Welcome to the Decision Guide for Rectal Pain or Itching.

This guide can help you to identify some of the causes that are most likely to explain your symptoms and to anticipate the recommendations that your doctor might make.

Rectal itching or minimal rectal pain can occasionally occur during normal bowel movements. However, significant rectal pain or persisting rectal itching is not normal and can sometimes be caused by a serious medical problem. For significant pain or persistent skin irritation around the rectum, you should always seek an evaluation by your doctor. This guide is intended to be used as a complement to discussions with your doctor, not as a substitute for office-based care.

If your major symptom is rectal bleeding, constipation, or diarrhea, you may find it more helpful to consult our other Health Decision Guides.

Click here to begin.

Women and men will have some issues that differ.

Please choose:

I am a woman.

I am a man.

Occasionally, an infection in the prostate ("prostatitis") can cause symptoms in the rectum or buttock. Please review the following symptoms that suggest a prostate problem:

• pain in the penis or testicles

• frequent urinating

• burning upon urinating

• difficulty starting your urine stream or inability to pass urine

• cloudiness or blood in the urine

• blood in your semen

• pain when you ejaculate.

Do you have one or more of these symptoms?

Yes I have one or more symptoms that suggest prostatitis.

No, I do not have these symptoms.

It does not sound like a prostate problem is likely. Let's divide up the remaining anatomy near the rectum and anus into three locations.

Please select the area that is having the most symptoms:

Buttock crease

Anus, rectum, or skin within an inch or two of the anus

Buttock cheek

You have identified that your symptoms are most noticeable close to your anus or rectum.

Is your most bothersome symptom pain or itching?

Pain

Itching

You are having uncomfortable pain in or around your anus or rectum. Additional symptoms might suggest an infection in this area, including

• fever and chills

• nausea and vomiting

• unexplained muscle aches and fatigue

• pus coming out of your rectum.

Are you having any of the symptoms that are listed above?

I do have a fever, feel ill, or notice a discharge of pus.

No, I do not have any of these symptoms.

Contact your doctor today. Your symptoms may be coming from an abscess next to your rectum. Drainage of an abscess is necessary to prevent it from enlarging or causing more serious illness.

Three diagnoses are most consistent with your symptoms; these are an anal abscess, an anal fistula, and acute prostatitis.

Anal abscess

An anal abscess is also known as a "perianal abscess" or a "perirectal abscess." Injury or inflammation in the lining of the rectum may permit bacteria to contaminate one of the mucus glands that surround the rectum. The mucus glands are normal structures that help to lubricate your rectum. When they become infected, the infection may quickly intensify to create a pocket of pus.

An anal abscess may cause pain with bowel movements or continuous pain. It commonly causes irritation of the nearby skin so it can create a red, tender or itchy patch of skin within an inch or two of the anus. Frequently, white or yellow pus can be seen through the center of this skin patch as the abscess prepares to drain pus.

It is possible for an abscess in this area to make you dangerously ill. An anal abscess requires drainage by your doctor.

Anal fistula

As described above, an anal abscess may drain pus through a break in the skin. An abscess can also drain pus through a break in the rectum lining. A draining pathway to the skin or rectum wall can persist for a long time without healing. A draining pathway that has not healed is called an anal fistula. An anal fistula usually causes a moist discharge from the rectum or skin. A fistula may look like an open sore or a pus-filled bump near the anus. An anal fistula requires professional treatment as directed by your doctor.

Acute prostatitis

You did not report symptoms in the urinary tract or genital region that would suggest prostatitis, but acute prostatitis is still a possible explanation for your pain and other symptoms. Acute prostatitis is an infection of the prostate that develops suddenly and intensifies quickly after contamination by bacteria from the gut or from sexual contact. Acute prostatitis sometimes causes a severe enough illness that it may require a hospital stay and intravenous antibiotics for treatment.

Call your doctor. Prostatitis can progress to a more severe infection. Treatment for prostatitis requires antibiotics.

Prostatitis can present in two different ways:

Acute prostatitis

If you have symptoms of fever, chills, muscle aches, nausea or vomiting, then you may have acute prostatitis. Acute prostatitis is an infection of the prostate that develops suddenly and intensifies quickly after contamination by bacteria from the gut or from sexual contact. Acute prostatitis sometimes causes a severe enough illness that it may require a hospital stay and intravenous antibiotics for treatment.

Chronic prostatitis

An infection that is stubbornly established in the prostate may cause persistent inflammation of the gland. The symptoms may be just mild discomfort in the rectal area, often with a frequent urge to urinate. There may be burning with urination and a slower stream. Fever is not usually present. Chronic prostatitis usually requires treatment with antibiotics for six weeks or longer.

