What should I do about a rash on my buttock and cheek?

Management of Rash on Buttock and Cheek

Apply a mild-to-moderate potency topical corticosteroid (such as 1% hydrocortisone cream) 2-4 times daily to the affected areas, along with regular use of alcohol-free moisturizing creams. 1

Initial Assessment

Before treating, you need to determine:

• Extent of involvement: Is the rash covering less than 10% of your body surface area (BSA), or more? 2
• Associated symptoms: Are you experiencing itching, tenderness, pain, or fever? 2
• Recent exposures: Have you started any new medications, anticancer treatments, or had recent travel? 2
• Signs of infection: Look for yellow crusts, discharge, painful lesions, or pustules that might indicate bacterial superinfection 2

Treatment Approach

For Mild Rash (Grade 1: <10% BSA)

• Apply topical hydrocortisone 1% cream to affected areas 3-4 times daily 1
• Use alcohol-free moisturizing creams twice daily, preferably containing 5-10% urea 2
• Avoid skin irritants including hot water, harsh soaps, and over-the-counter anti-acne products 2
• Apply sunscreen SPF 15 to exposed areas if going outside 2

For Moderate Rash (Grade 2: 10-30% BSA)

• Escalate to moderate-to-high potency topical steroids (such as betamethasone valerate 0.1% or clobetasone 0.05%) 2
• Add oral antihistamines if itching is present 2
• Consider oral antibiotics if there are signs of infection or pustules: doxycycline 100 mg twice daily for at least 14 days 2
• Reassess after 2 weeks—if not improving, seek medical evaluation 2

When to Seek Immediate Medical Care

Go to a healthcare provider urgently if you have:

• Rash covering more than 30% of your body 2
• Severe symptoms limiting your ability to perform self-care activities 2
• Fever, blistering, or skin sloughing 2
• Signs of infection (yellow crusts, discharge, worsening pain) 2
• Rash not improving after 2-4 weeks of treatment 2

Important Caveats

• If you are on cancer therapy (especially EGFR inhibitors, immune checkpoint inhibitors, or chemotherapy), this rash may be treatment-related and requires specific management protocols 2
• Avoid frequent hot water exposure and harsh cleansers, as these worsen skin barrier function 2
• Do not use topical antibiotics in alcohol-based formulations, as these can be irritating 2
• If infection is suspected and you fail to respond to initial antibiotic coverage, bacterial cultures should be obtained to guide targeted therapy 2