Scars on the buttocks are surprisingly common and usually result from one of a handful of causes: folliculitis (infected hair follicles), acne-like breakouts, stretch marks, cysts near the tailbone, or a chronic skin condition called hidradenitis suppurativa. The buttocks are especially prone to scarring because the skin there faces constant friction, pressure, moisture, and limited airflow. Understanding what your scars look like, where exactly they sit, and whether they’re flat, raised, or pitted can help you figure out what caused them.
Folliculitis and “Butt Acne”
The most common reason for small, scattered scars across the buttocks is folliculitis, an infection or irritation of the hair follicles. The buttocks are covered in hair follicles that get compressed every time you sit, trapped under layers of clothing that hold in sweat and warmth. When bacteria get into those follicles, you get red, pimple-like bumps that can fill with pus. Mild cases heal on their own within a few days without leaving a mark.
Severe or repeated folliculitis is a different story. When the infection goes deeper or you pick at the bumps, it can destroy enough tissue to leave permanent scars. These often show up as small pitted or slightly raised spots. You may also notice patches of skin that are darker or lighter than the surrounding area. That discoloration is called post-inflammatory hyperpigmentation (or hypopigmentation), and while it usually fades over months, it can persist if the inflammation was intense or kept recurring.
The key distinction: flat color changes with no texture difference are pigmentation marks, not true scars. If you run your finger over the spot and feel a dip, a bump, or rough texture, that’s structural scarring where the skin itself was damaged during healing.
Stretch Marks
If your scars look like long, indented streaks rather than dots or bumps, they’re likely stretch marks. The buttocks are one of the most common locations for them. They form when the skin stretches faster than its underlying support structure can keep up with, tearing the collagen fibers in the deeper layers. Common triggers include rapid weight gain or loss, growth spurts during puberty, pregnancy, and muscle building.
New stretch marks tend to look pink, red, or purple. Over time they fade to a silvery-white and become less noticeable, though the indented texture usually remains. Some people are genetically more prone to developing them regardless of how gradually their weight changes.
Hidradenitis Suppurativa
If your scars are thick, rope-like, or sit near areas where skin folds rub together (the crease between the buttocks, the groin, the inner thighs), you may be dealing with hidradenitis suppurativa, or HS. This is a chronic inflammatory condition where deep, painful nodules form under the skin, typically 0.5 to 2 centimeters in size. Unlike ordinary pimples, these lumps persist for days to months, tend to rupture, and can form tunnels under the skin that drain fluid.
HS progresses in stages. In earlier stages, you’ll see recurring abscesses that leave individual scars separated by normal skin. In advanced stages, the scarring becomes widespread: thick fibrous plaques that distort the shape of the skin, with interconnected tunnels and open pores sometimes called “tombstone” comedones. If your buttock scars came with a history of painful, deep lumps that kept coming back in the same general areas, HS is worth investigating with a dermatologist. It affects an estimated 1 to 4 percent of the population and is frequently underdiagnosed.
Pilonidal Cysts
A scar right at the top of the buttocks crease, near the tailbone, points to a pilonidal cyst. These are pockets under the skin that fill with hair and skin debris. They’re most common in young men and people who sit for long periods. A pilonidal cyst can become infected, swelling into a painful abscess that sometimes needs to be surgically drained. The resulting scar sits in a very specific spot: centered at the top of the cleft, sometimes with a small visible pit.
Pilonidal cysts have a frustrating tendency to come back. If you’ve had one drained or surgically removed, the scar you see may be from the procedure itself, from the infection, or both.
Telling Your Scars Apart
The appearance and location of your scars narrows down the cause considerably:
- Small, scattered pits or dark spots across both cheeks: folliculitis or butt acne
- Long, streaky indentations on the outer or lower buttocks: stretch marks
- Thick, ropy scars near skin folds, possibly with tunnels or drainage: hidradenitis suppurativa
- A single scar at the top of the buttocks crease: pilonidal cyst or its surgical repair
- Flat dark or light patches with no texture change: post-inflammatory pigmentation, not scarring
Reducing the Appearance of Existing Scars
Topical silicone gel is one of the most studied options for improving scar appearance. A meta-analysis of randomized controlled trials found that silicone gel significantly reduced scar pigmentation, height, and stiffness compared to no treatment, with the best results appearing after at least six months of consistent use. A minimum of two months of daily application is typically recommended before judging whether it’s working. Silicone sheets and gels are available over the counter and work best on raised or discolored scars rather than deep pits.
For more stubborn scars, laser treatments offer another option. Pulsed dye lasers showed some of the strongest results in clinical comparisons, particularly for reducing redness and overall scar appearance. Most laser treatments require multiple sessions, and results vary depending on skin tone and scar type. A dermatologist can recommend the right approach based on whether your scars are raised, depressed, or primarily a color issue.
Flat pigmentation marks often respond well to products containing ingredients like niacinamide, azelaic acid, or vitamin C, which help even out skin tone over several weeks. Sun exposure (or UV exposure from tanning) can darken these marks and slow fading, so keeping the area protected matters if you spend time in swimwear or direct sunlight.
Preventing New Scars
Most buttock scarring starts with inflammation that gets worse before it heals. Reducing friction and trapped moisture is the simplest preventive step. Switching to cotton underwear instead of synthetic fabrics like nylon or polyester allows better airflow and reduces the warm, damp environment that bacteria thrive in. Showering promptly after sweating, whether from exercise or just a hot day, helps clear bacteria from the skin before it can work into hair follicles.
Tight-fitting leggings and compression shorts are common culprits. If you’re prone to breakouts on the buttocks, looser clothing or at least changing out of sweaty workout gear quickly makes a meaningful difference. Resist the urge to squeeze or pick at bumps that do appear. Squeezing drives inflammation deeper into the skin and dramatically increases the chance of a permanent scar forming from what would have otherwise been a temporary blemish.