Black spots on the bum cheeks

Flat colour usually represents a past episode; tenderness, itch, pus or a new lump indicates current inflammation. An examination is needed when a lesion is deep, recurrent or behaving unlike the other marks.

The buttocks contain many hair follicles. Occlusion, sweat, close shaving and rubbing can inflame them, producing small follicle-centred bumps that later leave post-inflammatory pigment. Rough plugs without much inflammation can also make the surface feel uneven.

Folliculitis commonly presents with crops of itchy or tender bumps. A larger hot swelling, drainage or escalating pain is a different pattern and may indicate a deeper infection. Dark colour by itself does not establish the cause.

Change out of sweaty exercise clothing, wear breathable underwear and reduce prolonged rubbing where practical. Use a gentle body wash and moisturiser; do not pick, lance or scrub bumps, as injury can deepen the mark and introduce infection.

Pause close shaving if it repeatedly triggers bumps, and use clean equipment when hair removal resumes. Persistent follicular breakouts may require a clinician to decide whether an acne-type product, antimicrobial treatment or another approach fits the findings.

Seek timely medical care for fever, rapidly spreading redness, severe pain, a hot enlarging lump or substantial drainage. Recurrent deep nodules, tunnels beneath the skin, scarring, or lesions near the crease between the buttocks also merit clinical assessment.

Arrange a routine check when spots keep returning despite less friction, the diagnosis is uncertain, or one pigmented area changes shape, colour or surface.

Tell your clinician whether bumps begin after exercise, shaving or long periods of sitting, and whether they itch, drain or recur in the same place. Ask how to treat active inflammation, prevent further marks and manage any raised or indented scars.