Abscesses can appear anywhere on the body, but an abscess on your buttocks can be particularly painful and disruptive, interfering with your usual daily activities — from sitting down to walking. If you’ve ever experienced pain and discomfort around your butt, or even bleeding from the anus, you may have a buttock abscess.

Understandably, due to the location of the lesion, it can also be embarrassing to seek medical attention. However, it is important to get the abscess treated as soon as possible to avoid further complications with your infection.

What is a Buttock Abscess?

An abscess is a lump filled with pus caused by an infection. Put simply, a buttock abscess, or perianal abscess, just means that the abscess forms on the buttocks.

Common areas on the buttocks where abscesses can form are:

• Anorectal region — These can be [1, 2]: 
  
  • perianal abscesses – Infection spreads downwards from the anal sphincters, to the subcutaneous tissue near the anus.
    
  • ischiorectal abscesses – Infection spreads outwards from the anal sphincters, to the surrounding fat and fibrous tissue.
    
  • intersphincteric abscesses – Located between the internal and external anal sphincters.
    
  • supralevator abscesses – Infection in the rectal walls, above the levators.
    
  • submucosal abscesses – Located in the mucosal lining of the anal canal or rectum
    
• Pilonidal region (more commonly known as the “butt crack”) — Sometimes cysts called pilonidal cysts also form in the area.

Abscesses can also form anywhere on the skin of the buttocks, like a pimple. Symptoms of buttock abscesses differ according to the location of the lesion. Abscesses near to the surface of the skin can appear to have:

• A lump filled with pus
• Redness
• Swelling
• Pain and discomfort on the lump
  

Deeper abscesses can present the following:

• Pus-like discharge from the anus
• Bleeding from the anus
• Constipation
• Painful bowel movements
• Irritated skin around the anus

What causes a Buttock Abscess?

Anorectal abscesses

Anorectal abscesses form due to inflammation of the subcutaneous tissues, usually caused by clogged and infected anal glands. Bacteria start to grow in these clogged anal glands, which cause the body to produce an inflammatory response. 

A pocket of pus forms as a result of this inflammatory response, which subsequently causes pain and discomfort. Common bacteria that cause these infections include Escherichia Coli, Staphylococcus aureus, Streptococcus, and Enterococcus. Risk factors that can lead to anorectal abscesses include [3, 4]:

• Smoking
• Liquid stool entering the duct
• Dilated duct which leads to improper bowel emptying
• Infections (HIV or other STDs)
• Crohn's disease
• Trauma 
• Cancer
• Ingrown hairs
• Skin injuries or friction

Pilonidal abscess

Pilonidal abscess usually stem from pilonidal cysts, which usually happens when hair is stuck or embedded between folds of skin of the pilonidal region, the spot just above the buttock cracks. This can happen due to friction from clothing, rubbing of the skin, or sitting for long periods of time. This pocket of hair gradually collects dead skin cells, debris, or other matter and forms a cyst. 

If left untreated, the cyst may be infected and form into an abscess. Common risk factors for pilonidal cyst formation are:

• Excess weight
• Sedentary lifestyle
• Male sex
• Ingrown hairs
• Skin injuries or friction

What can happen to a Buttock Abscess if left untreated?

If left untreated, complications can occur, such as:

• Further infection — A buttock abscess can infect surrounding tissue (cellulitis) or even the bloodstream. In the case of a systemic spread, sepsis can occur, causing fever or even organ failure.

• Fistula — A fistula is an abnormal connection between the rectum or the anus, causing discomfort and may require surgical intervention.

• Chronic abscess — A chronic abscess is one that continues to recur as a result of improper treatment or healing.

• Scarring — Prolonged presence of an untreated abscess can lead to scar tissue formation.

How are Buttock Abscesses treated?

Treating buttock abscesses require medical intervention. Popping abscesses yourself can be painful and may lead to complications such as the abscess forming again, or further infections. Buttock abscesses are surgically removed through the following steps:

• Local anaesthesia – Local anaesthesia is usually applied to minimise patient pain and discomfort
  
• Incision – A cut is made on the abscess, sometimes in the shape of an ‘X’
  
• Drainage – The pus and debris are drained out from the incision, but the wound is left open to heal
  
• Packing – Wound packing can be applied to encourage further draining. The packing may need to be changed throughout the healing period
  
• Postoperative care – After the surgery patients will be given pain relief and laxatives to avoid constipation and further irritation. A sitz bath is also recommended for pain relief. Antibiotics may be prescribed by doctors, and patients will require a follow-up visit 3 to 8 weeks after the procedure to ensure proper and complete healing.

However, depending on the location of the abscess, some may be more complicated that others to treat. When consulting your doctor, they will inform you on the course of treatment that you may need to undergo.

Summary

Hopefully this guide helped you understand what buttock abscesses are and how they form. A buttock abscess can be frustrating and embarrassing to deal with, but it is entirely treatable. Getting it treated early will be less complicated and also reduces the risk for other issues to develop. Book a consultation with us today if you have any concerns about buttock abscesses and how to treat them.

More about Buttock Abscesses

Will buttock abscesses go away on their own?

Buttock abscesses rarely go away on their own. It’s also advised to avoid popping the abscess on your own as this can make the abscess even worse or spread the infection. Your doctor will help you remove the abscess safely and effectively.

How long does recovery take after surgery?

Recovery can take anywhere from 3 to 8 weeks after surgery.

Can a buttock abscess come back?

Yes, a buttock abscess can recur, especially if its underlying cause has not been addressed. Proper treatment, hygiene and adhering to your doctor’s advice can help prevent recurrence.

When do I need to see a doctor?

You should see a doctor if you experience any of the following:

• Pain and discomfort on the buttock
• Bleeding from the anus
• Fever and chills (may indicate an infection)
• A bump in your rectal area

References

1. Hogan AM, Mannion M, Ryan RS, Khan W, Waldron R, Barry K. Beware the ischiorectal abscess. Int J Surg Case Rep. 2013;4(3):299-301. doi: 10.1016/j.ijscr.2012.08.005. Epub 2012 Sep 1. PMID: 23396392; PMCID: PMC3604705.
2. Thompson DT, Hrabe JE. Intra-abdominal and Anorectal Abscesses. Gastroenterol Clin North Am. 2021 Jun;50(2):475-488. doi: 10.1016/j.gtc.2021.02.014. Epub 2021 Apr 23. PMID: 34024453.
3. Klein JW. Common anal problems. Med Clin North Am. 2014 May;98(3):609-23. doi: 10.1016/j.mcna.2014.01.011. Epub 2014 Mar 21. PMID: 24758964.
4. Martín-Lagos Maldonado A, Herrera Mercader MDC, Lozano Cejudo C. Proctitis and perirectal abscesses: is there anything else to think about? Rev Esp Enferm Dig. 2018 Jun;110(6):410. doi: 10.17235/reed.2018.5500/2018. PMID: 29722270.