What are the treatment options for acne (acne vulgaris) on the buttocks?

From the Guidelines

Acne treatment on the buttocks can be managed with topical therapies, such as benzoyl peroxide, topical retinoids, and topical antibiotics, as well as oral medications like doxycycline and isotretinoin.

Treatment Options

• Topical therapies: benzoyl peroxide, topical retinoids (e.g. adapalene, tretinoin, tazarotene, trifarotene), topical antibiotics, clascoterone, salicylic acid, and azelaic acid 1
• Oral medications: doxycycline, isotretinoin (for severe acne or acne that is causing psychosocial burden or scarring) 1

Recommendations

• Strong recommendations are made for benzoyl peroxide, topical retinoids, topical antibiotics, and oral doxycycline 1
• Conditional recommendations are made for topical clascoterone, salicylic acid, azelaic acid, oral minocycline, sarecycline, combined oral contraceptive pills, and spironolactone 1

Good Practice Statements

• Combining topical therapies with multiple mechanisms of action is recommended to optimize efficacy and reduce the risk of antibiotic resistance 1
• Limiting systemic antibiotic use and combining systemic antibiotics with topical therapies is recommended 1
• Adding intralesional corticosteroid injections for larger acne lesions is recommended 1

From the Research

Treatment Options for Acne Vulgaris on the Buttocks

The treatment options for acne vulgaris, including on the buttocks, can be categorized into several approaches:

• Topical treatments:
  • Retinoids, such as tretinoin and adapalene, which are effective in reducing acne lesion counts 2
  • Benzoyl peroxide, which can be used in combination with other topical agents 3, 2
  • Azelaic acid, which has antibacterial and anti-inflammatory properties 2
• Systemic treatments:
  • Oral antibiotics, such as doxycycline and minocycline, which can be used in combination with topical agents for more severe disease 2
  • Hormonal therapies, such as combination oral contraception (COC) or spironolactone, which can be effective in reducing inflammatory lesions 2
  • Isotretinoin, which is approved for treating severe recalcitrant nodular acne and can be used for resistant or persistent moderate to severe acne 4, 3, 2
• Combination therapies:
  • Using a combination of topical and systemic agents can be more effective than using a single therapy 3, 2
  • Combination products, such as fixed-combination products of topical retinoids and topical antibiotics or benzoyl peroxide, can be convenient and effective 5
• Other treatments:
  • Physical modalities, such as laser therapy, light therapy, and chemical peels, which have limited evidence for their effectiveness 3
  • Complementary therapies, such as purified bee venom, low-glycemic-load diet, and tea tree oil, which require further study to determine their effectiveness 3