Everyone always says not to Google your skin issues and ~ailments~ (it's always the worst-case scenario, and it's rarely ever correct), but guess what I do every single time I discover something new on my skin? Google it. Can't help myself. And on one of those occasions, I was searching the internet for answers about the butt acne I could feel behind me but couldn't really see. And naturally, the internet told me the bumps on my butt might not actually be "classic" acne at all, but something called folliculitis.
Here's the thing: "Butt acne," or folliculitis, is super common (we're all in this together), but it’s not always the same type of bump as the acne on your face. It's complicated, I know, so I turned to board-certified dermatologists to help break down all things butt acne and help clear up the pimples. So if you're very much done with dealing with your breakouts, keep reading to get rid of those breakouts and prevent them from coming right back on your butt.
Meet the experts
Neda Mehr, MD, is a board-certified dermatologist and medical director at Pure Dermatology Cosmetic & Hair Center. Dr. Mehr is also a Mohs surgeon, media expert, and the founder of DermBx skincare products.
Shereene Idriss, MD, is a board-certified dermatologist and founder of Idriss Dermatology. Dr. Idriss, aka Pillowtalk Derm, is a clinical instructor in dermatology at the Icahn School of Medicine at Mount Sinai.
Tiffany Libby, MD, is a board-certified dermatologist and Mohs surgeon based in Rhode Island.
Morgan Rabach, MD, is a board-certified dermatologist and cofounder of LM Medical NYC. Dr. Rabach is also a clinical assistant professor of dermatology at the Icahn School of Medicine at Mount Sinai.
What causes acne on the butt?
The short version? Acne is the result of an overproduction of oil. The long version? Board-certified dermatologist Neda Mehr, MD, breaks it down: Our oil glands are mainly triggered by one of four factors, which are hormones, stress, genetics, and diet. These four triggers send a signal to the oil glands to get bigger, and when the oil gland gets bigger, the channel that delivers the oil does, too.
Once the pore is opened up, the bacteria on the skin can now get inside and clog the pore. And when you’re talking about your butt, it’s so easy for the pore to get clogged because, well, you’re sitting on it. And when the pore gets clogged, there’s no exit, so it implodes, and there you have it—acne on your butt.
Is it normal to get acne on your bum?
Board-certified dermatologist Morgan Rabach, MD, says “butt acne” is super common (and, yes, normal!), but—surprise, surprise—butt acne is rarely real, traditional acne. If you want to get technical, and we do, what you’re probably experiencing is something called folliculitis, which is an inflammation of the hair follicles. “The term ‘butt acne’ usually refers to folliculitis, which presents similarly to acne elsewhere and basically results from blocked follicles and mild infection of the hair follicles, leading to acne-like bumps on the buttocks,” board-certified dermatologist Tiffany Libby, MD explains.
All that to say, even though folliculitis can look like acne (fungal acne, anyone?), they're not exactly the same skin condition. Although there might be a little overlap in how you treat and prevent body acne and folliculitis, recognizing the difference is key to your treatment and prevention approach.
So how can you tell if what you’re dealing with is folliculitis or acne? Glad you asked:
What does folliculitis look like?
Folliculitis and acne really do look similar to the untrained eye, which is why they're easily confused, but there are a few key distinctions a dermatologist can easily spot. Here's how they differ on closer inspection:
Acne vs. folliculitis
What acne looks like: “Acne is defined by having comedones, which are blackheads and whiteheads,” says Dr. Rabach. Basically, acne looks like...acne. A mix of little whiteheads, maybe some blackheads, maybe a cystic zit, maybe some painful, inflamed bumps.
What folliculitis looks like: “Folliculitis has a hair in the center of a red bump, and the white material associated with the bump is often dead skin and white blood cells,” says Dr. Rabach. It might look like a small whitehead, but usually, it won't be just a single bump—you'll likely have a smattering of same-size, whitehead-looking bumps (and no blackheads).
That said, there are instances where patients do get real zits on their butts (Dr. Mehr says this is usually in patients that have a history of facial acne, too), which is why both Dr. Rabach and board-certified dermatologist Shereene Idriss, MD, agree that you should see a derm to find out exactly what’s really going on and properly treat it.
