A bump in or around your butt is almost always one of a handful of common, treatable conditions. The most likely causes are hemorrhoids, pilonidal cysts, perianal abscesses, skin tags, or warts. While the location can feel alarming or embarrassing, the vast majority of these bumps are benign and resolve with straightforward care.
Where exactly the bump is, what it feels like, and whether it’s painful can help you narrow down what’s going on.
Hemorrhoids: The Most Common Cause
Hemorrhoids are swollen blood vessels in or around the anus, and they’re by far the most frequent reason people notice a bump in this area. External hemorrhoids sit just outside the anal opening and typically feel like a soft, tender swelling. They often cause itching, discomfort, and sometimes bleeding, especially during bowel movements.
Internal hemorrhoids are higher up inside the rectum, so you usually can’t see or feel them. Their main sign is painless bright red blood on toilet paper or in the bowl. Sometimes an internal hemorrhoid pushes through the anal opening (called a prolapsed hemorrhoid), which can feel like a bump and cause pain.
A thrombosed hemorrhoid is a more intense version. A blood clot forms inside the swollen vessel, creating a hard, discolored lump near the anus with severe pain and swelling. These are unmistakable because of how quickly the pain ramps up, often over just a few hours.
Pilonidal Cysts: Bumps Near the Tailbone
If the bump is at the top of your buttocks crease, near your tailbone rather than close to the anus, a pilonidal cyst is a strong possibility. These are pockets under the skin that typically contain trapped hair and skin debris. They’re especially common in younger adults, people who sit for long periods, and those with coarse body hair.
A pilonidal cyst can sit quietly for a long time without symptoms. Problems start when it gets infected. At that point you’ll notice swelling, redness, pain that gets worse when sitting, and sometimes pus or blood draining from a small opening in the skin. Infected pilonidal cysts can also produce a noticeable odor from the drainage. The pain tends to be localized right at the top of the crease and worsens with pressure.
Perianal Abscesses: Painful and Swollen
A perianal abscess is essentially a boil filled with pus that forms near the anus, rectum, or the space between your genitals and anus. Most develop when a small gland just inside the anus gets blocked or clogged. Other triggers include an infected anal tear, trauma to the area, sexually transmitted infections, or an infected cyst.
Abscesses tend to announce themselves clearly: the skin turns red and swollen, the area is very tender to touch, and you may develop a fever. The pain is often constant and throbbing, not just triggered by bowel movements. Some abscesses are deeper and don’t create a visible lump on the outside, but you’ll still feel significant pressure or pain in the rectal area. Unlike hemorrhoids, abscesses involve active infection and generally need to be drained by a doctor rather than managed at home.
If an abscess doesn’t heal completely, it can form a tunnel under the skin called a fistula. A fistula creates a small opening near the anus that intermittently drains pus, blood, or stool. The drainage may come and go, and the opening can temporarily close on its own before reopening.
Skin Tags and Warts
Not every bump is painful or swollen. If you’ve noticed a small, painless growth near the anus, it could be a skin tag or a wart, and telling them apart matters.
Anal skin tags are teardrop-shaped flaps of skin that match the color of surrounding tissue. They’re harmless, often forming after a healed hemorrhoid or from friction. They don’t grow, change color, or spread.
Anal warts, caused by HPV, look different. They start as small, dome-shaped bumps that can be flesh-colored, brown, white, or pink. The key distinction is that warts can grow quickly and cluster together in a pattern that resembles cauliflower. If a bump is multiplying or changing shape, that points toward warts rather than a skin tag.
Could It Be Something Serious?
Anal cancer is rare, accounting for about 0.5% of all new cancer cases in the U.S. Only about 2 in every 100,000 people are diagnosed per year. So while it’s understandable to worry, the odds strongly favor a benign explanation. That said, any bump that persists for weeks without improving, bleeds repeatedly, changes in size or shape, or comes with unexplained weight loss deserves a medical evaluation to rule out anything uncommon.
What a Doctor Visit Looks Like
If you do go in for evaluation, the process is straightforward and usually quick. The doctor starts with a visual inspection and a digital rectal exam, using a gloved, lubricated finger to check for tenderness, swelling, or blockages. If they need a closer look, they may use a proctoscope, a slim tube inserted gently through the anus to examine the lining of the rectum for hemorrhoids, inflammation, polyps, or other abnormalities. If anything looks unusual, they can take a small tissue sample through the scope for biopsy. The whole process typically takes just a few minutes.
Relief You Can Start at Home
For hemorrhoids and minor irritation, a sitz bath is one of the simplest and most effective remedies. Fill your bathtub or a small plastic basin with 3 to 4 inches of warm water, around 104°F (40°C). Soak the area for 15 to 20 minutes. You can do this three to four times a day for relief from pain, itching, and swelling. Pat the area dry gently afterward.
Over-the-counter creams and wipes containing witch hazel or a mild numbing agent can also help with hemorrhoid discomfort. Keeping the area clean, wearing loose cotton underwear, and avoiding straining during bowel movements all reduce irritation. Adding fiber to your diet softens stools and makes them easier to pass, which takes pressure off swollen tissue.
For pilonidal cysts that aren’t yet infected, warm compresses applied several times a day can encourage drainage. Once a cyst or abscess becomes infected, with redness spreading, fever, or worsening pain, home care alone won’t resolve it. These typically need to be drained by a healthcare provider, sometimes with a course of antibiotics.
Signs That Need Prompt Attention
Most bumps in this area are manageable, but certain symptoms signal that you shouldn’t wait. Fever combined with a painful lump points to an abscess that needs drainage. Heavy or persistent bleeding, especially if it’s dark rather than bright red, warrants evaluation. A lump that grows steadily over weeks, severe pain that prevents sitting or walking, and pus drainage that doesn’t stop are all reasons to get seen sooner rather than later.