Butt Acne: Causes, Treatment and Prevention - Health Essentials

Once upon a time, a sage by the name of Sir Mix-a-Lot took to the airwaves to extoll the virtues of a "Rump-o'-smooth-skin." Thirty years later, the skincare industry is awash with products designed to make that goal a reality — from butt butter and butt polish to butt masks and creams.

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Butt it still happens: baby got "buttne."

But what exactly is butt acne? Turns out — most of the time — it isn't really acne at all.

We talked to dermatology specialist Lauren Zamborsky, CNP, to find out what conditions cause pimple-esque blemishes on your behind, how to treat them and how to keep them from coming back.

What is butt acne, really?

The three most common causes of so-called butt acne aren't acne. Folliculitis, keratosis pilaris and boils (or, if there are multiple, carbuncles) are more common. In fact, you may have more than one of these conditions!

Folliculitis

When it comes to rump bumps, the most common culprit is folliculitis. Put simply, folliculitis is an irritation of a hair follicle.

That irritation could be the result of any number of issues, Zamborsky says. "It can be something very simple like friction, wearing clothing that's too tight, shaving too frequently or getting too close of a shave, waxing or even plucking hairs." Folliculitis can also be the result of a bacterial infection (the most common is staphylococcus aureus), a fungal infection (for example, a yeast infection of the skin) or even a mite.

People who have compromised immune systems (especially people with HIV and AIDS) can also contract rarer forms of folliculitis, like eosinophilic folliculitis. Doctors usually treat eosinophilic folliculitis with anti-retroviral medications.

Depending on what's causing the condition and the scope of the problem, folliculitis' appearance can differ. In some cases, folliculitis causes a single, pimple-like pustule to form. In other cases, it more closely resembles a rash.

Keratosis pilaris

Unlike folliculitis, which can make itself at home pretty much anywhere you've got hair, keratosis pilaris is usually confined to a few specific body parts:

• The back of your arms.
• The outside of your thighs.
• The back of your thighs
• You guessed it: your butt.

It's also commonly found on children's faces.

"Keratosis pilaris happens when keratin — a protein that's on the skin — builds up within the hair follicles," Zamborsky explains. "The conditions is very common among younger people. It's typically something you grow out of over the course of your lifetime."

She adds that keratosis pilaris occurs when your skin is very dry. As a result, the condition is more prominent during the winter.

Boils (carbuncles)

Fun fact: Boils are actually a specific type of folliculitis!

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OK … maybe not a fun fact. But it's good to know.

"You can have deep folliculitis or superficial folliculitis" Zamborsky notes. "Deep folliculitis is what we call a boil. The fancy name for a single boil is a furuncle. If there's multiple boils or they have multiple white heads in them, that's what we call a carbuncle."

The names are fun to say, but whatever you call them, these blemishes are no laughing matter.

"Boils are usually the result of an overgrowth of a bacteria called staphylococcus aureus — a staph infection," Zamborksy says.

About 20% of us have staphylococcus aureus living in our noses or on our skin, she continues. That bacteria can transfer under your fingernails and, from there, spread to other parts of your body. It's one of the many reasons you want to wash your hands regularly and avoid picking at zits of any kind.

While rare, fungi, streptococcus and pseudomonas can also cause these painful abscesses.

Other possibilities

While folliculitis, keratosis pliaris and boils are the most likely causes of so-called "butt acne," that doesn't mean there aren't other conditions that could be responsible. Some of the not-so-usual suspects include:

• Acne: While it's rare, you can have acne on your butt. "I always tell my patients, nothing in medicine is ever certain," Zamborsky says. "It would be rare for you to exclusively see acne on your butt. However, anything is possible."
• Contact dermatitis: Contact dermatitis is a fancy name for inflamed skin. Dermatitis happens when you make physical contact with an irritant or allergen. Perhaps the most common kind of dermatitis: eczema.
• Eczema: You can get eczema — a common condition that causes dry, itchy and scaly patches of skin — pretty much everywhere. Sometimes, eczema causes a bumpy rash that resembles pimples. 

Could I have a sexually transmitted infection (STI)?

If you've arrived at this article out of a fear that you've contracted a sexually transmitted infection, you aren't alone. A lot of people search the internet with this exact question.

The most common causes of butt acne aren't sexually transmitted, but it is possible to contract an STI with symptoms that include pimple-like bumps on your butt.

It's possible that what looks like butt acne is actually herpes. "Herpes simplex — the virus that can cause genital herpes — can sometimes look like pimples," Zamborsky says. "They're typically more blister-like and feel softer than a pimple."

For some people, herpes burns and itches. Other people don't notice any sensation at all.

Another possible diagnosis: Mpox (formerly known as monkeypox). This condition spreads through skin-to-skin contact and causes pus-filled blisters to form — and ultimately crust over — on your skin. While there is a vaccine for Mpox, it's not as widely available as one would hope. If you think you've been exposed to Mpox, you should see a doctor immediately, as you may be contagious.