The location of your symptoms will help determine what is likely to be bothering you and what you should do about it.

Please select the area that is having the most symptoms:

Buttock crease

Anus, rectum, or skin within an inch or two of the anus

Buttock cheek (or cheeks)

Genital area (vulva and vagina).

You have chosen the genital area (vulva and vagina) as the area that is causing you the most bothersome symptoms. You may find it more helpful to visit our Decision Guides titled Vaginal Pain or Discomfort and Vaginal Sores and Lumps.

You have chosen the area of your buttock cheek or cheeks as the part that is causing you the most bothersome symptoms. You may find it more helpful to visit our Decision Guide on Low Back Pain.

You have identified that your symptoms are most noticeable close to your anus or rectum.

Is your most bothersome symptom pain or itching?

Pain

Itching

Itching in the rectum or anus is a very common problem.

Is your itching accompanied by any moisture on the skin?

Yes, the skin around my anus opening has moisture.

No, my skin is dry.

Itching can come from a variety of rashes around the anus. Please select the most appropriate answer:

There is a lumpy rash or tissue protruding from my skin or anus.

I have a rash that is in a thin or flat layer.

I do not have any rash around my anus.

Itching around the anus can be caused by certain foods (particularly coffee, tea, cola, chocolate, tomatoes, alcohol, and citrus fruits) or from cosmetic products that are used in the area. Keep an eye out for a rash that might assist you and your doctor to identify a more specific cause of your itching.

If you have toddlers in your home, and if your itching is very prominent at night, then you may benefit from testing for pinworms.

Since you have a rash around your anus, this is the likely cause of your itching. Your rash is probably caused by one of the following problems:

Eczema

Eczema is an itchy rash that arises due to local irritants or allergy. A rash or itch around the anus can be caused by certain foods (particularly coffee, tea, cola, chocolate, tomatoes, alcohol, and citrus fruits) or from cosmetic products that are used in the area.

Psoriasis

Psoriasis is a recurring rash caused by a variation in your immune system. It very commonly causes a rash in the buttock crease, and it also most commonly affects the scalp, the ear, the groin, and the elbows and knees. Psoriasis causes the skin to appear red and thickened with a white or silvery crust. Many treatments are effective, ranging from skin creams to light exposure and oral medicines.

"Jock itch" (tinea cruris)

Tinea is a fungus infection of the skin, and it commonly affects the groin, upper thigh, and buttock crease. Tinea of the groin is named "tinea cruris" or jock itch. A tinea infection appears as a bright red or red-brown patch of skin with a well-defined boundary. This rash is very itchy.

Seborrheic dermatitis

Seborrheic dermatitis can cause a greasy red rash with some yellow crusts. If you have seborrheic dermatitis in your buttock crease, you probably have also noticed a similar rash at your scalp line or on your face or chest. Dandruff is a form of seborrheic dermatitis.

Yeast infection (candidiasis)

Yeast infections can cause an itchy or painful red rash on the skin. It is most common for a yeast infection to affect the skin in the folds of the groin (at the top of the thigh) and the skin around the genitals, but it may also occur in the anus area or the buttock crease.

Scabies

Scabies are mites that can infect your skin. Scabies are very contagious. Scabies can cause a rash and itching outside of the groin and buttock area, even if the infestation is localized to this area.

Genital warts

Warts in the genital or anal area can appear like a flat or thin layer when they are closely clustered. Warts are caused by a virus infection with "human papillomavirus." This virus is spread through sexual contact.

Since you have a lumps or abnormal tissue around your anus, this is the likely cause of your itching. There are several explanations that are worth considering, either because they are common or because they would be a cause for serious concern.

Hemorrhoids

Hemorrhoids are veins just beneath the inside surface of the rectum and anus. Hemorrhoids can become overfilled and bulging, particularly when straining to push out a bowel movement repeatedly interferes with normal circulation out of these veins. A bulging hemorrhoid can develop a weak area that can allow small amounts of blood to spill into the rectum. Hemorrhoids can cause itching or can soil or moisten your underwear, particularly when they create a bulge that pushes rectal tissue out of your anal opening. Most hemorrhoids do not cause pain, but some can be extremely painful. Pain from hemorrhoids usually comes after a blood clot forms, creating a "thrombosed" hemorrhoid.

Genital warts

Warts in the genital or anal area are caused by a virus infection with "human papillomavirus." This virus is spread through sexual contact.

