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Vaginal Acne: Reasons, Prevention, and Treatment of Acne in the Pubic Area

Most people will experience breakouts on their inner thighs at some point in their life. Despite the fact that it’s not actually located in the vagina, pimples along the “saddle” of the inner thighs and on the labia are commonly referred to as vaginal acne. Generally, it resembles pimples and acne that you might get on your face. 

It’s important to remember that the skin of your genital area is sensitive, so do not use over-the-counter facial acne products on or near your labia and vagina without a health care provider's guidance, and never place any kind of facial acne medication inside the vagina.

Why does genital acne occur?

The skin in the genital area is very sensitive, and sweat, tight clothing, and body hair create an environment that encourages rashes and acne. 

In addition, hormonal changes can cause acne on the face, neck, shoulders, torso, and vaginal area. If you’re susceptible to hormonal acne, you might also be susceptible to vaginal acne. During certain phases of your menstrual cycle, you may be more prone to acne too.  

The good news is that the older you get, the less likely you are to get acne. 

Skin trauma, stress, food habits, insulin resistance, and body mass index can all play a role in the development of acne.

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Everyone is different, but tracking your cycle, including the start and finish of your periods and ovulation, may help you and your health care provider control your genital acne flare-ups.

The female body is more prone to genital acne than the male body due to fluctuating hormones, tighter clothing, and a higher incidence of hair removal. These factors, coupled with sweat, create a climate that produces acne.

Acne vs. pimples: what’s the difference?

The terms acne and pimples are used interchangeably to describe small hyperkeratotic clogged pores in the skin. They occur when the sebaceous glands produce too much sebum and the pores become clogged with a mixture of oil and dead skin cells. Skin hyperkeratinization, inflammation, and the presence of anaerobic diphtheroid bacteria can also cause acne.

A pimple is a single infected bump that may or may not be caused by changing hormones. Acne refers to a group of pimples, redness, or rash. It’s typically persistent, although certain catalysts can cause acne flare-ups that cover a greater area of the skin.

Both acne and pimples can occur anywhere on the body but are more common in sensitive areas of the skin. The face, neck, back, and inner thigh/genital region are more prone to pimples and acne than other places, such as the legs or forearms. People who naturally produce more skin oil are also more likely to develop acne and pimples.

Vaginal acne treatment options

Treatment options for vaginal acne vary according to the type and cause. Contact with allergens, hormonal changes, sweat, or viral infections can all lead to the same result, but they require different treatments. 

In most cases, an over-the-counter solution recommended by your dermatologist will help reduce redness and itching. Ceasing the activity or changing the clothing that caused the acne may also reduce the risk of recurrence and help your treatment work.

Be careful when treating vaginal acne. Use only products that were approved by your health care provider for your particular condition and avoid picking at blemishes. The vagina is a mucous membrane, and picking at the skin around it may spread the infection to a vulnerable area.

Let’s take a closer look at conditions that can trigger or worsen vaginal acne.

Contact dermatitis

Contact dermatitis is the skin’s reaction to perfumes, dyes, or other chemicals. Even scented sanitary pads or tampons can cause contact dermatitis, so it’s best to opt for unscented products. 

Folliculitis

This is the medical term for the infection of one or more hair follicles due to bacteria. Folliculitis can occur after shaving your pubic hair because newly grown hair can curl back toward the skin, causing irritation. A hair can also grow back into the skin, which is called an ingrown hair. 

Ingrown hairs can be pulled out with tweezers, but make sure they are very clean — sterilize them with isopropyl alcohol before use. Your dermatologist can also remove ingrown hairs in a safe, sanitary environment to prevent scarring or infection. 

In addition, wearing tight clothing and sweating can also increase the risk of developing folliculitis.

Skin-against-skin chafing

This condition occurs when the delicate skin of the inner thighs rubs together. 

This happens to many people, especially in the summer or during vigorous exercise. 

Long-term friction may eventually cause the skin to break and become infected, resulting in redness and sometimes pimples. 

Viral infections

The DNA poxvirus molluscum contagiosum has a similar appearance to chafing and causes small flesh-colored bumps that may turn into pimples. It’s transmitted by coming into contact with the skin of an infected person. 

This virus can live for a while after being exposed to air, so items like underwear, towels, or anything else that come into contact with infected skin may transmit the virus. 

To be safe, don’t share towels or underwear and avoid sexual contact with people who exhibit symptoms.

Diagnosis is usually made via a visual inspection of the infected area, and a microscopic test can confirm diagnosis.

This infection can go away on its own, but there are creams and dermatological treatments that may help reduce the inflammation it causes.

  • Wash every piece of clothing that will come into contact with your genital area with unscented detergent. If your vaginal acne is caused by contact dermatitis, make sure to use only unscented products for your menstrual cycle and avoid douches (which should generally be avoided anyway).
  • Diligent hygiene during your period can help reduce acne flare-ups during this time. If you do have an acne flare-up, it’s very important to protect broken and infected skin from bacteria during your period. 
  • Irritation and tight clothing can further irritate the skin and cause pimples. Re-wash anything that was washed with a fragrance  and apply petroleum jelly to the affected areas until it heals.
  • Preventing ingrown hairs may mean foregoing hair removal or opting for other hair removal treatments, such as laser hair removal, instead of shaving. If you prefer shaving, use a sharp razor and change it frequently. 
  • Always shave in the direction of hair growth. Make sure to use a gentle exfoliant around the pubic area if you do choose some form of hair removal.

Your choice of underwear and other clothing can have a big impact on the recurrence of vaginal acne. Pure cotton or other natural, breathable material may help keep the skin from trapping sweat. Wash frequently, and avoid overly tight clothing for prolonged periods of time.

Something contagious can easily be mistaken for vaginal acne — certain kinds of STIs, such as genital warts and herpes, may mimic the appearance and symptoms of vaginal acne. 

It’s essential to have any rash or inflammation around this sensitive area checked by a dermatologist. For your comfort and your health, this condition should be treated promptly

“Hidradenitis Suppurativa.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 16 May 2019, www.mayoclinic.org/diseases-conditions/hidradenitis-suppurativa/symptoms-causes/syc-20352306.

UpToDate, www.uptodate.com/contents/pathogenesis-clinical-manifestations-and-diagnosis-of-acne-vulgaris?search=acne&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2.

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