Should I pop folliculitis bumps?
You already know the answer to this: That's a big ol' no, nope, never. You should never pop, pick, or prod anything yourself, really, and doing any of the above to your butt acne can not only make your breakout worse, but can also lead to scarring and post-inflammatory hyperpigmentation afterward. Oh, and one more thing to add to the list of things to avoid: heavy oils. “Avoid using thicker oils, like coconut oil, to moisturize as these can clog pores and lead to [the] formation of ‘butt acne,’” Dr. Libby warns.
Why do I get pimples on my bum cheeks?
In short, anything that causes friction can cause these butt bumps. “Common culprits are irritation from clothes rubbing against the buttocks, like tight gym clothes that can trap in sweat, oil, and bacteria, and friction or occlusion from sitting for prolonged periods,” Dr. Libby explains. For folliculitis, specifically, Dr. Mehr says things that inflame the hair follicle, like harsh skincare products, an allergic reaction (for instance, an allergy to the nickel in a shaving razor), or bacterial overgrowth could be the reason.
If you feel like your butt acne is more prevalent in the summer—exactly when you might be choosing to show off your butt—you’re right. Wet clothes, like a bathing suit or sweaty workout leggings, are two main offenders that lead to folliculitis. But don't stress! You don't have to swear off swimming and yoga forever. You just gotta know the right ways to go about your everyday life.
How to get rid of butt acne fast:
First, take the word "overnight" out of your vocabulary, because clear skin takes time. The next step in clearing up your butt acne for good is with a proper diagnosis from a derm, because can you only correctly treat your butt once you know what you're working with.
With that said, small changes to your regular routine might work wonders for improving your breakouts, fading the post-inflammatory hyperpigmentation that follows, and preventing them from popping back up, whether they actually are butt acne or folliculitis. So once you've made that appointment to see your derm, get started on the below.
1. Use a benzoyl peroxide body wash
Both Dr. Libby and Dr. Idriss recommend cleansing the area with an acne wash like PanOxyl, which uses 10% benzoyl peroxide—an MVP at killing acne-causing bacteria, unclogging pores, and reducing inflammation. If you have active bumps, Dr. Libby says to apply the product onto your breakouts once daily in the shower and suggests waiting two to three minutes before washing it off (aka short-contact therapy) to give the ingredient enough time to work without irritating the skin. And if you get these bumps regularly, Dr. Libby also recommends incorporating the benzoyl peroxide wash into your routine once a week in between breakouts to keep them at bay.
Heads up, though: Benzoyl peroxide is equally as known for bleaching fabrics as it is for clearing your skin, so if you don't want to risk ruining your favorite bath towels, make sure to rinse your skin really well after cleansing or designate a set of sheets, clothes, underwear—whatever—so you don't have to pick your battles.
2. Exfoliate your skin—but don't scrub it
While you may be tempted to exfoliate the hell out of your bumpy butt, leave the grainy physical scrubs alone. Instead, Dr. Mehr suggests using a gentle silicone scrubber (silicone repels bacteria) while in the shower and an exfoliating wipe once you hop out and dry off. Dr. Idriss also recommends swiping on a gentle chemical exfoliator, which uses ingredients like alpha-hydroxy acids (such as lactic or glycolic acids) or beta-hydroxy acids (salicylic acid) to keep dead skin cells from clogging your pores. Our faves:
3. Shower with a tea tree body wash
Another ingredient Dr. Mehr recommends scrubbing down with is tea tree (Trader Joe’s Tea Tree Body Wash is a fave), which has antibacterial and anti-inflammatory properties. Use your silicone shower brush to cleanse with the tea tree wash, followed by the benzoyl peroxide body wash to really kill off the bacteria.
4. Get a chemical peel
If you're determined to get rid of your butt acne overnight, Dr. Rabach says the best treatments are available at your dermatologist’s office. For the fastest results, she recommends an in-office chemical peel to encourage the shedding of skin. But for a less intense treatment, you can also try an at-home face peel, which relies on the same chemical exfoliants mentioned above to do the trick.
