction areas. Avoid harsh soaps, products with alcohol, and scented wipes, all of which strip the skin’s protective barrier.
Contact Dermatitis
Sometimes the sores aren’t from an infection at all but from something your skin is reacting to. Allergic or irritant contact dermatitis on the buttocks can be triggered by fragrances or preservatives in toilet paper, wet wipes, laundry detergent, or fabric softener. Formaldehyde (used as a preservative in some body washes), dyes in underwear fabric, and antibiotic creams are other known triggers.
The rash usually appears as red, itchy, sometimes blistered skin confined to the area that contacted the irritant. Switching to fragrance-free, dye-free products and unscented toilet paper often resolves it within a couple of weeks. If you recently changed brands of any product that touches the area, that’s the first thing to reverse.
Pressure Sores
People who sit for very long periods, use a wheelchair, or are bedridden are at risk for pressure sores on the buttocks. These develop when sustained pressure cuts off blood flow to the skin over bony areas like the tailbone and sit bones. The earliest stage looks like a patch of skin that stays red (or, on darker skin, stays blue or purple) and doesn’t lighten when you press on it. Left unaddressed, the damage progresses to an open wound that can eventually reach muscle or bone.
Prevention centers on regular repositioning. If you sit for extended hours at work, shift your weight frequently and stand when you can. Properly fitted clothing without thick seams or rivets reduces friction. Keeping skin clean and moisturized, while avoiding powders, helps maintain the skin’s integrity.
Signs That Need Prompt Attention
Most buttock sores are minor and heal with basic care. A few warning signs point to something that needs medical evaluation sooner rather than later: a sore surrounded by expanding redness, warmth, or swelling (which suggests spreading infection), fever alongside any skin sore, drainage that smells foul, sores that keep recurring in the same location over months, or deep lumps that never fully heal. These patterns can indicate conditions like MRSA, hidradenitis suppurativa, or herpes that benefit from specific treatment rather than general wound care.