Butt Acne

Medically Reviewed By William C. Lloyd III, MD, FACS
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What is butt acne?

Most people assume that a breakout of pimples on the butt is acne. In fact, butt acne isn’t really acne. Acne is a skin condition involving clogged pores. Pores become clogged when excess oil, dead skin cells, and bacteria are trapped inside them. Acne most often affects body sites that have a high concentration of oil glands. This includes the face, neck, chest, shoulders, and upper back. The skin of the buttocks does not have a lot of oil glands. So, true acne on butt cheeks is rare.

The pimples that show up on the butt are most likely folliculitis or keratosis pilaris. Keratosis pilaris is a harmless skin condition. It’s the result of a buildup of keratin—a hard skin protein—that blocks the hair follicle (this involves the infundibulum or pore that includes the hair shaft, sweat glands and oil glands). It causes small bumps that can look like acne. Folliculitis is inflammation of the hair follicle, which can also look like acne. The inflammation can be the result of irritation or infection. Contact dermatitis is another possible cause of a butt breakout.

Keratosis pilaris is very common and tends to run in families. Experts don’t really know what causes it. Folliculitis is the result of damage to the hair follicle that then causes irritation or allows germs to infect it. The damage can come from friction on the skin, wearing tight clothing, or shaving. While keratosis pilaris bumps usually don’t hurt or itch, folliculitis can be uncomfortable or painful.

“Butt acne” treatment depends on the underlying cause of the pimples. If it’s keratosis pilaris, you probably have similar bumps on the back of the upper arms or thighs. Moisturizing the skin right after showering can help soften the skin. An exfoliant cream containing lactic acid or similar ingredients can encourage the skin to turnover faster and prevent plugged follicles.

Treatment of folliculitis depends on whether or not it’s infectious. Folliculitis from irritation may improve if you remove the source of irritation, such as shaving or wearing tight clothing. Applying warm compresses and hydrocortisone cream may help soothe the area and reduce inflammation.

Because there can be several causes of so-called butt acne, see a dermatologist if the condition persists or is bothersome.

What are the symptoms of butt acne?

Most butt breakouts affect the center of the butt cheeks. The symptoms of the breakout can be clues to the true cause of the pimples.

Common symptoms of keratosis pilaris

Keratosis pilaris is a common cause of pimple-like bumps on the butt. It can also affect the upper arms and thighs. Like acne, it can happen at any age, but is common during adolescence and young adulthood. Common symptoms of keratosis pilaris include:

  • Rough, dry skin that can resemble sandpaper
  • Small, painless, bumps that can be pointy, have a white tip or center, or look reddish and smooth
  • Worsening of the condition when the skin is dry or the humidity is low, such as in the winter

Common symptoms of folliculitis

Folliculitis often affects the skin on the butt, groin, thigh, face, neck or underarm. It can happen to anyone. Common symptoms of folliculitis include:

  • Small red or white bumps around hair follicles
  • Swollen or irritated follicles
  • Tenderness, pain, itching or burning

In some cases, folliculitis can cause pus-filled blisters that open and crust.

See your doctor if you are concerned about the appearance of pimples on your butt or if they are painful or look infected. Several conditions can cause pimple-like breakouts on the butt. Getting an accurate diagnosis is important so you know how to treat it properly.

What causes butt acne?

Butt acne causes usually don’t involve acne at all. Pimples on the butt are rarely true acne. Instead, the most common causes of pimple-like breakouts on the butt are keratosis pilaris and folliculitis. Keratosis pilaris occurs when keratin builds up and clogs pores. This is different from acne, in which excess oil, dead skin, and bacteria become trapped and block pores. Keratosis pilaris is genetic and often worsens during dry weather or with dry skin.

Folliculitis results from damage to a hair follicle. The damage causes irritation and makes the follicle more prone to infection. Sources of irritation include shaving, tight clothing, and friction or rubbing. Hot, humid weather and sweating often worsen the problem. The most common cause of infectious folliculitis is Staphylococcus aureus bacteria.

What are the risk factors for butt acne?

The risk factors for developing a breakout on the butt depend on the cause. Keratosis pilaris is genetic, so having a parent with it increases your risk. It can show up during childhood, but is most common during the teenage years. In fact, about half of teenagers have this common skin condition. Things that make keratosis pilaris worse include dry skin and dry weather. It often goes away with age, but it can persist throughout adulthood.

Risk factors for developing folliculitis include:

  • Gaining weight, causing friction with clothes or other areas of skin
  • Having acne, dermatitis, or a medical condition that weakens your immune system
  • Shaving, waxing, wearing tight clothing, or wearing clothes that trap heat, moisture or sweat
  • Soaking in an improperly maintained hot tub
  • Using certain medications, such as steroid creams

Reducing your risk of butt acne

You may be able to lower your risk of developing pimples on your butt by:

  • Changing out of wet or damp bathing suits and workout clothes right away. Be sure to wash these items after each use.
  • Making sure hot tubs are properly maintained before using
  • Using proper technique if you shave or remove hair from your butt cheeks
  • Wearing loose clothing, especially when it’s hot or humid

If you are concerned about your risk of butt acne, talk with your doctor about strategies to keep your skin clear.

How is butt acne treated?

Butt acne home remedies and treatment depend on the cause of the breakout. Since it isn’t truly acne, acne products aren’t likely to work. In fact, they may make it worse. If you aren’t sure of the cause, see your doctor for the right treatment strategy.

For keratosis pilaris, moisturizing the skin while it’s still damp after a shower is a main treatment. Try products containing lanolin, glycerin, or petroleum jelly. Keeping the skin soft can help prevent keratin buildup. Using an over-the-counter exfoliant cream can help encourage skin turnover to keep follicles from clogging. Look for ingredients such as lactic acid, salicylic acid, urea, alpha hydroxy acid, or adapalene. In some cases, prescription-strength retinoid creams may be necessary. Other home remedies include:

  • Avoiding harsh cleansers and soaps and vigorous scrubbing or rubbing. Gentle exfoliation and mild cleansers will be less irritating to the skin. Remember to pat skin dry instead of rubbing it, as well.
  • Bathing with warm water for the shortest time possible. Long showers or baths and hot water can dry out the skin, making keratosis pilaris worse.
  • Using a humidifier during dry winter months. Turning up the one on your furnace may do the trick. Otherwise, consider a portable one.
  • Wearing loose clothing to avoid friction

Folliculitis treatment depends on whether or not an infection is present. Regardless, it’s important to avoid whatever is causing the folliculitis. This could include wearing loose clothing instead of tight, changing out of wet or damp clothing immediately, or not using hot tubs or heated pools. Seeing a dermatologist is helpful to understand what behaviors you need to change. A dermatologist can also prescribe treatment when an infection is present. This may include antibiotic creams or lotions. Other remedies for folliculitis include:

  • Applying warm, moist compresses several times a day and using soothing, anti-itch lotions
  • Using an antibacterial soap or cleanser
  • Washing towels and washcloths in hot water and changing them after each use

Because treatment approaches are different, it’s important to know what you’re treating. See your doctor or dermatologist for the proper diagnosis.

What are the potential complications of butt acne?

When butt breakouts are due to keratosis pilaris, it’s harmless physically. However, it can be embarrassing and make people self-conscious. With folliculitis, physical complications can be serious. When an infection is present, it can go deeper, forming boils—or furuncles. The infection can also spread, causing clusters of boils called carbuncles. This can permanently damage hair follicles and the skin, resulting in scarring or dark spots.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Oct 12
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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