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Dermatologist Dr. Karan Lal examines the causes of butt acne and shares tips on treatment and pimple prevention
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How to Treat Butt Acne and Avoid Zit Breakouts

Last Updated: Jan 16, 2024 / By Bobby Box

To pop or not to pop the zit... that is the question! Bobby Box spoke with Dr. Karan Lal to examine the causes of butt zits, treating them, and how to prevent butt acne from appearing on your patootie.

I am no stranger to acne. Indeed, I was one of those quiet, insecure teens who rarely went without a face full of zits. It had gotten so bad that I was eventually advised to take a strong prescription medication to keep breakouts at bay.

I still get the occasional zit, but these have been manageable. The ones I'm more offended by reside on a different landscape. A place of bouncy abundance, where the sun doesn't shine. I'm talking, of course, about my butt, and butt acne AKA "butt-ne". 

According to market research from NPD, we're experiencing something of a butt acne pandemic, given the popularity of "athleisure" fashion, which we typically sweat in and is tighter-fitting. This combination, you will soon discover, makes your booty a breeding ground for bacteria and inflammation.

While the occasional "butt-ne" breakout is common, they still impact your sexual confidence. I've personally gone forward with the hygienic rituals for a hookup only to discover a butt zit breakout in the mirror and promptly call everything off. Would he have cared? I'm not sure, but I sure as hell did.

To help offer some guidance on the matter, I reached out to double board certified medical and cosmetic dermatologist, Dr. Karan Lal, on how to avoid and treat these backside blemishes so you can bottom with confidence.


Here's the thing: Butt acne, in most cases, isn't acne at all. What we perceive as butt acne is actually folliculitis (hair follicles that have become inflamed), which look nearly identical, but are caused by slightly different factors.

Pimples, for instance, are caused when a buildup of oil and dead skin cells clog hair follicles, causing inflammation and infection. Butt acne, however, occurs when the hair follicle is damaged or irritated, causing inflammation and infection. Mild cases of folliculitis last a few days.

Karan says that bacteria, moist environments, pressure, genetics, and smoking can all contribute to folliculitis on your rear. Considering these factors, butts are prone to folliculitis on your rear because the area is sweaty, prone to bacteria, frequently presented with pressure, and dressed in tighter-fitting clothing, all of which irritate and damage the hair follicle.

Sprinkle shaving, waxing, and trimming on top of that (each of which introduces bacteria, causing further inflammation) and it's no wonder we experience the occasional breakout.


Many confuse butt acne with STIs. However, STIs often present with rectal pain, rectal discharge, pain upon urination, and redness around the anus. And again, folliculitis often goes away in a few days. Karan notes herpes can appear similar to folliculitis, especially in those living with HIV.

RESOURCES: The complete guides on PrEP and practicing safer sex

If you find wounds that don't heal after a few weeks, you experience pain with pooping and/or urinating, you see the infection has spread, or you have an accompanying fever, Karan advises you speak with a doctor. Butt acne can also mimic a serious condition called "hidradenitis suppurativa" (a painful, long-term skin condition that causes abscesses and anal scars) and it is important to get an evaluation if you are getting recurrent butt breakouts.


If you want to limit the number of butt zit breakouts you experience, Dr. Karan says an antibacterial cleanser using benzoyl peroxide, salicylic acid, and/or chlorhexidine is your greatest defense as it attacks bacteria. He recommends you use it daily, especially if you're prone to breakouts in the area.

Learn how to treat butt acne and prevent pimples on the buttocks

The Acne Foaming Cleanser, made with four percent benzoyl peroxide, or the Acne Control Gel, made with two percent salicylic acid, both from Cerave, are effective and affordable options.

If you shave your cakes, Karan advises you to limit irritation by shaving with the grain, not against, and to change your razor blade every three to four shaves. He says you should also limit shaving to once a week, and, depending on the hair's length, trim it first so that it's roughly the length of a grain of rice. When you're done shaving, exfoliate using a salicylic acid or lactic acid-containing lotion.

Shower right after a workout and don't sit in sweaty undies. If you are experiencing a breakout, just trim the area, since shaving will only irritate things further. Some people also think it's wise to use alcohol to treat the area, but Karan says this too will further irritate the area.

No scrubbing, either. When we see a breakout, our inclination is to scrub the crap out of it to keep the area clean. But this is the opposite of what you want to do. Remember: these blemishes on your booty are not pimples, it is likely folliculitis. So what you're doing is harshly scrubbing an already irritated area, which can lead to hyperpigmentation and scarring.

Sitting also causes folliculitis due to pressure, but if you're working a desk job, that can be difficult. You should wear new underwear each day; perhaps even wear a new pair when they become sweaty. Similarly, in the warmer months, try your best not to lounge in a wet swimsuit. If possible, change into dry clothes as soon as you can.


If you do have a butt zit breakout, whip out a cleanser with benzoyl peroxide (Panoxyl is another option) and wash with it daily.

If a few of the blemishes grow and become painful, using a warm compress can help alleviate any discomfort and bring these bumps to the head. If the case becomes severe and/or persistent, consider seeing a dermatologist for topical and oral antibiotics which will help clear the area quicker.

Essentially, the best ways of treating butt acne are the same methods for preventing them. Clean using proper products, wear looser-fitting clothing, put less pressure on your bum when sitting, avoid shaving the area, change your undies often, and generally keep the area as dry as possible.


Found this guide on getting rid of butt zits useful? Go ahead and prime your patootie for the Summer and beyond with our best ass care tips.

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