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You woke up early to exercise, sweated your way through a hot yoga session and were enjoying your post-workout endorphin high — until you noticed pimples starting to form on your bum and along your bra line. Sigh.
While body acne is common, finding effective prevention and treatment options can be more challenging than your morning vinyasa. From moisturizers and lotions to body washes and butt masks (yes, it’s a thing), it can be hard to know what products will actually work.
“There are also hundreds of over-the-counter products being marketed to you, plus well-intended people providing inaccurate advice in all forms of media, so it’s hard to know what to believe,” says James Vary, MD, a dermatologist at the Dermatology Clinic at UW Medical Center – Roosevelt.
Luckily, banishing blemishes and caring for your skin doesn’t have to be complicated. Simplify skin care with these easy and effective methods for treating body acne.
What are the different types of body acne?
While we often call all red, pimple-like bumps found on our bodies acne, there are actually two main categories of pimples: acne and folliculitis.
Acne is an inflammation caused by plugged hair follicles with a buildup of fatty substances secreted by your skin’s oil glands. Acne usually only develops on your face, upper chest and back, because that’s where these oil glands are most concentrated.
Folliculitis, on the other hand, is inflammation or an infection of hair follicles, often caused by staph bacteria, so it can occur anywhere hair follicles are found. (This means if you have a pimple on your bum or legs, folliculitis is the likely culprit.)
Healthcare workers and athletes are particularly prone to folliculitis because staph bacteria are present in hospitals and gyms.
Other factors that lead to the formation of both acne and folliculitis include tight clothing, diet, heavy makeup or moisturizers, hormones, pollution and poor hygiene (but we’re talking really poor hygiene, like not showering for weeks — not just skipping a hair wash day here and there).
How can you prevent body acne?
One of the best ways to deal with acne and folliculitis is to prevent them from occurring in the first place. (Easier said than done, of course.)
“Acne treatments don’t do very much good for the acne you already have — they’re better at preventing the acne you’ll have in six to eight weeks, so starting a skincare regimen will get your skin looking clearer once your current acne has run its course,” says Vary.
Here are some ways to prevent body acne.
Wear loose, clean clothing
If your blemishes are centralized on your legs or bum, tight-fitting clothing like leggings or yoga pants might be to blame.
To help your pores breathe, add some looser items into your weekly rotation and be sure to wash your workout gear (and other clothing) between uses.
“It depends too on the material of the clothing, as some clothing wicks the sweat away better versus trapping it against your skin,” says Tanya Greywal, MD, a dermatologist at the UW Medicine Eastside Specialty Center.
Consider your diet
While more research is needed, some studies have found that dairy and foods with high sugar content can increase your risk of breaking out. This includes high-glycemic foods like bread, white rice and potatoes.
If you experience random break outs, pay attention to what you are eating to see if there are specific foods that trigger these blemishes.
“For people who notice that dairy exacerbates their acne, limiting how much you’re eating can be helpful. Choosing whole milk or whole-fat dairy over skim milk is preferred since non-fat dairy products have a higher glycemic index,” Greywal says.
Reduce stress
“Reducing stress is a great goal for nearly every problem we see as physicians, and acne is no exception,” Vary says.
Getting movement during the day can help reduce stress. Make sure you talk with a professional if your stress is becoming too overwhelming.
Shower smarter
Regularly cleaning your face and body helps keep your skin healthy and clear by removing excess sweat and body oil. Try especially to shower after you’ve worked out or sweated more than usual.
But be aware that you don’t need to go out and buy any fancy shower tools to keep your body clean.
“Loofahs, sponges, washcloths and other abrasive products can actually irritate the skin, making it respond with more inflammation,” Vary says. “Our outer skin’s epidermis naturally sheds constantly and actually turns over completely every four weeks. It doesn’t need help with this.”
To maximize the benefits of your shower, use a gentle cleanser or soap, or an antibacterial soap if you have acne pustules on your body.
Be picky with your products
Ironically, your skin care routine might actually be contributing to the problem.
Be sure that your moisturizers, makeup and lotions say noncomedogenic on the bottle, which means they’re less likely to plug your follicles and form acne. If you are still breaking out after using a noncomedogenic lotion or sunscreen, it might mean it is too heavy for your skin type, and it is plugging your pores.