5. See your dermatologist for a topical antibiotic
Dr. Rabach also recommends asking your doctor about clindamycin lotion, which is a super-light topical medication that’s non-greasy and won’t stain your clothes. This antibiotic can be used to calm inflammation and kill bacteria that can lead to acne, or in this case, butt acne.
6. Choose breathable fabrics
The lighter, looser, and more breathable the fabric of your clothing is, the less likely you are to cause a folliculitis flare-up, which is why Dr. Rabach recommends cotton underwear over, say, nylon. Trapped sweat and friction are not only the two main culprits of chafed skin, but also a big cause of inflammation in the hair follicle.
Dr. Rabach has noticed way more patients with folliculitis lately, and all that work-from-home athleisure may be to blame. If a pair of tight pants rubs you the wrong way, maybe chill on wearing them for a bit until you get everything under control. When you absolutely have to wear tight-fitting gym clothes to work out, opt for cotton to prevent the sweat from getting trapped against your skin. Because sweat creates the perfect environment for bacteria, which could lead to a breakout. And speaking of sweat...
7. Change out of sweaty clothes
Say it with me: Activewear is not loungewear. Take off your sweaty workout clothes as soon as you get home (or even sooner if you can). Wearing tight leggings made from synthetic fabric, sweating in them, and then sitting in them is one sure-fire way to get yourself some butt acne. Dr. Mehr explains that non-breathable fabrics “cause all that sweat with all that bacteria to hug your skin and form a cellophane-like barrier, and if you’re got a propensity for acne, that bacteria’s going to go inside the oil gland, and you’re going to get all these pimples on your butt.” Oh, and Dr. Rabach says the same goes for your wet swimsuits or any other damp clothing. Who likes sitting in swampy swimsuits anyway??
8. Shower after sweating to prevent butt acne
Listen, I know you're tired after working out, and we're already asking a lot of you to peel off your sticky bike shorts when your arms are still burning, but once you've made it that far, you might as well step in the shower and wash away all that sweat, oil, and dirt with cool water. According to Dr. Libby and Dr. Rabach, a quick rinse or a cleanse with body wash is key for treating and preventing butt acne, and it also works like a charm for acne all over your body, like the acne on your back.
9. Use salicylic acid to get rid of acne scars on your butt
We touched on salicylic acid (an oil-soluble beta-hydroxy acid) as a face wash or spot treatment for smoothing out the bumps of butt acne, thanks to its ability to remove excess oil and unclog pores. But since the ingredient exfoliates and increases cellular turnover as well, Dr. Libby also recommends sal-acid products as daily leave-on treatments to minimize the hyperpigmentation, butt acne scars, and dark spots left behind on your thighs or butt by the old active lesions. This will not only help to lighten the spots by encouraging new skin cells but also prevent them from popping up, so it's a good ingredient to keep on hand (err—butt? Idk).
10. Get laser hair removal.
If you've never had acne and now out of nowhere you now have bumps on your butt, Dr. Mehr says it's more likely that your butt acne is actually folliculitis. “That bacteria, instead of having an entry into the inside world from a pore, got an entry into the inside world by tracking down a hair follicle,” Dr. Mehr explains. “So the key with folliculitis is destroy the root of the hair follicle. How? Laser hair removal.” Not only will lasering the hair away prevent folliculitis, but it also will help minimize scarring that can come from folliculitis caused by other methods of hair removal. Dr. Mehr explains that sugaring or waxing “basically allows the outside bacteria to get inside and cause pimples, which lead to scarring.”
The takeaway:
In summary, get your butt to the derm. A board-certified dermatologist is much better at distinguishing an acne breakout from folliculitis than you are (and that's not a knock against you—these people are doctors who studied this very thing) and can tell you the right treatment approach for your given situation. Dr. Rabach says dermatologists see this all the time, so butt acne is nothing to be embarrassed about and no reason to put it off. Just whatever you do, stop sitting in sweaty yoga pants already.
Article written by Brooke Shunatona for Cosmopolitan
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