Recurring Red Bumps on the Buttocks: Causes and Treatments

Red bumps continuously appear on the buttocks?

I have a persistent red lump that appears in a fixed spot on my left buttock.
It has been there for over a decade, and I've learned to live with it, but in the past two years, it has been appearing more frequently, possibly due to recurrent infections.
Sometimes, I also notice it on the inner thigh, and when I squeeze it, a lump of white discharge comes out, similar to squeezing toothpaste, with an opening larger than that of a pimple.
The most painful part is that the already red and swollen bump often rubs against my clothing, causing intense pain.
Using adhesive bandages doesn't help.

Should I consider surgery to resolve this issue? However, I’ve read that buttock areas are prone to recurrence.
I can't tolerate this discomfort any longer.
If I do opt for surgery, will they remove the entire cyst, which I estimate to be about 2 centimeters in size, potentially causing a dent in my skin that would look unsightly? Or will they just make a small incision to drain the cyst? I'm also worried about the possibility of recurrence.
Will this surgery require hospitalization? After all, it's a procedure on the buttock, and walking would definitely feel awkward.

Pipi Guniang, 30~39 year old female. Ask Date: 2020/08/05

Dr. Wu Yuxin reply Dermatology

It could be a cyst; after surgery, there may indeed be a depression.
Generally, hospitalization is not required.

Reply Date: 2020/08/05

More Info

Recurring red bumps on the buttocks can be a frustrating and uncomfortable issue, especially when they cause pain and irritation. Based on your description, it sounds like you may be dealing with a condition known as a pilonidal cyst or possibly a form of folliculitis or abscess. These conditions can lead to the formation of painful lumps that may become infected, resulting in the discharge of pus or other fluids.

Causes of Recurring Red Bumps
1. Pilonidal Cyst: This is a common condition that occurs when hair follicles become clogged with hair, skin debris, and bacteria, leading to the formation of a cyst. They often occur in the sacrococcygeal area (the area near the tailbone) and can become inflamed or infected, resulting in painful bumps.

2. Folliculitis: This is an inflammation of the hair follicles, often caused by bacterial or fungal infections. It can lead to red, itchy bumps that may ooze pus.

3. Abscess: An abscess is a localized collection of pus that can form due to infection. It can cause significant pain and swelling and may require drainage.

4. Skin Irritation: Constant friction from clothing can exacerbate these conditions, leading to increased inflammation and discomfort.

Treatment Options
1. Conservative Management: If the bumps are not causing significant pain or infection, conservative measures such as warm compresses, topical antibiotics, and good hygiene may be sufficient. Keeping the area clean and dry can help prevent further irritation.

2. Drainage: If the bumps become painful or are filled with pus, drainage may be necessary. This can often be done in a doctor's office. The procedure involves making a small incision to allow the pus to escape, which can alleviate pain and promote healing.

3. Surgical Intervention: If you experience recurrent infections or if the cysts are particularly large, surgical removal may be recommended. This can involve excising the cyst and surrounding tissue to prevent recurrence. While this may leave a scar, it can provide a long-term solution to the problem. The procedure is typically performed under local anesthesia, and in most cases, does not require hospitalization.

4. Post-Surgical Care: After surgery, it’s important to follow your doctor’s instructions for care. This may include keeping the area clean, changing dressings regularly, and avoiding tight clothing that could irritate the area.

Concerns About Recurrence and Scarring
It is true that pilonidal cysts can recur, especially if the underlying causes (like hair growth in the area) are not addressed. However, surgical removal can significantly reduce the likelihood of recurrence. As for scarring, while any surgical procedure can leave a scar, many patients find that the benefits of resolving the painful condition outweigh the cosmetic concerns.

When to Seek Medical Attention
Given the chronic nature of your symptoms and the discomfort you are experiencing, it would be advisable to consult a healthcare professional. They can provide a thorough examination, confirm the diagnosis, and discuss the best treatment options tailored to your specific situation. If you are considering surgery, they can explain the procedure in detail, including recovery time and any potential complications.

In summary, while recurring red bumps on the buttocks can be bothersome, there are effective treatment options available. Consulting with a healthcare provider will help you determine the best course of action to alleviate your symptoms and improve your quality of life.

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