Bikini line bumps are never welcome visitors. Whether they're ingrown hairs or inflammation from post-razor nicks, below-the-belt bumps hurt. To make matters worse, turns out there's another type of lump you should be weary of: vulvar acne (also sometimes called vagina acne). We asked the experts to weigh in on the under-the-underwear breakouts, as well as explain how to get rid of them.
## What is vulvar acne, pimples on the area near your vagina?
The acne that can appear around your vulva and bikini line isn't exactly acne, at least not in the way you're familiar with it on your face or other areas of the body. "Acne in the groin area is really more of a form of folliculitis, which is an inflammation around the hair follicles," Shari Marchbein, a board-certified dermatologist in New York City, tells Allure. "These can be pustules (pus bumps), red inflamed papilla, and even occasionally cysts."
Your hormones can also play a role in below-the-belt bumps — just like they can when it comes to breakouts on your face. "Some women may experience true flares with hormonal changes, which is more similar to traditional acne," Michelle Henry, a board-certified dermatologist in New York City, tells Allure .
The sensitive skin around your vulva and bikini line can also be susceptible to blackheads, Leah Millheiser, a clinical assistant professor of obstetrics and gynecology at Stanford University School of Medicine, tells Allure. "Blackheads on the labia are quite common," she says. Just like pores on your face can get clogged, so can the pores on your vulva.
All three of these acne-like bumps are different from ingrown hairs, which are also quite common below the belt and can also appear like painful cystic acne. From the surface, it can be tricky to tell the difference. "Acne lesions do not contain a trapped hair as ingrown hairs do," Henry explains. With the latter, the bumps will typically pop up right after waxing. (If they show up after shaving, especially if you didn't use a shaving cream, Henry says they're likely razor burn — not acne.)
## What causes these types of bumps on the bikini line?
What we think of as "vagina acne," can be caused by a variety of things. Folliculitis proper is caused by "inflammation of the hair follicles, which can be genetic," says Millheiser. "It can also be caused by wearing clothes that are too tight or being in warm moist weather," she says. In all cases, the bumps form when bacteria get trapped in the hair follicle.
Waxing and shaving can also trigger pimple-like bumps "as the sensitive skin in this area is more easily irritated and inflamed after hair removal," explains Marchbein. "Make sure to change razor blade every two to three shaves so that it is sharp and store it blade side up in the shower so as to not get it contaminated with bacteria."
## How can I tell if it's actually herpes?
Noticing a red bump on your vulva or labia might send up some red flags. But it's more likely to be acne or an ingrown than a herpes sore. "A herpes outbreak is usually proceeded by pain and sensitivity," explains Henry. "In addition, you will notice fluid or puss-filled bumps that will break open and then crust over." (For more on herpes, also known as HSV-2, check out this explainer, which highlights symptoms, treatments, and more.)
## How is vulvar acne treated?
"There are places that do what are called, 'vajacials.' They'll actually do an exfoliating scrub, and they'll take a little lancet and unroot any ingrown hairs," Millheiser says. As a gynecologist, she doesn't recommend these vagina facials. "For one, you don't know how sanitary some of these places are and secondly, exfoliants used on the vulva can actually serve as an irritant and make the problem worse."
For most follicular bumps, a gentle acne-fighting wash can help clear things up. "Ten percent benzoyl peroxide wash is a highly effective antibacterial wash that can be used daily on the bikini area," says Marchbein. "It can both treat and prevent breakouts." Just be sure you stick to the vulva (the outside, frontal part) and not the actual vagina (the moist area between the folds of your labia). If below the belt acne is hormonal (which is more likely to occur if you have certain conditions like polycystic ovary syndrome (PCOS), birth control can help, says Henry.
If the bumps are chronic (and especially if you're getting painful cyst-like bumps), check in with your dermatologist. They might recommend a topical or even an oral antibiotic to help clear things up.
Whatever you do, don't try to pop or pick at any of the bumps. "That can create an open sore, which puts you at risk for both a skin infection and also transmission of sexually transmitted infection," explains Millheiser. If the bumps are really bothering you, she recommends an at-home version of the "vulva facial": Soak in a warm tub with Epsom salts and use a loofah to gently massage the area in a circular motion.
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