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Psoriasis can develop almost anywhere on the body, including the buttocks. Many people with psoriasis experience flare-ups in the genital area or on the buttocks, and it’s a common topic of discussion among MyPsoriasisTeam members.
“I need to know if anyone has had a patch of psoriasis on the butt cheek or at the butt crack,” a member wrote. Another said, “I had a bad flare-up on my buttocks where it hurt to just sit down.”
Psoriasis on the buttocks can cause stress and significantly affect daily life, so it can help to learn more about the condition and how to manage it.
Psoriasis on the buttocks can look different depending on the type of psoriasis and where it develops. Two common types of psoriasis that affect the buttocks are plaque psoriasis and inverse psoriasis.
Plaque psoriasis is the most common form of psoriasis. When it develops on the buttocks, the skin may look:
Affecting 21 percent to 30 percent of people with psoriasis, inverse psoriasis looks different from plaque psoriasis. The affected skin is usually smooth and shiny rather than thick and scaly. Doctors also call this form intertriginous psoriasis.
Inverse psoriasis often occurs in skin folds, creases, and other areas where skin touches skin, including the armpits, inner thighs near the groin, under the breasts, and between or under the buttocks.
Psoriasis between the buttocks is often grouped with genital psoriasis and is usually a form of inverse psoriasis.
Young children can also develop a type of psoriasis called napkin psoriasis (also known as napkin eruption). This type of psoriasis occurs in the diaper area and appears as well-defined, discolored patches or plaques.
Many people with psoriasis say that symptoms on their buttocks are especially uncomfortable and affect their quality of life. Common symptoms include:
These symptoms can interfere with exercise, social activities, sexual relationships, and other parts of everyday life.
Doctors usually diagnose psoriasis by examining the skin and asking about medical history.
To rule out other causes of your rash, a dermatologist may order lab tests or take a biopsy (a small skin sample examined under a microscope). These tests can help determine whether your rash is caused by another condition, such as a bacterial or fungal infection or a sexually transmitted infection.
Treatment for psoriasis on the buttocks depends on the severity and location of your psoriasis patches. Although biologics and oral medications can help, you may not need them if your psoriasis affects only this area.
Psoriasis between the buttocks may be treated differently from psoriasis on other body parts, such as your legs or face. The skin in this area is sensitive and prone to moisture, and some treatments can cause irritation or other side effects. Your dermatologist may prescribe topical creams or ointments that are less likely to irritate your skin.
Low- or moderate-potency topical corticosteroids (steroid creams or ointments applied to the skin) may help ease symptoms. Options include hydrocortisone, triamcinolone, and desonide.
It’s important to always use topical steroids exactly as your doctor directs to help avoid side effects, which may include:
Because the skin between the buttocks is delicate, it may be more prone to irritation and side effects from topical corticosteroids, such as skin thinning.
If your dermatologist determines your skin is too sensitive for a steroid, they may prescribe a nonsteroidal cream, such as roflumilast (Zoryve) or tapinarof (Vtama). Both are approved by the U.S. Food and Drug Administration (FDA) to treat plaque psoriasis.
One MyPsoriasisTeam member reported good results with tapinarof: “It seems to be working great between my legs, specifically on my vulva, perineum, and butt crack.”
Other treatment options for psoriasis on the buttocks include:
Pimecrolimus and tacrolimus are medications that affect the immune system and are approved to treat atopic dermatitis (the most common type of eczema). Dermatologists may prescribe them off-label (for a condition they aren’t specifically approved to treat) to manage psoriasis.
The right psoriasis treatment will depend on the exact location of your rash and the type of skin affected. Certain treatments may be too irritating for the thin, sensitive skin within the intergluteal fold (butt crack). However, they may be appropriate for the outer buttocks, where the skin is thicker.
To treat psoriasis inside the intergluteal fold, your dermatologist may recommend avoiding or limiting treatments that can irritate sensitive skin, such as:
Psoriasis flare-ups on the buttocks can be painful and uncomfortable. The good news is that you can take steps to manage symptoms and help prevent flare-ups.
Urine, stool, and sweat can irritate affected areas. Use soft, high-quality toilet paper or a bidet after using the toilet.
Wash gently with a mild, fragrance-free cleanser. Avoid soaps, body washes, or deodorants with strong fragrances or harsh chemicals, which may cause more irritation.
Rubbing can irritate sensitive skin. Wear loose-fitting, breathable underwear and clothing to reduce friction. Applying a fragrance-free moisturizer or barrier cream can also help protect the skin from rubbing and irritation.
Eating enough fiber helps keep bowel movements regular. This may help reduce constipation and straining during bowel movements, which can irritate the skin and worsen psoriasis on the buttocks.
Aim for the recommended daily amount of fiber — 21 to 25 grams for women and 30 to 38 grams for men, according to Mayo Clinic.
Good sources of fiber include:
If needed, consider trying fiber supplements. Start with small amounts to avoid gas or bloating. If you have intestinal problems, such as inflammatory bowel disease, speak with your doctor before starting supplements.
It can feel embarrassing to talk about psoriasis in sensitive areas like the buttocks, but your healthcare team is there to help you. Be open with your dermatologist or doctor about your symptoms. Remember that you’re not alone — many people living with psoriasis experience similar symptoms.
You can let your provider know you’re nervous by saying something like “I’ve never discussed this before” or writing down your symptoms ahead of time. Don’t worry about using the right terms. You might also bring a trusted friend or family member to the appointment for support.
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