Before we begin discussing this topic, let’s get a couple of things out of the way. The first thing is this: We know talking about acne isn’t fun. In fact, it can sometimes be a little uncomfortable. When acne is found on your, um, derrière, the discussion can take a turn for rather embarrassing territory. However, despite all that, it’s definitely worth talking about. Not only is—what we will now refer to as butt acne—way more common than you think, but there are also easy steps you can take to fix it.
That’s why we asked two dermatologists to give us the lowdown. They offered up some expert advice so that you can feel comfortable wearing the cheekiest of bathing suit bottoms all summer long.
Types of Butt Acne
According to dermatologist Dr. Amanda Doyle, there are different types of butt acne—closed comedonal, open comedonal, pustules, papules, and cysts. The causes and treatments for each one are essentially the same, but for the sake of specificity, let's go over each type.
"Closed comedones are usually small skin-colored bumps," Doyle says. "Open comedones are dark brown/black bumps with an opening to the surface of the skin. We also see pustules (which are pus-filled bumps), papules (which are small, red, swollen bumps) and cysts (which are larger, deeper bumps that can become red, angry and inflamed that sometimes drain material)." Most acne flare-ups will consist of two or more of these different types.
According to David Lortscher, MD, of Curology, “The causes of bottom acne are very similar to that of other acne on the rest of the body as well as the face. A mixture of genetics, normal hormonal fluctuations, stress, diet, and other lifestyle choices can all contribute.” Let's break each of these causes down in order to find out how to best prevent butt acne from ever happening in the first place.
Genetics: However unfortunate and unfair it might be, some people are simply more prone to acne flare-ups than others. The bad news is that you can't change your genes. In other words, if you're susceptible to acne, there's not much you can do to change that other than keeping your skin clean, your mind and body healthy, and your vanity stocked with effective skincare products. The news isn't all bad, though. There are some steps you can take to keep breakouts at bay (keep reading to see what they are).
Stress: It's no secret that chronic stress can cause acne. As such, the best holistic acne remedy is anything that helps you balance your mood, calm your frazzled nerves, and relax. Maybe it's a daily workout class or a yoga flow. Maybe it's a morning journaling session or a nightly meditation practice. Use self-care as a tool to see if boosting your mental and emotional health will also boost your skin's health.
Diet: You are what you eat. That can certainly hold true when it comes to acne. Avoid certain foods that have been shown to spike acne flare-ups, such as sugar and skim milk. Focus instead on eating leafy greens, fruits, and other non-processed foods that are shown to keep breakouts at bay. (On that note: check out the 7-day anti-acne diet one editor tried).
Hormonal fluctuations: If it's hormones that are making you breakout on your bum, you'll likely need to enlist the help of a dermatologist. Hormonal acne is notoriously tricky, but with certain tailored remedies, and "hormonal manipulations" like birth control, it can be sorted out.
Restrictive clothing: We've covered some of the main causes of acne in general. Now it's time to talk about one of the main (and most common) causes of butt acne in particular: restrictive clothing. Tight clothing, and the friction it causes on the skin, can lead to breakouts. "We often see acne in women that occurs along the line of a sports bra or otherwise," Lortscher says.
When you combine tight clothing with synthetic athletic fabric, it creates an even stronger possibility for butt acne to appear. This is due to the fact that athletic fabrics aren't as breathable as other fabrics, such as cotton. It’s bad news for yoga pant devotees, but it’s good news for anyone suffering from acne flare-ups—simply change out of athletic fabrics. Doyle recommends wearing "light, cotton attire that is breathable." She also cautions against sitting for prolonged periods of time.
Perspiration: First, let's make something clear. Sweating from exercise doesn't cause acne. However, letting sweat sit on your skin for long periods of time without washing it off can cause acne, since the high-moisture environment encourages icky bacteria to thrive. Let Lortscher explain. “The eccrine glands produce sweat, and the sebaceous glands produce sebum—so revving up the sweat glands does not turn on the oil glands involved in acne breakouts,” he says. However, “the moisture produced may encourage acne as it lets bacteria proliferate.”
