What causes pimples on the butt?

We may be used to finding acne on our faces and upper body, but what causes pimples on the butt? Technically acne vulgaris, what we generally refer to as acne, rarely appears on the buttocks. There are some conditions that commonly appear on the behind that can look similar to acne–but are not.


What causes pimples on the butt
Acne on the butt usually isn’t acne vulgaris


Keratosis pilaris

Keratosis pilaris (or KP) is a common skin finding on many people that can look like acne but is not.  People with keratosis pilaris may have red, brown or flesh-colored scaly papules that look like pimples.  These papules mostly typically appear on the backs of arms, upper back, lateral thighs and sometimes also the butt.  Sometimes keratosis pilaris occurs on the cheeks but usually in children.  Keratosis pilaris can look like acne or acne with hyperpigmentation.  As acne is common, sometimes a person has both keratosis pilaris and acne vulgaris.  On the buttocks, however, KP is more likely the condition.

Keratosis pilaris is a normal finding on some people’s skin.  Some people don’t like the appearance and want to treat it.  Moisturizing and exfoliation with products such as salicylic acid, glycolic acid or azeleic acid sometimes reduces the feel and appearance of the bumps, however, keratosis pilaris is difficult to treat.

buttock keratosis pilaris
Keratosis pilaris on the butt may look like acne

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Folliculitis is either inflammation or infection in the hair follicle.  Technically, acne vulgaris is a type of sterile inflammation in the hair follicle that originates from a clogged pore, or microcomedo.  The microcomedo, in conjunction with the activity of normal bacteria that live in the hair follicle, causes an inflammatory reaction which creates a pimple.  On the buttocks, however, pimples more commonly arise from a bacterial infection or inflammation from excessive sweating or friction.  Depending on the cause, the treatments for pimples on the butt that are really folliculitis differs.  If there is an infection then antibiotics and benzoyl peroxide wash can be the remedy.  If the cause is sweating, benzoyl peroxide wash is also helpful.  Your dermatologist may also prescribe a prescription antipersperant.  (Note, that benzoyl peroxide bleaches fabric.  It’s important to wash it off carefully so as not to damage towels, bathmats, sheets and clothing–especially when using it on the body).

RELATED: What will a dermatologist do for back acne?


Boils, carbuncles, and furuncles are bacterial infections that start in the hair follicles, like acne, but grow larger.  These pimples are generally larger than 1 cm and can develop into an abscess. Boils on the butt can be the sign of a serious skin infection, such as with the bacteria Staphlococcus aureus. If the boil comes to a head, sometimes it is enough to treat it with surgical drainage.  Your dermatologist may also want to send a culture to the laboratory to determine the cause and which antibiotics the organism is sensitive to. A culture can be especially helpful is these types of pimples on the butt recur frequently.  In addition to surgical drainage, treatment for boils on the butt includes antibiotics, benzoyl peroxide wash, and antibacterial soap.

So, when you wonder what causes pimples on the butt–that isn’t acne, these are some of the conditions to consider.  If you require help for acne on the butt or other problems, make an appointment with our expert, Manhattan dermatologist Dr. Dina Strachan here.


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