I understand your concerns about the persistent red/purple line in your gluteal cleft, especially since it has been present for several years and affects your confidence. It’s reassuring to know that there is no associated pain or itching, and that previous evaluations have not indicated a serious underlying condition. However, I can appreciate how cosmetic concerns can significantly impact one's self-esteem. Here are a few options you might consider: Dermatological Evaluation: A thorough evaluation by a dermatologist can help determine if there is a specific skin condition contributing to the discoloration. They might perform a dermatoscopic examination or, if necessary, a biopsy to rule out any underlying skin disorders. Topical Treatments: Depending on the diagnosis, topical treatments such as corticosteroids, antifungal creams, or other medicated creams might be recommended to help reduce the discoloration. Laser Therapy: If the line is due to vascular changes or pigmentation, laser therapy might be an option to consider. Lasers can target and reduce pigmentation or vascular lesions effectively. Cosmetic Camouflage: In some cases, using a medical-grade concealer can help mask the appearance of the line, providing a temporary solution to improve appearance. Lifestyle and Skincare Adjustments: Sometimes, friction or moisture can exacerbate skin changes. Ensuring proper hygiene and using gentle, non-irritating products can be helpful. Wearing breathable fabrics may also reduce friction and irritation. It is crucial to have a personalized consultation with a board-certified dermatologist who can provide tailored advice and treatment options based on a comprehensive assessment of your condition. They can guide you through the most appropriate steps to address your concerns effectively.