Taking a break to sit and rest might not sound so appealing if you’re living with hidradenitis suppurativa (HS). Sitting might actually be painful, especially if HS lesions affect your buttocks.

“I’m having serious problems with HS on my right butt cheek,” a myHSteam member wrote. Another member said, “I am at my sickest when I have them in my bottom.”

Also known as acne inversa, HS commonly affects areas of the body like the buttocks, armpits, and groin. Understanding how to manage symptoms and find relief is important, especially when painful nodules develop in sensitive areas, such as between or below your buttocks.

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Symptoms of Hidradenitis Suppurativa on the Buttocks

The symptoms of hidradenitis suppurativa vary depending on the type of HS, severity of the disease, and area of skin affected. The type of HS is characterized using the Hurley staging system:

• Hurley stage 1 — Single or multiple lesions with minor scarring
• Hurley stage 2 — Single or multiple lesions with some tunneling and scarring
• Hurley stage 3 — Multiple interconnected lesions with extensive tunneling and scarring across a large area of skin

Risk factors for HS generally include having a family history, smoking, being female, and having a high body weight, according to Mayo Clinic. Early symptoms of HS on the buttocks include pain, burning, itching, and excessive sweating. These symptoms may occur for 12 to 48 hours before skin lesions form.

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Skin lesions can appear on or between the buttocks and on the perianal area (skin surrounding the anus) and can last for days to months. A lesion may appear as a deep, pea-sized bump similar to an acne cyst or a boil. Some skin lesions will grow and burst, draining foul-smelling pus. Over time, lesions may leave scars and form interconnecting tunnels under the skin. Lesions can also disappear and then reappear.

“I’m having serious problems with HS on my right butt cheek.”

— A myHSteam member

“I have multiple painful boils and tunnels under the skin. My skin has darkened, and I have a burning sensation,” a myHSteam member shared.

Treating Hidradenitis Suppurativa on the Buttocks

Although there’s no cure for HS, several treatment options may help relieve your symptoms and reduce flare-ups. Your dermatologist will recommend a treatment plan based on your type of lesions, area of skin affected, and severity of HS. Commonly used treatments for mild HS (Hurley stage 1) include:

• Topical agents
• Topical antibiotics
• Pain relievers
• Oral antibiotics
• Corticosteroid injections

One myHSteam member described their experience with topical agents: “Using lidocaine has somewhat helped me with the pain on my buttocks. I completely cover the area of skin with the cream, gently rubbing in light circular motions. I don’t cover my lesions, and I let the medication dry. I only cover my lesions when they are leaking.”

Moderate and severe forms of HS (Hurley stages 2 and 3) may require a combination of topical and oral medications and other therapies. Medications that may be recommended for people with moderate to severe HS include:

• Oral antibiotics
• Oral retinoids
• Oral anti-inflammatory medications
• Corticosteroids
• Hormonal medications
• Biologic medications

Other therapies, such as laser hair removal and surgical treatments to remove damaged tissue, have shown some benefit for treating moderate to severe HS. Laser hair removal may also help people with mild HS.

How To Manage Hidradenitis Suppurativa on the Buttocks at Home

In addition to using the HS treatment recommended by your dermatology team, you might consider ways to manage HS flare-ups on your buttocks at home. In the early stages of HS, you might try these tips:

• Use only gentle skin products.
• Stop using loofahs, washcloths, or brushes to clean your skin.
• Avoid shaving the buttocks during breakouts.
• Clean buttocks daily with antibacterial soap or cleanser.
• Wear loose-fitting clothing to prevent rubbing or friction against the skin.
• Use a warm compress or heating pad on the buttocks for 10 minutes at a time.
• Keep your skin cool and dry.

“Using lidocaine has somewhat helped me with the pain on my buttocks.”

— A myHSteam member

Some myHSteam members also offered their suggestions:

• “Warm baths with pure Epsom salts soaking solution.”
• “I use nonstick pads on my buttocks, which don’t hurt when I take them off.”
• “Keep your buttocks dry and clean.”
• “I apply a clear petroleum jelly to avoid further irritation to draining lesions.”

Speak with your doctor about the best options for your HS before making any lifestyle changes or trying at-home strategies like those above.

Relieving Pain

Having HS lesions on your buttocks may make it painful to walk, sit, exercise, or even use the bathroom. To help relieve the pain so you can get back to your normal activities, consider trying over-the-counter (OTC) remedies after getting your healthcare team’s OK. Strategies such as these may offer relief:

• Use OTC topical creams with numbing qualities, such as those that contain lidocaine, menthol, pramoxine, benzocaine, or prilocaine.
• Take pain medications such as ibuprofen or other nonsteroidal anti-inflammatory drugs (NSAIDs).
• Use mild heat, like a warm compress, if a lesion on your buttocks is inflamed and looks like it may burst soon.
• Apply an ice pack if the lesion is swelling but not close to bursting or if one recently burst and is painful.

If these strategies don’t work, consider asking your dermatologist for a referral to a doctor who specializes in pain management. They can recommend strategies that may help reduce your pain and improve your quality of life.

Bandaging HS Lesions on Your Buttocks

Wrapping or bandaging HS abscesses may absorb drainage and ease friction where your skin rubs against your underwear or pants. Finding the method that works best for you may depend on where the HS lesions are located and could take some trial and error. For instance, some people find that sanitary pads work well, while large self-adhesive bandages work best for others. Ask your dermatologist for recommendations on the best bandage types for you.

“I use nonstick pads on my buttocks, which don’t hurt when I take them off.”

— A myHSteam member

Always wash your hands and the affected area of your buttocks before applying a bandage. If your dermatologist recommends it, consider applying a topical antibiotic ointment or petroleum jelly to the lesion site before putting on the bandage.

Managing Other Risk Factors

Several risk factors have been linked with HS. Changing certain lifestyle habits or adopting new ones may also help control the skin condition.

Weight Loss

Researchers have reported that having a higher weight, obesity, or metabolic syndrome is a risk factor for HS. Weight loss or maintaining a healthy weight may reduce your risk of a flare-up or worsening symptoms. Many people with HS on their buttocks avoid physical activities because of their painful skin lesions. However, swimming may be a great exercise option to help relieve painful lesions.

Smoking Cessation

Smoking cigarettes is linked to HS. Researchers have found that 70 percent to 90 percent of people who develop HS also smoke. Quitting can help prevent worsening symptoms and reduce your risk of flare-ups.

Diet

What you eat may affect your HS. Certain foods may trigger flare-ups, and others can help prevent them. Dermatologists have reported improvements in some people with HS who followed a Mediterranean or plant-based diet. Always speak with your dermatologist or primary care provider before changing your diet.

Talk With Others Who Understand

On myHSteam, people share their experiences with hidradenitis suppurativa, get advice, and find support from others who understand.

How do you treat HS symptoms on your buttocks? Let others know in the comments below.