Skin tags

Skin tags are flesh-colored pieces of skin that are not cancerous. When they form at the anus, they may be left over from a bulging hemorrhoid that has improved.

Molluscum contagiosum

Molluscum contagiosum is a viral rash that creates small flesh-colored bumps on the skin. It spreads from one person to the next during sexual contact.

Syphilis

Syphilis can cause a rash with lumpy or thickened skin in the anal or genital area. Syphilis is a sexually transmitted infection. If any itching occurs, it will be mild.

Anal cancer

Cancer at the rim of the anus is sometimes the result of a sexually passed infection, human papillomavirus. Anal cancer is more likely to result from this virus if you are infected with HIV (human immunodeficiency virus). Anal cancer may look like a skin sore that will not heal. It commonly causes bleeding with bowel movements.

To understand the cause of your itching, we probably need to identify the source of this moisture.

Is the moisture clearly coming out of your rectum or anus, or is it from an outside rash or sore?

The moisture is from inside the rectum or anus.

It is from an outside rash or sore.

Since you have moisture around your anus, this is the likely cause of your itching. But what is causing your moisture? There are several possibilities that are worth considering, either because they are common or because they would be a cause for serious concern.

Yeast infection (candidiasis)

Yeast infections can cause an itchy or painful red rash on the skin. It is most common for a yeast infection to affect the skin in the folds of the groin (at the top of the thigh) and the skin around the genitals, but it may also occur in the anus area or the buttock crease.

Anal fistula

Injury or inflammation in the lining of the rectum may permit bacteria to contaminate one of the mucus glands that surround the rectum. When a mucus gland becomes infected, the infection may quickly intensify to create a pocket of pus (anal abscess). An anal abscess may drain pus through a break in the skin. An abscess can also drain pus through a break in the rectum lining. A draining pathway to the skin or rectum wall can persist for a long time without healing. A draining pathway that has not healed is called an anal fistula. An anal fistula usually causes a moist discharge of pus from the rectum or skin. A fistula may look like an open sore or a pus-filled bump near the anus. An anal fistula must be treated by a surgeon in order to heal.

Draining pilonidal cyst (Pilonidal sinus)

Where your skin and tissue fold inward at the top of your buttock crease, a hair can easily become ingrown so that its tip re-enters the skin and creates irritation. Doctors think that is a likely reason that the buttock crease can develop a pilonidal cyst, which is an irritated pocket of fluid and hairs under the skin surface. Pilonidal cysts are most common in men under age 40, and they are more likely to occur in people with abundant body hair. Pilonidal cysts that become infected can cause pain and may create an area on the overlying skin surface that is red, tender, and swollen. A pilonidal cyst can develop one or more draining holes to the skin surface, creating a constant discharge of blood, pus, or clear fluid. A cyst with a draining hole is known as a pilonidal sinus. Pilonidal sinuses usually require the attention of a surgeon and do not heal permanently on their own.

Hidradenitis suppurativa

Blockage of a hair follicle can allow sweat glands just beneath the hair root to become congested and inflamed. When this occurs, the sweat glands can deteriorate and combine into pockets of fluid under the skin. This can make the skin look as if it has acne, it can cause scarring, and it can cause you to form repeated "boils" (pockets of pus underneath the skin). If you have a lot of problems from congestion and inflammation of your sweat glands, your condition is called "hidradenitis suppurativa" (also known as "acne inversus"). Antibiotics may be helpful; large boils may require drainage by your doctor.

Sweating

Sweat may collect in creases. Well-ventilated clothing and frequent showers may help.

Anal cancer

Cancer at the rim of the anus is sometimes the result of a sexually passed infection, human papillomavirus. Anal cancer is more likely to result from this virus if you are infected with HIV (human immunodeficiency virus). Anal cancer may look like a skin sore that will not heal. It commonly causes bleeding with bowel movements.

Syphilis

Syphilis can cause a moist rash with lumpy or thickened skin in the anal or genital area. Syphilis is a sexually transmitted infection. If any itching occurs, it will be mild.

Since you have moisture around your anus, this is the likely cause of your itching. But what is causing your moisture? There are several possibilities that are worth considering, either because they are common or because they would be a cause for serious concern.

Hemorrhoids

Hemorrhoids are veins just beneath the inside surface of the rectum and anus. Hemorrhoids can become overfilled and bulging, particularly when straining to push out a bowel movement repeatedly interferes with normal circulation out of these veins. A bulging hemorrhoid can develop a weak area that can allow small amounts of blood to spill into the rectum. Hemorrhoids can cause itching or can soil or moisten your underwear, particularly when they create a bulge that pushes rectal tissue out of your anal opening. Most hemorrhoids do not cause pain, but some can be extremely painful. Pain from hemorrhoids usually comes after a blood clot forms, creating a "thrombosed" hemorrhoid.