It's also important to remember that both herpes simplex and Mpox can be spread through nonsexual contact as well. When in doubt, get tested.

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What causes butt acne?

At this point, we've established that "butt acne" is a misnomer. As there's a wide range of conditions that could manifest in pimple-like bumps on your behind, the list of possible causes is long. That said, there's such as thing as an "ideal ecosystem" for these kinds of problems. Let's break down the components:

• Sweating. Zamborksy notes that this is a particular problem for athletes — especially student athletes, who may be stuck in their sweaty uniforms for hours before they're able to get home and shower.
• Friction. Think carefully about the clothes you wear — particularly the fabric content and fit. You may need to dump the athleisure aesthetic in favor of something more breathable.
• Sitting. If your body isn't moving very much, all the sweat and bacteria you generate in a day are getting trapped on your bum.
• Shaving, waxing, depilating … messing with your hair follicles is a recipe for inflammation.

It's pretty hard to avoid booty blemishes, but you can reduce your risk with some minor lifestyle adjustments.

How to get rid of butt acne

Let's be honest: Butt pimples can be a bit embarrassing. If they're not causing you serious pain, you may prefer to treat them yourself at home. It's fine to try the DIY approach at first.

Here's the order of operations Zamborsky recommends:

1. If you aren't showering daily, start. Use simple soap and water and cleanse the affected area gently. If that doesn't work…
2. Try using an acne wash with benzoyl peroxide or salicylic acid in it. These kinds of washes may dry out your skin, so don't overuse them. "It's OK if it's not something you use every day," Zamborsky says. If you do use it every day, follow up with a noncomedogenic moisturizer (more on that later). If that doesn't resolve the problem…
3. Go to the drugstore and purchase an antimicrobial wash like Chlorhexidine® or Hibiclens®. "That's what we use for more severe cases," Zamborsky says.

If these at-home treatments aren't working, she advises getting checked out by a doctor.

"There can be a lot of different causes of butt blemishes. It's often a bacteria, but it could also be something like yeast. It could even be viral. Getting to the root of what's causing this issue is important and your healthcare provider will be able to work with you to figure it out."

In some cases — say, when a boil is particularly painful or severe — the doctor may need to lance it. Do not do that yourself. In fact, keep your hands away from your rump bumps as much as possible.

"The biggest thing I want people to be cognizant of is how important it is that you not pick your skin," Zamborsky emphasizes. "The more we pick our skin, the more irritated we make it and the worse the problem gets."

Butt acne prevention

As you can imagine, preventing butt acne is easier said than done. Still, there are a few things you can do to reduce the chances of recurrence.

• Get in the shower immediately after working out. If that's not possible, Zamborsky recommends at least changing your clothes.
• Wash often and gently. Showering every day can be helpful for a whole host of reasons beyond butt acne. It's also one of the most important lifestyle changes you can make to prevent zits. But resist the urge to scour your bottom with lots of fancy exfoliants: A gentle cleanse with soap and water — or one of the washes we mentioned earlier — is less likely to cause irritation.
• Use noncomedogenic moisturizers. Occlusive moisturizers have their place in your skin care regimen, but that place is not your butt. Opt instead for oil-free and noncomedogenic products that won't clog your pores.
• Get up and move. Whether by choice or obligation, sitting on your butt raises the likelihood that you'll encounter skin issues. Getting up and exercising throughout the day — even if only for a moment — can help.
• Maintain a healthy diet. We've all heard it: What you eat and drink impacts your complexion. That goes for your peach's complexion, too! Be sure to drink plenty of water and limit the amount of dairy, high-carb and sugary foods you eat every day. 
• Keep it cotton. Everybody loves a good pair of "funderwear," but if you're trying to keep your derrière clear of pimples, plain old cotton underpants are the way to go. If you can't stand the thought of plain panties, opt for breathable fabrics and avoid thongs.
• Avoid tight-fitting clothing. Friction isn't your friend when it comes to butt acne. So set aside the yoga pants and skinny jeans in favor of loose, breathable clothes.
• No pimple popping! Popping pimples may be satisfying, but it's also a bad idea. Remember, chances are you're not dealing with a run-of-the-mill zit (not that you should pop those either). If you have folliculitis or a carbuncle, you might cause the infection to spread or worsen. Still worse, you could pass it on to somebody else.

Questions your doctor might ask

If you decide to see a healthcare provider about your butt bumps, be prepared to answer the following questions to the best of your availability:

• How long has this been going on?
• Is this the only location where you're having this issue? Do you get it anywhere else?
• Is there anything that makes it better or worse?
• Do you wear tight-fitting clothing?
• How active (or inactive) are you?
• Do you sweat a lot in that area?

These questions will help your doctor figure out what the right diagnosis is and how to go about treating you.

The bottom line

If you like smooth butts (and you cannot lie), "buttne" can be a real buzzkill. While you can't avoid the conditions that cause butt blemishes entirely, simple adjustments to your daily routine can go a long way in protecting your posterior.