and Treating Butt Acne: Causes and Solutions

Acne on the buttocks?

Hello Doctor: I’m not sure if it’s related to prolonged sitting, but I have developed something that looks like a pimple on my buttocks, about 3 to 5 centimeters from the anal opening.
It shouldn’t be an external mole.
Initially, the bump was painful when sitting on it.
I tried applying Neomycin ointment (an antibiotic), and for the first couple of days, the bump reduced a bit, but then it remained slightly red, swollen, and raised (without any pus) for almost a week without improvement.
Although it no longer hurts when sitting, pressing on the bump still causes pain.
Should I continue applying the ointment? How long might it take to heal? I’ve also heard that anal fistulas can start as a pimple-like condition; is this what I have? Given the current pandemic, it’s quite awkward to go to the hospital for this issue.
I appreciate your guidance.

BIN, 40~49 year old female. Ask Date: 2022/05/26

Dr. Wu Yuxin reply Dermatology

I cannot provide an answer because I haven't seen the lesion and cannot determine what the issue is.
If it is causing you significant distress, please seek medical attention promptly to avoid delaying treatment, as the prognosis for acne and anal fistulas is different.

Reply Date: 2022/05/26

More Info

Understanding and treating butt acne, also known as folliculitis or acne mechanica, can be a complex issue that involves various factors, including hygiene, skin type, and lifestyle habits. The condition you are describing, where you have developed a painful bump on your buttocks, could indeed resemble acne, but it may also be related to other skin conditions.

Causes of Butt Acne
1. Folliculitis: This is an inflammation of the hair follicles, often caused by bacterial infection, irritation, or blockage. It can occur in areas where friction is common, such as the buttocks, especially if you sit for long periods.

2. Acne Mechanica: This type of acne is triggered by friction, heat, and pressure on the skin. It can occur from tight clothing, sitting for extended periods, or sweating.

3. Hygiene: Poor hygiene can contribute to the development of acne. Sweat, oil, and bacteria can accumulate on the skin, leading to clogged pores.

4. Hormonal Changes: Hormonal fluctuations can increase oil production in the skin, leading to acne.

5. Diet and Lifestyle: Certain dietary choices and lifestyle factors, such as stress and lack of sleep, can also influence skin health.

Treatment Options
1. Topical Antibiotics: You mentioned using a topical antibiotic ointment (like Neomycin). This can be effective in reducing bacterial load and inflammation. If you notice some improvement initially, it may be worth continuing for a short period, but if there is no significant change after a week, it may be time to consult a healthcare professional.

2. Over-the-Counter Treatments: Products containing benzoyl peroxide or salicylic acid can help reduce acne by unclogging pores and reducing inflammation.

3. Hygiene Practices: Ensure that you are keeping the area clean and dry. Regularly wash the area with a gentle cleanser and avoid using harsh soaps that can irritate the skin.

4. Avoid Tight Clothing: Wear loose-fitting clothing to reduce friction and allow the skin to breathe.

5. Warm Compresses: Applying a warm compress can help soothe the area and may promote drainage if there is any underlying infection.

When to Seek Medical Attention
If the bump does not improve with over-the-counter treatments or if it worsens, it is advisable to seek medical attention. A healthcare provider can assess the area and determine if it is indeed acne or if it could be something else, such as a pilonidal cyst or an abscess.

Concerns About Anal Fistulas
You mentioned concerns about anal fistulas. While it is true that some conditions can start as bumps or cysts near the anus, they typically present with additional symptoms such as persistent pain, drainage, or changes in bowel habits. If you experience any of these symptoms, it is crucial to consult a healthcare provider for a thorough evaluation.

Conclusion
In summary, while it is possible that you are dealing with a form of acne or folliculitis, the persistence of the bump and pain suggests that a more thorough evaluation may be necessary. Continuing the antibiotic ointment for a short period may be beneficial, but if there is no improvement, seeking medical advice is the best course of action. Remember, maintaining good hygiene and avoiding irritants can help prevent future occurrences. If you have any further concerns or if the situation worsens, do not hesitate to reach out to a healthcare professional.

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