Rectal prolapse

Constipation and straining at stool can occasionally cause the last portion of the rectum to sag downwards through the anus, exposing a bulge of moist pink or red tissue. This can cause moisture and itching in the anal area and may soil your undergarments. If you think you may have rectal prolapse, you should discuss strategies to control constipation with your doctor.

Anal fistula

Injury or inflammation in the lining of the rectum may permit bacteria to contaminate one of the mucus glands that surround the rectum. When they become infected, the infection may quickly intensify to create a pocket of pus (anal abscess). An anal abscess may drain pus through a break in the skin. An abscess can also drain pus through a break in the rectum lining. A draining pathway to the skin or rectum wall can persist for a long time without healing. A draining pathway that has not healed is called an anal fistula. An anal fistula usually causes a moist discharge of pus from the rectum or skin. A fistula may look like an open sore or a pus-filled bump near the anus. An anal fistula requires professional treatment as directed by your doctor.

Colorectal cancer

Cancer in the rectum can cause pain or itching in the rectum, and it commonly causes rectal bleeding. You are at a higher risk for colorectal cancer (cancer in the colon or rectum) if you have a family history of polyps or cancer in the colon, or if you are over the age of 50.

Anal cancer

Cancer at the rim of the anus is sometimes the result of a sexually passed infection, human papillomavirus. Anal cancer is more likely to result from this virus if you are infected with HIV (human immunodeficiency virus). Anal cancer may look like a skin sore that will not heal. It commonly causes bleeding with bowel movements.

Fecal incontinence

Repeated leakage of stool or rectal moisture is a common cause of itching. It can result from a nerve or spinal cord injury or from injury to the anal sphincter.

You are having uncomfortable pain in or around your anus or rectum. Additional symptoms might suggest an infection in this area, including

• fever and chills

• nausea and vomiting

• unexplained muscle aches and fatigue

• pus coming out of your rectum.

Are you having any of the symptoms that are listed above?

I do have a fever, feel ill, or notice a discharge of pus.

No, I do not have any of these symptoms.

Is your pain worse when you have bowel movements?

Yes, my pain is worse during bowel movements.

No, my pain is not closely associated with bowel movements.

Most people with pain in the rectal or anal area that is not closely associated with bowel movements have one of the following conditions:

Hemorrhoids

Hemorrhoids are veins just beneath the inside surface of the rectum and anus. Hemorrhoids can become overfilled and bulging, particularly when straining to push out a bowel movement repeatedly interferes with normal circulation out of these veins. A bulging hemorrhoid can develop a weak area that can allow small amounts of blood to spill into the rectum. Hemorrhoids can cause itching or can soil or moisten your underwear. Most hemorrhoids do not cause pain, but some can be extremely painful. Pain from hemorrhoids usually comes after a blood clot forms, creating a "thrombosed" hemorrhoid.

Anal abscess

An anal abscess is also known as a "perianal abscess" or a "perirectal abscess." Injury or inflammation in the lining of the rectum may permit bacteria to contaminate one of the mucus glands that surround the rectum. The mucus glands are normal structures that help to lubricate your rectum. When they become infected, the infection may quickly intensify to create a pocket of pus. An anal abscess may cause pain with bowel movements or continuous pain. It commonly causes irritation of the nearby skin so it can create a red, tender or itchy patch of skin within an inch or two of the anus. Frequently, white or yellow pus can be seen through the center of this skin patch as the abscess prepares to drain pus. It is possible for an abscess in this area to make you dangerously ill. An anal abscess requires drainage by your doctor.

Hidradenitis suppurativa

Blockage of a hair follicle can allow sweat glands just beneath the hair root to become congested and inflamed. When this occurs, the sweat glands can deteriorate and combine into pockets of fluid under the skin. This can make the skin look as if it has acne, it can cause scarring, and it can cause you to form repeated "boils" (pockets of pus underneath the skin). If you have a lot of problems from congestion and inflammation of your sweat glands, your condition is called "hidradenitis suppurativa" (also known as "acne inversus"). Antibiotics may be helpful; large boils may require drainage by your doctor.

Herpes infection

Herpes is a virus infection that is spread by sexual contact. It can cause a blistering and painful rash on the skin, or it may cause an open sore in the lining of the rectum (called a rectal ulcer). Swelling around a rectal ulcer can cause a sensation that your rectum will not completely empty, and it can also cause you to pass mucus with or between your stools.

