Why Do I Get Pimples On My Butt?

Overview

It is important to know that butt acne is not actually acne. It is not regarded as true acne but is mostly classified as folliculitis, which is a form of skin irritation. It is quite common, and it mostly affects men. It is generally benign and non-life threatening.¹ Butt acne could be secondary to an infection, however, there are other important non-infectious causes of butt acne (eg., eosinophilic folliculitis).² There are various types of butt acne:

1. Closed comedonal, which are small skin-coloured bumps
2. Open comedonal, which are dark brown/black bumps with an opening to the surface of the skin
3. Pustules, which are pus-filled bumps
4. Papules, which are small, red, swollen bumps
5. Cysts, which are larger, deeper bumps that can become red, angry and inflamed, and may sometimes drain material. 

Butt acne mostly consists of two or more of the above types.

Causes of butt pimples

While it's not impossible to have pimples on the butt, it's not a common site for breakouts. Depending on the causes of the butt acne, they appear differently. Butt acne could have several causes, among which the following are most common: folliculitis boils and keratosis pilaris.

1. Folliculitis is a result of inflammation of the hair follicles and is the most common cause of butt acne. It could also result from bacterial infection, such as Staphylococcus aureus, a fungal infection or even a mite infestation.³
2. Boils (skin abscesses) are painful, very large pimples or clusters of larger pimples that develop when a hair follicle gets infected. They can form on any part of the body, the butt being a common location.
3. Keratosis pilaris happens to be another very common skin condition. They look like tiny pimples and develop when there is a buildup of the protein that forms the protective layer of the skin. This could result in the formation of a hard plug creating the bump seen and felt on the butt.⁴

Other causes of butt pimples are contact dermatitis, eczema, and acne.

Signs and symptoms of butt pimples

The signs and symptoms of butt acne could help in determining the cause of the breakout. Based on the causes, the following are some symptoms of butt:

1. Keratosis pilaris presents itself as painless, dry and small bumps. The skin may be itchy and rough.
2. Folliculitis presents itself as small red or white bumps around the hair follicles. The hair follicles may be swollen or irritated. Pus-filled blisters that may burst and crust can also form. There may be an overall feeling of tenderness, pain, itching or burning.

Management and treatment for butt pimples

Treatment of butt acne depends on the cause.

1. Folliculitis mostly goes away on its own. The eruptions dry out after a cascade of inflammatory responses in the hair follicle. Butt acne is mostly treated with topical antibiotic creams or wash such as benzoyl peroxide. Benzoyl peroxide reduces the level of acne-causing bacteria and inflammation. The product should be applied and left for about 5 minutes on the target region before rinsing it off to allow effective therapy.
2. Keratosis pilaris is often considered to be a result of dry skin. Hence, moisturising helps in dealing with dry patches.
3. Boils are often treated with oral or topical antibiotics because they go deeper into the skin. In some instances, a healthcare provider may prescribe antibiotics or pierce and drain out the accumulated pus from the boil. and bandage it to cover the exposed skin.⁵ 

It is important to maintain appropriate hygienic conditions to combat butt acne. Shower regularly using simple soap and water to clean off the affected areas, wear loose clothing, and exfoliate regularly using a mild exfoliating wash. Antimicrobial washes such as Chlorhexidine could be used. It is important to get to the root cause of the acne to adequately treat it. 

How can I prevent butt pimples?

Butt acne can feel unusually embarrassing. To prevent breakouts on the butt, the following should be considered:

1. Clothing: Loose-fitting clothing and cotton underwear should be prioritised. Tight-fitting clothing can contribute to irritation of the skin hence causing inflammation.
2. After-workout showers: Staying in your workout outfit for long after a workout session increases your risk of having breakouts not only on the butt but also on other areas of the body. Showering immediately after your workout with antibacterial soap is a necessary precaution to prevent breakouts on the butt.⁷ 
3. Laundry: you must wash your clothes, towels, and sheets regularly to prevent the transfer of bacteria to your skin.⁸
4. Avoid fabric softeners: Avoid such products or ensure they do not, for example, contain dyes.
5. Healthy diet: it is necessary to maintain a healthy diet. What you eat and drink impacts your complexion. Make it a habit to drink plenty of water daily.
6. Moisturiser: opt for an oil-free moisturiser that will not clog your pores.
7. Pimple popping: to avoid at all costs. 

When should I see a doctor?

The appearance of butt pimples should be reported to your healthcare provider to receive the appropriate treatment. When butt acne becomes inflamed or severe, the bumps are larger, pus-filled, or very tender. Call your doctor right away as this could be the result of an infection and may require a stronger prescription.

Summary

Butt acne is usually due to an underlying condition such as folliculitis, keratosis pilaris, or boils. Very rarely, it is true acne. Butt acne is treatable, and once you experience butt acne, it is advised to contact your healthcare provider so that an accurate diagnosis can be performed and the appropriate treatment can be administered.