We all want the same thing from shaving—smooth, bumpless, irritation-free skin. But at the same time, we expose our armpits to some pretty intense stuff (hello, razor blades), plus deodorants, body wash, etc. The result can be pimples—or more likely, skin conditions that look like, but are not in fact pimples. Fortunately, most of the skin concerns that arise in this area have simple solutions—and can even be mitigated by changing the way you shave.
What Are Armpit Breakouts?
Most often, what might look like a pimple (or pimples) in the armpits, is in fact, something else, but that’s not to say it’s impossible to break out under your arms. "Typically, 'pimples' in the armpit or underarm are not actually acne," says South Carolina-based, board-certified dermatologist Dr. Marguerite Germain. There are a few options for what you could be dealing with–and you might need to seek professional help to make sure you get it correctly ID-ed.
These are some of the common culprits:
- Folliculitis & Pseudofolliculitis: A condition in which the hair follicles become inflamed or infected and can commonly occur after the skin is open (like after shaving). It is also common in those who are immunosuppressed, or prone to skin infections, Massachusetts-based, board-certified dermatologist Dr. Abigail Waldman explains. Pseudofolliculitis, she says, comes from "irritation of the follicle or an ingrown hair resulting from shaving or waxing or tweezing."
- Bacterial Infection (aka furuncles): A larger infection of the follicle is often referred to by the peculiar name of 'furuncle.' (Also known as a boil, these are painful infections that form around a hair follicle and contain pus.)
- Contact Dermatitis: This usually appears as itchy, bumpy, red irritated skin and is a result of using a product that may have an ingredient you are allergic or sensitive to.
- Hidradenitis Suppurativa: If you’re struggling to identify what’s going on with the skin underneath your arms, you’ll want to see a dermatologist just in case you have hidradenitis suppurativa. It’s an autoimmune condition that causes swollen pustules in areas like the underarms (and also groin).
Causes
"Either blockage or infection of the hair follicles in the armpit cause pimples in this area," Waldman says. "When infected, skin bacteria are the most common culprit, although fungal infections can also occur. Common causes include shaving, plucking and waxing hair, wearing tight clothing, or sudden weight gain causing occlusion of the area, as well as certain medications and exposure to infectious sources (such as hot tubs)." Additionally, products and tools (like deodorant and razors) can lead to irritation. "Certain types of deodorant can sometimes cause irritation or allergic contact dermatitis in those with sensitive skin, resulting in bumps, redness, and itching in the underarm area. Because shaving opens the skin, it can also cause irritation and even an infection like folliculitis," Germain says. And of course, the moist, warm nature of our underarms sets the stage for inflammation as well. “Heat plays a role and can cause bumps and breakouts in areas where sweat accumulates, like the underarms," she adds.
Prevention
The good news is there’s a lot of lifestyle changes and habit adjustments that can be made to help decrease the likelihood of underarm irritation.
"Wear loose clothing, especially when it’s hot and humid to avoid rubbing in the area; use well maintained hot tubs and avoid other sources of infection; for shaving, shave with the direction of the hair using a single blade razor or electric razor—laser hair removal may also improve condition as it can help avoid or reduce need for shaving," Waldman says. (Oui The People’s Rose Gold Sensitive Skin Razor is a super sharp razor that will give you an impossibly close shave.) Another option, according to Massachusetts-based, board-certified dermatologist Dr. Ranella Hirsch, is to find a good quality multi-blade women’s razor. This is because women’s razors typically have several blades and a hydrating strip. This helps to minimize the need for more than one pass which is a major culprit at play here," she says. (We like the soap-surrounded Schick Intuition Sensitive Care Razor).
Other keys: shower immediately after exercising and make sure to use a gentle soap, like CeraVe Soothing Body Wash (even if you only use it on your underarms). And when you shower, make sure not to share towels with anyone else.
Also important: making sure your shaving routine does everything it can to prevent irritation—and we have all the tips and tricks on how to do so.
- Never dry-shave
- Don’t shave immediately when you get in the shower: "Wait until you’ve been in the warm shower or bath for several minutes before beginning to shave, as the heat will soften the hair follicle and make it easier to remove," Germain explains.
- Use a fresh, clean razor—and replace the blade regularly. "When shaving, make sure you are changing razor blades frequently and never using a dull blade," Germain suggests. Clean the blade between uses, and swap it out after five-six uses, or sooner if it appears old or rusty.
- Swap out every 5-6 uses or sooner if the blade appears to be dingy and rusty.
- Shave with one pass in the direction of the hair growth. "You then want to press gently to do one pass in the direction of the hair growth," notes Dr. Hirsch. "This is key because it’s the repeated cuts at multiple angles (during multiple passes) that worsen the problem," she explains.
Treatment
These issues are treatable—and we’ll go over some of the common methods used, but as always (and especially if you’ve already tried some of the prevention and treatment methods discussed), it’s best to make an appointment with a board-certified dermatologist who can not only identify the problem (and make sure it is what you think it is—or help if it’s not), but also devise a treatment plan.
Make Hair Removal Permanent With Laser Hair Removal
If you struggle with persistent ingrown hairs or folliculitis, laser hair removal offers a long-term/permanent solution. Yes, it's expensive, but you also won’t really spend money on shaving supplies once it’s done. “Many patients find that laser hair removal, which is a permanent way of shrinking up hair follicles, eliminates recurrent armpit folliculitis,” says California-based board-certified dermatologist Dr. Lisa Chipps.
Apply a Warm Compress
Sometimes it can be difficult to tell the difference between pseudofollicultis and folliculitis, Waldman says. But both, she explains, “will often resolve in around a week with regular warm compresses and making sure to keep the skin clean.”
Discuss Topical/Oral Medications With Your Dermatologist
If the condition does not improve after several weeks, or if it is painful, you may want to consult with your doctor or dermatologist. “Topical or oral antibiotics can help to rapidly improve the condition within days,” Waldman says. And, “even when it’s not caused by bacterial or fungal infection, your doctor may be able to prescribe topical or oral medications that reduce the redness and symptoms or prescribe common acne medications that decrease the formation of blocked follicles.”
Spot Treat With Hydrocortisone Cream
If you’re really red after shaving, Dr. Hirsch recommends applying a 1% hydrocortisone (available over the counter) gently to the area for a day—while you implement the preventative shaving techniques, which will hopefully eliminate the need for a treatment cream.
Try a Spot Treatment or a Targeted Body Wash
If your underarm pores are plugged up and need help, try a spot treatment (the same ones we use for our faces). New York City-based, board-certified dermatologist Dr. Nikhil Dhingra is a fan of the classic La Roche-Posay Effaclar Dual Action Acne Spot Treatment, which contains 5.5% micronized benzoyl peroxide. "Benzoyl peroxide is an antibiotic topical available in wash and cream forms and can target acne- and folliculitis-causing bacteria," he explains. You can also try a medicated body wash used just in the affected areas, like PanOxyl (which also has benzoyl peroxide) or something with salicylic acid. "Salicylic acid can exfoliate the skin around the hair follicles, minimizing ingrown hairs and skin debris trapping into glands," Dhingra explains. Try Neutrogena’s Body Clear Pink Grapefruit Acne Body Wash.
Finally, if the area is determined to be infected, you can use an “antibacterial soap (only in the armpit area, as they can be drying to other areas of the skin). This will help clear up the infection,” Germaine adds.
Identify Allergens
If you notice a rash after using a product consistently, discontinue use. You may want to get better clarity by seeing a dermatologist or allergist, who, Hirsch explains, can do patch testing to help identify the offending ingredient.