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DocSpot: Pimples on the thighs

Dear Dr Margaret
I have lots of pimples on the tops of my legs. It’s embarrassing in a swimsuit. How can I get rid of them? I don’t want to bother my doctor.

To get a proper diagnosis of a skin problem, your doctor needs to examine it and ask you some questions (such as how long you have had it, and whether it comes and goes). It is perfectly reasonable to see your doctor about skin pimples if they are bothering you, or if you think they might be infected.
One of the commonest possibilities is a condition called ‘keratosis pilaris’. These are tiny pimples centred on hair follicles (‘pilaris’ means ‘of hairs’). They are about 1 millimetre across and if you look through a magnifying glass you would see that they are rough and scaly. They often run in families, and about 4 out of 10 people have them, so you could almost say they are normal. Usually they occur on the backs of the upper arms, the buttocks and the thighs. They can look somewhat red and inflamed, but they do not contain yellow pus. Unfortunately it is not easy to get rid of keratosis pilaris. You could try fake tan, which will make them less obvious. You could also use a buff-puff which will reduce the roughness, but don’t overdo it. Keeping the skin moisturized will also help with the roughness – ask your pharmacist for an emollient bath oil. If this doesn't do the trick, your doctor could try a ‘keratolytic’ cream (as used in some types of acne) to reduce the scaliness. If the pimples look red and inflamed, your doctor might try a tetracycline-type antibiotic.
‘Folliculitis’ is another possibility. This is an infection of the hair follicles, so the pimples may contain tiny amounts of pus. You can catch folliculitis from other people in hot tubs, or it may be caused by bacteria already on your skin. Antibiotics are not always needed – an antiseptic skin cleanser may get rid of it. Do not use an ordinary disinfectant on your skin, or put disinfectant in your bath, because that would damage the skin and could make your problem worse.
If you have been shaving the area, check our section on shaving rash.

Last updated; Sunday, August 30th 2020

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