Have you ever looked down at your bikini area and wondered: Is that acne, a bunch of ingrown hairs, or something health-related I should be concerned about? Because if you have, you’re not alone, it’s just that talking about acne and vaginas is still typically taboo, and for that reason it isn’t always easy to find answers. To learn more about acne in the pubic areas, we reached out to two dermatologists with our most pressing questions. Here’s what they had to say:
Julia Tzu, M.D., the Founder and Medical Director of Wall Street Dermatology, explains that acne in the private area can be separated into two categories: Folliculitis (inflammation of the hair follicle) and pseudofolliculitis (inflammation from an ingrown hair).
“Technically speaking, this isn’t acne,” Dr. Tzu tells us. “However, both folliculitis and acne appear as scattered red, inflamed bumps, or pus-filled bumps. In the case of folliculitis, the inflammation is centered around the hair follicle.” Joshua Zeichner, M.D., the Director of Cosmetic and Clinical Research for Mount Sinai Hospital’s Department of Dermatology, reaffirms this and adds that true acne in the genital area is uncommon, but can occur because there are many oil glands in that region.
Since razor bumps and folliculitis are two different things, Dr. Tzu explains, “The difference between folliculitis and pseudofolliculitis is whether the inflammation is centered around the actual hair follicle (folliculitis) or whether it is centered on the hair shaft repenetrating the skin (pseudofolliculitis).” She adds that it can be difficult to distinguish between the two because they look similar. Most of the time, according to Dr. Tzu, both pseudofolliculitis and folliculitis are present because shaving and waxing can lead to both conditions. Additionally, Dr. Zeichner says that folliculitis is a minor infection of the hair follicle that causes red bumps around the follicle along with pus pimples, and razor bumps are caused by ingrown hairs and razor burn.
Dr. Tzu says that several factors can contribute to folliculitis. Firstly, there’s irritation caused by friction, which can come from shaving, waxing, or constant rubbing. To help prevent it, use loose-fitting clothes and use an anti-chaffing product.
The second thing that could be causing vagina pimples and acne is moisture being trapped in the pubic area. This can happen if you don’t fully dry the area after bathing, if you wear tight clothing for extended amounts of time, and if there is a lot of dead skin cell build-up. To prevent this, make sure to towel-dry your intimate area post-shower, wear breathable materials (like cotton and linen), shower immediately after exercising, and exfoliate your vulva twice a week with a non-irritating body scrub or exfoliator.
It’s important to make a distinction between true acne in the pubic area and folliculitis. The former isn’t widespread, while the latter tends to be more common. “Folliculitis is very common and can occur on the chest, buttocks, scalp, and genitals,” states Dr. Tzu. “Folliculitis of the genitals specifically is common enough for me to see several cases a week.”
“Folliculitis may be treated with antibacterial soaps or a surgical grade cleanser called Hibiclens,” says Dr. Zeichner. “Alternatively, try a benzoyl peroxide-containing wash to kill bacteria on the skin, and make sure to leave it on your skin while you sing the alphabet—this gives it enough contact time to do its job.”
To keep the pubic area acne-free, Dr. Tzu recommends that we also avoid frictional irritation while keeping the pubic area clean and dry. Both Dr. Tzu and Dr. Zeichner suggest that one consider laser hair removal if they permanently want to eliminate hair removal-related breakouts. However, Dr. Zeichner mentions that such a procedure is typically not covered by insurance, so take into consideration the pricing before jumping in.
“If over-the-counter products aren’t working, visit your dermatologist for evaluation for a prescription options,” Dr. Zeichner concludes. “Topical dapsone is a non-irritating option that will not bleach fabrics, two factors that are important when treating the bikini area.”