As for other at-home or natural products like coconut oil or shea butter, it depends on your skin type. Oil-based moisturizers might work for people with dry skin, but for those prone to oily skin, these products will exacerbate acne and folliculitis.
Benzoyl peroxide washes can be helpful, too. Start with a product that has a smaller percentage of benzoyl peroxide, maybe 2% to 5%, and gradually increase how often you use it, so it doesn’t dry your skin out. (And note that benzoyl peroxide has a bleaching effect if it gets on towels or clothing.)
“There’s been some concern recently about benzene being found in some benzoyl peroxide products, and while the manufacturers are all trying to fix this ASAP, storing it in the refrigerator seems to really reduce the risk of benzene forming and is probably a good idea,” Vary says.
How can you treat body acne and folliculitis?
“A lot of treatments we use for acne can work for folliculitis, too, such as a benzoyl peroxide wash and topical antibiotics,” says Greywal.
Applying a topical antibiotic like an antibacterial body wash or scrub with added benzoyl peroxide will help treat blemishes.
Chemical exfoliants — meaning body wash products with salicylic acid, glycolic acid, alpha hydroxy acid (AHA) or beta hydroxy acid (BHA) — will remove the plugs from your hair follicles.
And avoiding irritants like tight clothing or heavy makeup during a breakout allows your skin to heal.
However, more persistent or severe breakouts require working with a doctor on specialized treatments.
Body acne treatments
If you’ve tried the standard treatments and are still dealing with body acne, it might be time for a topical retinoid, which is an ingredient chemically related to vitamin A that will remove any dead skin in your pores.
Based on your skin type and the severity of your body acne, you have some retinoid options. You can purchase over-the-counter products that contain a retinoid (adapalene), or a doctor can prescribe you prescription-strength retinoid such as tretinoin.
In more severe cases of acne caused by excessive oil production, a doctor can also prescribe hormonal medicines like oral contraceptive pills or spironolactone to treat acne. Your doctor can also prescribe oral forms of vitamin A, called isotretinoin, which can help if you have severe acne that hasn’t already responded to other prescription medications.
Folliculitis treatments
It can help to avoid some of the same things you would to prevent acne, namely tight clothing (a mechanical irritant), as well as harsh lotions and makeup (chemical irritants) that can exacerbate a breakout.
If your pus bumps persist, speak with a doctor, as the folliculitis might be caused by other factors, like different types of yeast, that might need to be treated with antifungal topicals or pills.
Pigmentation and acne scarring treatments
Taking care to prevent new pimples is the first step to fighting pigmentation and scarring. Once your acne is under control, you have more options to deal with the after-effects.
It can take a long time for your body to clear up any discoloration from prior pimples — but in most cases, it will clear up eventually. However, acne scarring which commonly appears as depressions in the skin can be permanent if left untreated.
To avoid this, apply topical retinoids or products that contain hydroquinone, glycolic acid, azelaic acid, or tranexamic acid, which help lighten pigmentation. It is also important to use noncomedogenic sunscreen, both as a general skin care rule and because it will prevent further pigmentation. Tinted sunscreens may be especially helpful at both preventing further pigmentation while also temporarily minimizing its appearance.
For those who do need more intensive treatments, options include chemical peels, microneedling and skin lasers, which target pigment by brightening the skin and stimulating new collagen production, filling in the indentations left by scars. Just be sure to consult with a trusted doctor before moving forward with any of these procedures, as they should be done under the guidance of an experienced specialist.
When to seek out an expert
You may think you can only turn to a dermatologist in more severe cases where prescription medication or intensive treatments are needed, but it’s OK to seek help for simpler scenarios, like deciding on a skin care routine. Ask your primary care doctor if they think you need a referral (though keep in mind that there’s a shortage of dermatologists, so you might have to wait a while before you can get in for an appointment).
And if you’ve tried various products and still aren’t seeing results, a dermatologist can provide some additional options. They will conduct a physical exam, perform testing if necessary and develop a treatment plan that will be most helpful for you.
“If you’re getting acne and continuing to get more of it, it’s better to see a dermatologist sooner rather than later to help prevent scarring,” Greywal says. “We can combine over-the-counter medications with prescription medications to help you get better results.”
This article was originally published June 21, 2021. It has been reviewed and updated with new info. McKenna Princing contributed to this article.