So the first step in clearing butt acne is the same as clearing facial acne. Keep the area clean and dry, focus on your mental and emotional health, and ensure you're eating a healthy, well-balanced diet. If it sticks around or it's particularly tenacious, it's time to see a dermatologist.
Butt Acne Treatments
Salicylic Acid: This is a safe-for-skin acid that exfoliates on a cellular level by dissolving the 'glue' that holds skin dead cells together. It also penetrates deep into the pores to clear away clogging impurities (other exfoliating acids only work on the surface of the skin). "[Salicylic acid] provides exfoliation that helps to prevent and treat blocked pores, and it may help diminish some types of superficial hyperpigmentation," Lortscher explains.
“Our bodies (with the exception of the neck, underarms, and groin) can tolerate stronger ingredients than our faces do. So, even if your face does not tolerate exfoliation often (or at all), your back, shoulders, and probably your mid-chest typically should." He recommends using exfoliating washes formulated with salicylic acid, such as Neutrogena Body Clear Body Wash ($26), or Neutrogena Oil-Free Acne Wash ($10). These washes offer an easy way to treat acne-afflicted skin with salicylic acid. Simply lather up and rinse off.
"I like the La Roche Posay Effaclar Dermatological Acne System," Doyle says. "This comes with a wash that you can use in the shower. After you get out, you can use the Clarifying Solution ($15), which contains salicylic and glycolic acid."
Benzoyl Peroxide: Another star ingredient for decreasing acne is benzoyl peroxide. “Benzoyl peroxide washes can be beneficial, despite the brief contact with skin,” Lortscher says. Just be careful, and maybe patch-test first. "I’d advise being careful with products containing benzoyl peroxide—some people are allergic to this active ingredient—you’ll know if you’re one of them, as an itchy rash will result every time you use it." If your skin doesn’t react, you’re in the clear (figuratively and literally). Lortscher recommends Clean & Clear Advantage 3-in-1 Exfoliating Cleanser ($18). He also likes Noble Formula 2% Pyrithione Zinc Bar Soap ($17). “Use it every other day in the shower to start, and then increase to daily as tolerated,” he advises.
LED Devices: They don't just look cool, they actually work. LED light therapy can be used to alleviate a number of skin ailments, including acne. Doyle recommends the Eterno LED Device ($254) specifically. "The Eterno LED Device is an FDA cleared device that uses NASA LED red lights to penetrate deep into the skin and can be used to massage the topical into the area, increasing the penetration and thus the benefit of the topical treatment," she says. "The red light component helps to reduce inflammation (redness and swelling) which also improves the appearance of the skin."
Prescriptions: If your skin doesn't respond to any of the treatments listed above, it's time to consult a dermatologist for a topical prescription. These are stronger than store-bought products, which is useful, considering "the skin here is a bit thicker than facial skin." Because of this, Doyle says butt acne can be unresponsive to traditional store-bought products that might work on facial acne.
Interestingly enough, if your butt acne is caused by bacteria that are proliferating due to the moisture provided by excess sweating, Doyle would address it directly with a prescription-strength medication, like Qbrexza. It's an effective remedy for Hyperhidrosis (otherwise known as chronic sweating). By reducing sweat, you'll reduce moisture, which will reduce acne-causing bacteria.
It's also a good rule of thumb to avoid using any heavy pore-clogging lotions or body washes. If you’re unsure whether or not a product will clog pores, check it on cosDNA. “Pull up and run the ingredient list through the ‘Analyze Cosmetics’ section of their website,” Lortscher says. “Once you click Analyze, look in the ‘acne’ column—if there are any 3s, 4s, or 5s, consider stopping the use of this product.” It’s a good resource for learning more about the products you use.
It is possible, however, that butt acne isn't actually acne. It could be a disease called hidradenitis suppurativa or HS. “HS is a complex disease process that can mimic acne, and it has been called inverse acne—but it is not acne, he says. Characterized by recurrent boil-like lumps (abscesses), difficult-to-heal open wounds and scarring, it commonly occurs in the groin, bottom, the underarms (axillae) and under the breasts.” So please take note: Always (again, always) see a dermatologist if you’re unsure—it never hurts to get a medical professional’s advice.