QQ: Why Do I Have Acne on My Legs?

So you think you have acne...on your legs. First things first: “It is exceedingly rare for acne to occur on the legs,” says Redondo Beach, CA–based board-certified dermatologist Annie Chiu. What might look like acne is usually, in fact, folliculitis, which, simply put, refers to inflammation of the hair follicles. “Folliculitis presents as small red bumps or white-headed pimples. The bumps tend to center around leg hairs—even the thinnest ones can be inflamed,” Chiu explains.

However, she notes, “sometimes they can be pus-filled and crusty and people tend to pick at these. They can itch or burn and be painful. If folliculitis occurs suddenly or develops yellow crusting, it should be cultured by a dermatologist to rule out a bacterial infection.” 

Causes and Prevention of Folliculitis

Folliculitis results from a number of specific scenarios, many of which we can address on our own. That’s because, Chiu explains, “ingrown hairs, or heat, sweat, and occlusion” are the most common causes. These causes are pretty common, but fortunately, there are behavioral changes we can make that will often help address folliculitis. To prevent folliculitis, beware of tight clothing. Florida-based board-certified dermatologist Stacy Chimento, MD, recommends “opting for looser, cotton clothing whenever possible, and make sure to change out of sweaty clothes and shower right after if you’ve been sweating or at the gym.” 

Another key? Pay attention to your hair removal methods. While it might be annoying, it’s probably best to stop shaving in the areas folliculitis is occurring altogether—and it’s not recommended to start again until your skin is healed. When you do shave, however, Chiu notes, make sure to utilize the following tips and tricks:

• Exfoliate before shaving
• Use a washcloth in a circular motion to raise embedded hairs
• Use plenty of shaving cream
• Always shave in the direction of hair growth
• Always use a sharp razor
• Moisturize immediately afterwards. Chiu recommends lotions with soothing ingredients like oatmeal (we like Aveeno Daily Moisturizing Lotion With Oat For Dry Skin or First Aid Beauty Ultra Repair Cream Intense Hydration).

Finally, if you notice that conditions worsen after other hair removal methods, like waxing, it might be time to switch. “If folliculitis is persistently annoying, laser hair removal to reduce hair growth is recommended,” Chiu says.

How Is Folliculitis Treated?

Treatment often combines both prescription and over-the-counter topicals. New York City–based board-certified dermatologist Shari Marchbein, MD, recommends “cleansers that feature ingredients like salicylic acid and benzoyl peroxide—like PanOxyl (which has 10% benzoyl peroxide)—followed by topical antibiotics like clindamycin lotion twice daily.” In severe cases, she notes, “oral antibiotics are sometimes used.”