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Suffer from tear in upper gluteal cleft and bleeding. Noticed yellow opaque fluid. Used Neosporin and Desitin cream. What to do?

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Practicing since : 1997
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For a few months now (I just found out about it roughly three weeks ago!), my teenaged son has been dealing with a split/tear in his upper gluteal cleft. It has been bleeding enough to leave some spots of blood in his briefs, but about three or so weeks ago, he had been sitting on the floor and I can only guess he split it open further, because he noticed his undies were feeling wet in that area and when he stood up there was a good sized amount of blood on the carpet. While I was with my son helping clean up and to see what had happened to him, my husband cleaned up the spot on the carpet and he believes there was something n addition to blood, like something kind of yellow opaque fluid, he thought could be pus? There was no evidence of any pus on his tear, not is there any redness outside of the gluteal cleft, but I was upset to see that the tear was1.5" long and open. The blood wasn't just oozing out, but there was some blood at the surface of the wound and when I tried to clean it with a baby wipe, I definitely had blood on it, and it really hurt him whenever I tried to seperate his butt cheeks to see it, as well as whenever I touched it. I had done some research online and we decided to try to treat it with some Neosporin and Desitin cream to help dry up the area. By the way, he sweats a lot down there, enough so we recently switched from briefs to boxers to keep him cooler and hopefully, drier. After a couple of says, the amount of blood left on his undies has really decreased, we were beginning to feel a bit better about things, but then, he sat in such a position that he opened it up all over again, and still had a ways to go beore he completely healed. This go 'round, it bled more so than the last time, and it felt more painful when I would try to get a look at it and when I touched it with a swab with some Neosporin. I couldn't apply anything at this point, his butt stayed clinched to keep me from looking or treating. Two nights ago, I tried to treat it with one of those creams to treat jock itch and while I successfully cleaned it, I also aggravated it and made it start bleeding some more, and that was just with my spraying some water there--then I applied that cream. The next day, he still had some blood on one of feminine hygiene XXXXXXX pads I had applied to the upper area of his boxers to "catch" the blood. Tonight, I decided against the more thorough cleaning I had been attempting, for cleaning the area just outside of the intergluteal cleft. Then, instead of the jock itch cream, I used a powder form, making it a lot easier to get it where it was needed. But I'm not expecting much, if any, of a difference tomorrow. He refuses to go to the doctor with this, and I'm really hoping to avoid him being embarrassed by asking you for help in helping us to treat this properly in order to allow it to close up and heal. Can you please give me the necessary advice? Sorry this was so long, I just wanted to make sure I hit on everything in order to get the right "prescription" we'll say! Thank you for your help in advance. Please help us. ~Laura
Posted Fri, 2 Aug 2013 in Abdominal Pain
Answered by Dr. Kulsoom Qureshi 1 hour later
Thanks for discussing your problem to us.
I think you should not keep on trying things on your own as this is not likely to cure it. Keeping his history of allergy & asthma this may prove XXXXXXX for him. I strongly recommend you to prepare him & your self to see a doctor ( preferably a surgeon ) as by reading your story the top most diagnoses which are coming to my mind are all surgical conditions which need expert opinion & may be some surgical treatment.
It could be either a fistula, a sinus, an abscess or even a fissure. Diagnosis & treatment is impossible without medical help. Only thing I can suggest online is to avoid constipation by giving him plenty of water, high fiber diet & maintain good local hygiene.
Hope I have been able to convince you to seek medical help at the earliest.
Best wishes.
Above answer was peer-reviewed by
Follow-up: Suffer from tear in upper gluteal cleft and bleeding. Noticed yellow opaque fluid. Used Neosporin and Desitin cream. What to do? 8 hours later
Thank you for your advice, Dr. Qureshi. I suppose I already knew deep down that this would be your recommendation. I will let my son know only that it is time for me to take him in to see his pediatrician, sparing him the scarier details of your reply. (I'm even scared myself.)

Thank you again.
Answered by Dr. Kulsoom Qureshi 14 hours later
You are welcome here with all your questions.
I am really sorry if I had scared you but sometimes it is necessary for us to counsel patients in the directions they are trying to avoid.
I think you should be strong & confident while preparing your son. Stress him that you are taking him to doctor to save him from the discomfort & pain he is in & not to harm him. Doctors are there to help, & don't want to harm you. Most of these conditions can be cured but certainly timely & appropriate treatment is essential.
Wish you best of luck & good health.
Above answer was peer-reviewed by
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