Conditions that are less common but are concerning include:

Colorectal cancer

Cancer in the rectum can cause pain or itching in the rectum, and it commonly causes rectal bleeding. You are at a higher risk for colorectal cancer (cancer in the colon or rectum) if you have a family history of polyps or cancer in the colon, or if you are over the age of 50.

Anal cancer

Cancer at the rim of the anus is sometimes the result of a sexually passed infection, human papillomavirus. Anal cancer is more likely to result from this virus if you are infected with HIV (human immunodeficiency virus). Anal cancer may look like a skin sore that will not heal. It commonly causes bleeding with bowel movements.

In order to prioritize what conditions might be causing you pain, please identify whether you have been diagnosed with any of the following illnesses. These illnesses can predispose you to develop bacterial contamination in the structures that surround the rectum.

• Crohn's disease

• ulcerative colitis

• diverticulitis

• antibiotic-associated diarrhea (Clostridium difficile diarrhea or "C. Diff. ")

• any condition that requires you to take prednisone or another medication that suppresses your immune system.

Yes, I have one of these medical conditions.

No, I do not have any of these conditions.

The most common cause of severe pain with bowel movements is an anal fissure. Several other diagnoses may also fit your symptoms, if your pain is not severe.

Anal fissure

A cut or tear at the anal opening can occur if the anus is overstretched by trauma or by very hard stools, or it can occur if there is an infection within the rectum.

Hemorrhoids

Hemorrhoids are veins just beneath the inside surface of the rectum and anus. Hemorrhoids can become overfilled and bulging, particularly when straining to push out a bowel movement repeatedly interferes with normal circulation out of these veins. A bulging hemorrhoid can develop a weak area that can allow small amounts of blood to spill into the rectum. Hemorrhoids can cause itching or can soil or moisten your underwear. Most hemorrhoids do not cause pain, but some can be extremely painful. Pain from hemorrhoids usually comes after a blood clot forms, creating a "thrombosed" hemorrhoid.

Anal abscess

An anal abscess is also known as a "perianal abscess" or a "perirectal abscess." Injury or inflammation in the lining of the rectum may permit bacteria to contaminate one of the mucus glands that surround the rectum. The mucus glands are normal structures that help to lubricate your rectum. When they become infected, the infection may quickly intensify to create a pocket of pus. An anal abscess may cause pain with bowel movements or continuous pain. It commonly causes irritation of the nearby skin so it can create a red, tender or itchy patch of skin within an inch or two of the anus. Frequently, white or yellow pus can be seen through the center of this skin patch as the abscess prepares to drain pus. It is possible for an abscess in this area to make you dangerously ill. An anal abscess requires drainage by your doctor.

Anal fistula

As described above, an anal abscess may drain pus through a break in the skin. An abscess can also drain pus through a break in the rectum lining. A draining pathway to the skin or rectum wall can persist for a long time without healing. A draining pathway that has not healed is called an anal fistula. An anal fistula usually causes a moist discharge from the rectum or skin. A fistula may look like an open sore or a pus-filled bump near the anus. An anal fistula requires professional treatment as directed by your doctor.

Rectal ulcer

An open sore in the lining of the rectum is called a rectal ulcer. The most common cause of a rectal ulcer is a herpes infection. Swelling around a rectal ulcer can cause a sensation that your rectum will not completely empty. Rectal ulcers can also cause you to pass mucus with or between your stools.

Inflammatory bowel disease (Crohn's disease or ulcerative colitis)

Inflammation in the rectum or colon can be the result of an autoimmune illness (an attack by your own immune system). If your symptoms have been persistent or recurrent, one of the autoimmune conditions known as "inflammatory bowel disease" may fit well as an explanation. Most inflammatory bowel disease is eventually identified as one of two conditions: "Crohn's disease" or "ulcerative colitis." Any of the anal or rectal problems above can be caused by inflammatory bowel disease. These conditions are more likely to begin when you are a young adult, although older adults can develop inflammatory bowel disease as well.

Conditions that are less common but are concerning include:

Colorectal cancer

Cancer in the rectum can cause pain or itching in the rectum, and it commonly causes rectal bleeding. You are at a higher risk for colorectal cancer (cancer in the colon or rectum) if you have a family history of polyps or cancer in the colon, or if you are over the age of 50.

