Sores on the buttocks can come from a wide range of causes, from infected hair follicles and friction-related skin breakdown to chronic conditions like psoriasis or hidradenitis suppurativa. The location makes this area especially prone to problems: it’s warm, often moist, subject to constant pressure from sitting, and covered by clothing that traps heat. Identifying the type of sore you’re dealing with is the first step toward getting rid of it.
Folliculitis: Infected Hair Follicles
Folliculitis is one of the most common reasons people develop sores on their buttocks. It happens when hair follicles become infected, usually by staph bacteria. The result is clusters of small bumps or pimples around hair follicles, often itchy and tender. Some fill with pus, break open, and crust over. Fungal folliculitis, caused by yeast, looks similar but tends to appear more on the back and chest. On the buttocks, bacterial folliculitis is more typical.
Anything that damages or blocks hair follicles raises your risk: tight clothing, prolonged sitting, shaving, and excessive sweating. Mild cases often clear on their own with basic hygiene changes, but deeper infections can turn into painful boils that need medical treatment.
Pilonidal Cysts
A pilonidal cyst is an abnormal pocket in the skin near the tailbone, right at the top of the buttocks crease. These cysts usually contain trapped hair and skin debris. They form when loose hairs puncture the skin and become embedded, often driven in by friction, pressure from tight clothing, cycling, or long periods of sitting. The body tries to wall off the hair by forming a cyst around it.
An uninfected pilonidal cyst may cause little or no discomfort. Once it becomes infected, though, it can be extremely painful. Signs of infection include swelling, redness, pus or blood leaking from a small opening in the skin, and sometimes a noticeable odor. Pilonidal cysts are most common in young adults, particularly those with coarse or thick body hair, and they tend to recur without definitive treatment.
Psoriasis on the Buttocks
Psoriasis is an immune-driven condition where the body produces skin cells far too quickly. Normal skin cells grow and shed over about a month. With psoriasis, that cycle compresses to three or four days, and the excess cells pile up on the surface instead of shedding.
Two types commonly affect the buttocks. Plaque psoriasis produces raised patches that look red with silvery-white buildup on lighter skin, or purple, gray, or dark brown on darker skin. These patches can crack, itch, and bleed. Inverse psoriasis (also called flexural psoriasis) appears in skin folds, including the gluteal cleft and the crease where the legs meet the buttocks. Unlike plaque psoriasis, inverse psoriasis looks smooth rather than scaly. The skin may appear red, purple, or darker than surrounding areas and feel tight. Sweat and friction in these folds tend to make it worse, causing splitting, itching, and significant discomfort.
Hidradenitis Suppurativa
Hidradenitis suppurativa (HS) is a chronic condition that causes painful lumps under the skin in areas with many sweat and oil glands, or where skin rubs together. The buttocks, groin, armpits, and breasts are the most common sites. It typically starts after puberty and before age 40, affecting roughly 0.1% to 1% of the general population.
The condition usually begins with a single painful, pea-sized lump under the skin that persists for weeks or months. Over time, more bumps form. Some break open and drain pus with an unpleasant odor. Paired blackheads in small pitted areas of skin are another hallmark. In more advanced cases, tunnels form under the skin connecting the lumps. These tunnels heal slowly, if at all, and can drain blood and pus. The course is highly variable, but HS tends to worsen over time without treatment. Scarring is common.
Herpes Simplex (Genital Herpes)
Genital herpes can cause sores directly on the buttocks. The virus produces small bumps or blisters that rupture into painful open ulcers, then scab over and heal. Sores develop wherever the infection enters the body, and they can also spread through touch to other areas.
Outbreaks tend to recur. Many people notice warning signs hours or days before new sores appear: tingling, shooting pain, or aching in the legs, hips, or buttocks. Between outbreaks, the skin looks completely normal. If you’re getting recurring clusters of blisters on the buttocks that heal and come back in the same spot, herpes is a strong possibility worth testing for.
Pressure Sores (Bedsores)
Pressure sores develop when sustained pressure on the skin cuts off blood flow to the tissue. The buttocks are one of the most common locations because of the bony prominences underneath. These sores primarily affect people who are bedridden, use wheelchairs, or have limited mobility.
Pressure sores progress through four stages. In the earliest stage, you’ll see a patch of skin that stays red (or a different color from surrounding skin in darker-toned individuals) and doesn’t lighten when pressed. Stage two involves a shallow open wound or a blister, sometimes filled with clear fluid. By stage three, the damage extends deeper into the tissue, with visible fat beneath the skin surface. Stage four is the most severe: full-thickness tissue loss exposing bone, tendon, or muscle. Catching pressure sores early makes a significant difference, since advanced stages heal very slowly and carry serious infection risk.
Friction and Chafing
Sometimes the cause is purely mechanical. Repeated rubbing from clothing, exercise, or skin-on-skin contact can break down the outer layer of the buttock skin, creating raw, irritated patches that look and feel like sores. Hot, humid conditions make this worse because moisture softens the skin and increases friction.
Chafing is especially common during running, cycling, or any prolonged physical activity. Wet clothing that sticks and bunches against the skin amplifies the problem. While chafing isn’t a disease, the broken skin it creates can become a gateway for bacterial or fungal infections if not cared for properly.
Reducing Your Risk
Many buttock sores share overlapping triggers: moisture, friction, pressure, and trapped heat. A few practical habits help address most of them:
- Choose moisture-wicking fabrics over heavy materials like cotton, especially during physical activity. Tighter-fitting underwear that stays in place creates less friction than loose garments that shift and rub.
- Manage moisture with powders that absorb sweat. Change out of wet or sweaty clothing as soon as possible.
- Reduce friction in vulnerable areas with petroleum jelly or anti-chafing balms before exercise.
- Keep the area clean and dry. Wash with mild soap and warm water, and pat dry rather than rubbing.
- Avoid prolonged sitting without breaks, especially on hard surfaces. If you’re at risk for pressure sores, shift your weight regularly.
If you have an existing sore, gently clean it, apply an unscented moisturizer or petroleum jelly, and protect it with a bandage to prevent further irritation. Sores that keep coming back, drain pus, grow deeper, or don’t heal within a couple of weeks point to something beyond simple skin irritation and warrant a closer look.