How to Treat Vaginal Acne, According to Dermatologists

Acne on any part of the body can be a tremendous challenge to treat. But breakouts in the vaginal area are especially difficult. Not to fret, though—according to experts, pimples down there happen to almost everyone, and they're absolutely treatable.

Sometimes, this happens along the bikini line; other times, pores on your vulva can become clogged, causing blackheads in private areas. We tapped board-certified dermatologists Michele Green, MD, and Marina I. Peredo, MD, FAAD, and aesthetician and dermatological nurse Natalie Aguilar, for the lowdown on below-the-belt breakouts. Read on for everything you need to know about treating and preventing vaginal acne.

What Is Vaginal Acne?

"Vaginal" is actually a bit of a misnomer, as the vagina is the term used to describe the actual canal, an area that isn't prone to acne. Instead, the correct term is vulvar acne. There are a few different types of breakouts that can develop in the vulvar area, including "comedonal lesions (much like a blackhead), a papule, pustule (pus-filled lesion), or cyst (which are generally larger and more painful)," says Green.

Although common, breakouts along the bikini line and groin are, according to Green, "very upsetting for my patients. Without warning, many people develop sebaceous cysts or acne-type eruptions in the groin and vaginal area. It is very important to stay on top of these things, as serious bacterial infections can occur."

Although vulvar is common, Aguilar notes that "there are also several other conditions, some infectious, that may be mistaken for vaginal pimples such as yeast or viruses"—another reason to keep an eye on any breakouts in the groin area.

What Are the Causes and Types of Vaginal Acne?

Folliculitis

According to Peredo, one of the most common types of acne that can develop on the genitals is folliculitis. "Folliculitis is inflammation around the hair follicles, typically from shaving. The hair gets trapped under the skin and becomes clogged," she explains. "Folliculitis can also occur from wearing tight clothing and ingrown hairs. The hair in the genital area tends to be curly, so it is more common for folliculitis to occur. The key is to make sure that you have good personal hygiene after shaving." Ingrown hairs are easy to identify, as Green says you can often "visualize a bump underneath" that appears as a "small black dot."

To avoid folliculitis, especially if you're prone to developing ingrown hairs, Green advises laser hair removal treatments.

Hidradenitis Suppurativa

Another highly common type of vaginal acne is hidradenitis suppurativa, which Peredo calls "inverse acne. These are large, painful cysts that normally affect the vaginal area, genital area, or under the arms or the breasts. This occurs when a hair follicle becomes clogged, which is followed by follicular rupture and a foreign body-type immune system response. They can be painful and don't heal very well, which can result in scars. Green notes that this type of acne and "infection can be so large and painful that oral antibiotics, cortisone injections, and surgical excision are often necessary to treat this. Hidradenitis suppurativa can also be treated with isotretinoin in some cases.

Clogged Pores

Aguilar says clogged pores can also contribute to vaginal acne: "Vaginal pimples can form when dirt, sweat, and bacteria build up inside a pore, causing inflammation." These types of pimples are, according to Aguilar, "just like pimples on any other part of our face and body. They can be small, or they can be big."

Irritation

Irritation or excess heat, according to Green, is another cause of vaginal acne. "Many people, especially during the summer, exercise, swim, and stay out in the heat without showering. The perspiration and clogged pores, especially in the buttock and vaginal area, can cause acne breakouts."

If the breakout results from contact dermatitis, Green says "exposure to different chemicals, creams, laundry detergent, fragrance, sanitary pads, feminine wipes, perfume, fragrant bubble baths or lotions, or anything else that comes in contact with the vaginal area" can be the culprit. "Occlusion from heat, sweating, tight clothes, spandex (and other fabrics other than cotton) can cause this type of acne or cysts in the vaginal area," she explains.

Treatment

• Keep the area clean and pH balanced: "It's best to clean the bikini line with appropriate pH-balanced cleansers made for the vaginal area," suggests Aguilar. "Other cleansers can irritate and throw off the pH of the area, causing a bacterial imbalance and making it an ideal environment for bacteria."
• Compresses: Compresses are a good solution to "bring down inflammation and calm some of the pain," says Aguilar. "You can hold a warm water compress, followed by an ice-cold water compress" to the area. Peredo is also a fan of warm compresses, followed by spot treatments. "Benzoyl peroxide is a great product to use to prevent breakouts," she says.
• Products: Aguilar suggests you apply Fur's Ingrown Concentrate Oil ($32). "This oil can be applied post-shave or after cleansing. It helps soothe irritation and lightens discoloration." She also likes Completely Bare Bikini Bump Blaster Pads ($11), which are saturated in witch hazel, salicylic acid, and glycolic acid. "This blend helps reduce the appearance of ingrown hairs and bikini bumps." Plus, she loves the acidic combo: "It's amazing for blemishes and keeping the pores fresh, clean, and balanced," she says.

When to See a Doctor

To prevent further infection, you might have to see a doctor, even to treat an ingrown hair. "If it doesn't resolve within two to five days and becomes more painful, you may need to see a gynecologist or dermatologist," advises Aguilar. She notes a doctor can "recommend a topical or oral antibiotic to soothe inflammation and prevent further infection. They may also have to extract the hair."

She says these types of breakouts shouldn't be embarrassing. "Anyone who grooms, whether it be shaving, waxing, trimming, plucking, sugaring, or even cleansing, can be prone to [folliculitis]. I also have several clients who are prone to ingrown hairs simply from riding a bike. It is more common than we will ever know."

Finally, a physician's diagnosis is always a good idea with these breakouts. According to Peredo, some lesions may look like acne but are, in fact, sexually transmitted diseases or infections. "Herpes on the genital area can appear as a pimple, but it's really a vesicle, a fluid-filled pimple," she says. "Molluscum contagiosum can often be confused with acne because it looks like tiny brown bumps with a dimple in the center. This virus is sexually transmitted." Similar to condyloma, or vaginal warts, "molluscum contagiosum can spread," says Green, "and needs to be treated."

Finally, any discharge or odor from the vaginal area, according to Green, should warrant a consultation with a board-certified dermatologist "to assist you before the problem becomes more serious."