Anal cancer

Cancer at the rim of the anus is sometimes the result of a sexually passed infection, human papillomavirus. Anal cancer is more likely to result from this virus if you are infected with HIV (human immunodeficiency virus). Anal cancer may look like a skin sore that will not heal. It commonly causes bleeding with bowel movements.

Because your medical history puts you at extra risk for an abscess next to your rectum, your symptoms require the attention of your doctor today. If an abscess is present, drainage is necessary to prevent it from enlarging or causing more serious illness.

An anal abscess is the most concerning diagnosis that could be the cause of your symptoms, but it is one of several likely explanations:

Hemorrhoids

Hemorrhoids are veins just beneath the inside surface of the rectum and anus. Hemorrhoids can become overfilled and bulging, particularly when straining to push out a bowel movement repeatedly interferes with normal circulation out of these veins. A bulging hemorrhoid can develop a weak area that can allow small amounts of blood to spill into the rectum. Hemorrhoids can cause itching or can soil or moisten your underwear. Most hemorrhoids do not cause pain, but some can be extremely painful. Pain from hemorrhoids usually comes after a blood clot forms, creating a "thrombosed" hemorrhoid.

Anal abscess

An anal abscess is also known as a "perianal abscess" or a "perirectal abscess." Injury or inflammation in the lining of the rectum may permit bacteria to contaminate one of the mucus glands that surround the rectum. The mucus glands are normal structures that help to lubricate your rectum. When they become infected, the infection may quickly intensify to create a pocket of pus. An anal abscess may cause pain with bowel movements or continuous pain. It commonly causes irritation of the nearby skin so it can create a red, tender or itchy patch of skin within an inch or two of the anus. Frequently, white or yellow pus can be seen through the center of this skin patch as the abscess prepares to drain pus. It is possible for an abscess in this area to make you dangerously ill. An anal abscess requires drainage by your doctor.

Anal fistula

As described above, an anal abscess may drain pus through a break in the skin. An abscess can also drain pus through a break in the rectum lining. A draining pathway to the skin or rectum wall can persist for a long time without healing. A draining pathway that has not healed is called an anal fistula. An anal fistula usually causes a moist discharge from the rectum or skin. A fistula may look like an open sore or a pus-filled bump near the anus. An anal fistula requires professional treatment as directed by your doctor.

Anal fissure

A cut or tear at the anal opening can occur if the anus is overstretched by trauma or by very hard stools, or it can occur if there is an infection within the rectum.

Rectal ulcer

An open sore in the lining of the rectum is called a rectal ulcer. The most common cause of a rectal ulcer is a herpes infection. Swelling around a rectal ulcer can cause a sensation that your rectum will not completely empty. Rectal ulcers can also cause you to pass mucus with or between your stools.

Inflammatory bowel disease (Crohn's disease or ulcerative colitis)

Inflammation in the rectum or colon can be the result of an autoimmune illness (an attack by your own immune system). If your symptoms have been persistent or recurrent, one of the autoimmune conditions known as "inflammatory bowel disease" may fit well as an explanation. Most inflammatory bowel disease is eventually identified as one of two conditions: "Crohn's disease" or "ulcerative colitis." Any of the anal or rectal problems above can be caused by inflammatory bowel disease. These conditions are more likely to begin when you are a young adult, although older adults can develop inflammatory bowel disease as well.

Conditions that are less common but are concerning include:

Colorectal cancer

Cancer in the rectum can cause pain or itching in the rectum, and it commonly causes rectal bleeding. You are at a higher risk for colorectal cancer (cancer in the colon or rectum) if you have a family history of polyps or cancer in the colon, or if you are over the age of 50.

Anal cancer

Cancer at the rim of the anus is sometimes the result of a sexually passed infection, human papillomavirus. Anal cancer is more likely to result from this virus if you are infected with HIV (human immunodeficiency virus). Anal cancer may look like a skin sore that will not heal. It commonly causes bleeding with bowel movements.

Your symptoms may be coming from an abscess next to your rectum. Drainage of an abscess is necessary to prevent it from enlarging or causing more serious illness.

An anal abscess is closely related to another problem, called an anal fistula

Anal abscess

An anal abscess is also known as a "perianal abscess" or a "perirectal abscess." Injury or inflammation in the lining of the rectum may permit bacteria to contaminate one of the mucus glands that surround the rectum. The mucus glands are normal structures that help to lubricate your rectum. When they become infected, the infection may quickly intensify to create a pocket of pus. An anal abscess may cause pain with bowel movements or continuous pain. It commonly causes irritation of the nearby skin so it can create a red, tender or itchy patch of skin within an inch or two of the anus. Frequently, white or yellow pus can be seen through the center of this skin patch as the abscess prepares to drain pus. It is possible for an abscess in this area to make you dangerously ill. An anal abscess requires drainage by your doctor.

Anal fistula

As described above, an anal abscess may drain pus through a break in the skin. An abscess can also drain pus through a break in the rectum lining. A draining pathway to the skin or rectum wall can persist for a long time without healing. A draining pathway that has not healed is called an anal fistula. An anal fistula usually causes a moist discharge from the rectum or skin. A fistula may look like an open sore or a pus-filled bump near the anus. An anal fistula requires professional treatment as directed by your doctor.

You have identified that your symptoms are most noticeable in your buttock crease.

Is your most bothersome symptom pain or itching?

Itching

Pain

You are having uncomfortable pain in the crease between your buttocks.

One of the conditions that may be the cause of your pain is an infected pilonidal cyst. An infected pilonidal cyst needs to be drained by a doctor. Schedule an urgent evaluation with your doctor to make sure that an infected cyst is not the source of your pain.

The two structures that commonly cause pain in the buttock crease are your tailbone (coccyx) and skin. There are five common problems that can result in pain in the buttock crease:

Bedsore (Decubitus Ulcer)

People who are bed-bound or obligated to remain in a wheelchair can remain in one position for long stretches of time. The skin over the tailbone receives poor circulation when it is compressed by sitting or lying. It is common for the skin overlying the tailbone to thin and disintegrate if a person's weight is not regularly shifted. The first signs of an ulcer are reddening of an area of skin and pain. When the skin breaks down, an open sore (ulcer) forms. Pressure ulcers on the buttock are called "decubitus ulcers." Relief of pressure and meticulous wound care is needed in order for a decubitus ulcer to heal.

Yeast infection (candidiasis)

Yeast infections can cause an itchy or painful red rash on the skin. It is most common for a yeast infection to affect the skin in the folds of the groin (at the top of the thigh) and the skin around the genitals, but it may also occur in the anus area or the buttock crease.

Infected pilonidal cyst

Where your skin and tissue fold inward at the top of your buttock crease, a hair can easily become ingrown so that its tip re-enters the skin and creates irritation. Doctors think that is a likely reason that the buttock crease can develop a pilonidal cyst, which is an irritated pocket of fluid and hairs under the skin surface. Pilonidal cysts are most common in men under age 40, and they are more likely to occur in people with abundant body hair. Pilonidal cysts that become infected can cause pain and may create an area on the overlying skin surface that is red, tender, and swollen. A pilonidal cyst can develop one or more draining holes to the skin surface, creating a constant discharge of blood, pus, or clear fluid. A cyst with a draining hole is known as a pilonidal sinus.

Hidradenitis suppurativa

Blockage of a hair follicle can allow sweat glands just beneath the hair root to become congested and inflamed. When this occurs, the sweat glands can deteriorate and combine into pockets of fluid under the skin. This can make the skin look as if it has acne, it can cause scarring, and it can cause you to form repeated "boils" (pockets of pus underneath the skin). Boils can be painful. If you have a lot of problems from congestion and inflammation of your sweat glands, your condition is called "hidradenitis suppurativa" (also known as "acne inversus"). Antibiotics may be helpful; large boils may require drainage by your doctor.

Pain from the tailbone (coccyx)

The coccyx (tailbone) is a pointed bone at the bottom of your sacrum. It is possible for the coccyx to crack or fracture with trauma. More commonly, pain in the tailbone arises due to the pull of strong pelvic muscles that attach to this bone. Coccyx pain can occur if a pelvic muscle is in spasm, a common problem after childbirth, pelvic surgery, or trauma.

You are having uncomfortable itching in the crease between your buttocks. If you have a moist discharge in the buttock crease, that can help to suggest a specific diagnosis.

Please select an answer:

I have a moist discharge in my buttock crease.

The skin surface in my buttock crease is dry.

You have dry, itchy skin in the crease between your buttocks. Your problem is likely to be caused by one of several conditions:

Psoriasis

Psoriasis is a recurring rash caused by a variation in your immune system. It very commonly causes a rash in the buttock crease, and it also most commonly affects the scalp, the ear, the groin, and the elbows and knees. Psoriasis causes the skin to appear red and thickened with a white or silvery crust. Many treatments are effective, ranging from skin creams to ultraviolet light exposure and oral medicines.

"Jock itch" (tinea cruris)

Tinea is a fungus infection of the skin, and it commonly affects the groin, upper thigh, and buttock crease. Tinea of the groin is named "tinea cruris" or jock itch. A tinea infection appears as a bright red or red-brown patch of skin with a well-defined boundary. This rash is very itchy.

Hidradenitis suppurativa

Blockage of a hair follicle can allow sweat glands just beneath the hair root to become congested and inflamed. When this occurs, the sweat glands can deteriorate and combine into pockets of fluid under the skin. This can make the skin look as if it has acne, it can cause scarring, and it can cause you to form repeated "boils" (pockets of pus underneath the skin). If you have a lot of problems from congestion and inflammation of your sweat glands, your condition is called "hidradenitis suppurativa" (also known as "acne inversus"). Antibiotics may be helpful; large boils may require drainage by your doctor.

Scabies

Scabies are mites that can infect your skin. Scabies are very contagious. Scabies can cause a rash and itching outside of the groin and buttock area, even if the infestation is localized to this area.

Pilonidal cyst

Where your skin and tissue fold inward at the top of your buttock crease, a hair can easily become ingrown so that its tip re-enters the skin and creates irritation. Doctors think that is a likely reason that the buttock crease can develop a pilonidal cyst, which is an irritated pocket of fluid and hairs under the skin surface. Pilonidal cysts are most common in men under age 40, and they are more likely to occur in people with abundant body hair. Pilonidal cysts that become infected can cause pain and may create an area on the overlying skin surface that is red, tender, and swollen. A pilonidal cyst can develop one or more draining holes to the skin surface, creating a constant discharge of blood, pus, or clear fluid. A cyst with a draining hole is known as a pilonidal sinus. Pilonidal sinuses and infected pilonidal cysts usually require the attention of a surgeon and do not heal permanently on their own. Pilonidal cysts that are less symptomatic may not need any treatment.

Seborrheic dermatitis

Seborrheic dermatitis can cause a greasy red rash with some yellow crusts. If you have seborrheic dermatitis in your buttock crease, you probably have also noticed a similar rash at your scalp line or on your face or chest. Dandruff is a form of seborrheic dermatitis.

Yeast infection (candidiasis)

Yeast infections can cause an itchy or painful red rash on the skin. It is most common for a yeast infection to affect the skin in the folds of the groin (at the top of the thigh) and the skin around the genitals, but it may also occur in the anus area or the buttock crease.

Molluscum contagiosum

Molluscum contagiosum is a viral rash that creates small flesh-colored bumps on the skin. It spreads from one person to the next during sexual contact.

Since you have moisture within your buttock crease, this is the likely cause of your itching. But what is causing your moisture? There are several likely possibilities.

Draining pilonidal cyst (Pilonidal sinus)

Where your skin and tissue fold inward at the top of your buttock crease, a hair can easily become ingrown so that its tip re-enters the skin and creates irritation. Doctors think that is a likely reason that the buttock crease can develop a pilonidal cyst, which is an irritated pocket of fluid and hairs under the skin surface. Pilonidal cysts are most common in men under age 40, and they are more likely to occur in people with abundant body hair. Pilonidal cysts that become infected can cause pain and may create an area on the overlying skin surface that is red, tender, and swollen. A pilonidal cyst can develop one or more draining holes to the skin surface, creating a constant discharge of blood, pus, or clear fluid. A cyst with a draining hole is known as a pilonidal sinus. Pilonidal sinuses usually require the attention of a surgeon and do not heal permanently on their own.

Hidradenitis suppurativa

Blockage of a hair follicle can allow sweat glands just beneath the hair root to become congested and inflamed. When this occurs, the sweat glands can deteriorate and combine into pockets of fluid under the skin. This can make the skin look as if it has acne, it can cause scarring, and it can cause you to form repeated "boils" (pockets of pus underneath the skin). If you have a lot of problems from congestion and inflammation of your sweat glands, your condition is called "hidradenitis suppurativa" (also known as "acne inversus"). Antibiotics may be helpful; large boils may require drainage by your doctor.

"Jock itch" (tinea cruris)

Tinea is a fungus infection of the skin, and it commonly affects the groin, upper thigh, and buttock crease. Tinea of the groin is named "tinea cruris" or jock itch. A tinea infection appears as a bright red or red-brown patch of skin with a well-defined boundary. This rash is very itchy.

Yeast infection (candidiasis)

Yeast infections can cause an itchy or painful red rash on the skin. It is most common for a yeast infection to affect the skin in the folds of the groin (at the top of the thigh) and the skin around the genitals, but it may also occur in the anus area or the buttock crease.

Sweating

Sweat may collect in creases. Well-ventilated clothing and frequent showers may help.