Q:

Hi, Autostraddle. I have an embarrassing problem.

I love my partner with all my heart. They are the love of my life, and the hottest, sexiest person I have ever laid eyes on!!! There’s just one problem… Every time I go down on them, I get the nastiest acne of my entire life.

I haven’t struggled with acne almost at all in my lifetime, but after eating my partner out, I break out with a “beard” of zits that lasts all week. It’s awful. My partner is not unclean or anything; they shower every day. Further info: Neither one of us has an STI, and neither one of us is on any kind of hormones.

What is going on?? I would very much like to “travel downtown” without it ruining my whole face.

A:

Hey anon!

Hmmm yeah. That sounds like skin hell. I consulted my domicile’s resident skin expert (my girlfriend) on this one. I’ll be pairing our thoughts and whatever other sources I can locate to figure out your situation. I’ll also say that nothing I’m exploring here should be considered medical advice and honestly, this is definitely the wheelhouse of a dermatologist or other doctor.

Going off what you’ve described, it sounds a lot like your facial skin is reacting aggressively to vaginal fluids or something in the vicinity of the vulva. You described the post dining-out experience as the nastiest acne of my entire life and don’t have much history of acne. That’s suggestive of an acute reaction to direct stimuli rather than something longer-term.

Reading up on your situation was challenging because there’s little research on these exact circumstances. I’m gonna have to roll on anatomical knowledge and what little research there is on the topic here.

With no history of an STI, no additional hormone replacement therapy (I’ll presume we’re talking about a cisgender vulva here), the potential options are narrowed down further. I’m gonna start with two anatomical considerations: hair and vaginal pH.

A ‘typical’ vaginal pH in women of ‘childbearing age’ is 3.8 to 5.0. That’s moderately acidic. For reference, neutral pH is 7.0 and the range of 4.0 to 5.0 includes tomatoes, acid rain, black coffee, and…bananas? Vaginal pH rises after menopause due to hormone fluctuations, so it’ll start acidic and move closer to neutral over time.

All of this matters because when you’re eating your partner out, you’re exposing your mouth and chin area to a fair amount of vaginal fluid. At least, that’s the expectation if you’re proceeding with enthusiasm and they’re responding well. If that acidic fluid (and its accompanying contents) are allowed to sit on your face, they could be sensitizing your skin and leading to acne breakouts. Most people can handle significantly more acidic stuff on their skin before developing a response, but everyone has different sensitivities. Slightly concentrated lemonade can make my lips a little bit puffy and sensitive, but I know a girl who does shots of vinegar because she enjoys the taste of sour so much. Nobody is identical.

Again, it’s hard to locate case studies for these circumstances. I found this case study involving a man who experienced something like this but not much else. Nonetheless, the composition of facial skin is very diverse and it’s generally characterized as more sensitive than skin over the body. It’s possible that you have a particularly strong reaction to the pH of your partner’s vaginal fluids that is contributing to the problem.

Next up, hair. This is something to consider whether or not your partner has a lot of pubic hair or keeps it manicured, shaven, or waxed. Hair (including pubic hair) can harbor a diverse microbial environment because it’s very dense in surface area and also close to the skin where a lot of bacteria grows. Even when hair seems clean, it can harbor a lot of interesting bacteria (helpful and otherwise) that can be transmitted to sensitive or damaged skin and cause a strong reaction.

If your partner shaves, trims, waxes or does anything else that shortens the hair before you eat them out, that can also contribute. Short or fresh-cut hair is utterly notorious for irritating the skin. Most examples of this involve heterosexual relationships with a bearded man and it even has a name: beard burn. Beard burn doesn’t just apply to full beards. It’s described as contact dermatitis that results from hair-related friction. Any sufficiently coarse hair can contribute to the risk. Pubic hair is coarse at any length. Depending on your table manners and enthusiasm for the meal presented before you, it’s possible you could just be rubbing your lips and lower face a bit raw. Again, this is bearable for most people in your position (between someone’s legs), but it’s possible that you just have a particularly horrible reaction. The only way you could really rule this out is if your partner has minimal and soft pubic hair, likely as a result of laser hair removal or more permanent hair removal methods like electrolysis.

At this point, I could guess that friction and abrasion from eating your partner out could be interacting with vaginal fluids. You might be experiencing a one-two punch where your enthusiasm leads to microscopic abrasions on the skin that allow acidic fluid and bacteria to enter. Remember it’s possible to begin developing something bacterial and have skin heal over the infection before the inflammation can be exposed. At the small scale on skin, this can manifest as acne. It’s more noticeable in other cases like acute paronychia.

So I’ve done my best to present some general possibilities for your experience, but I also had a specific thought come up. Your description of a beard of zits. That was positively visceral for me to think about, but also a very helpful image. A consistent spread of acne-like irritation over an area is a common sign of folliculitis. Folliculitis is irritation of the hair follicles—often alongside bacteria. It can both carpet a large area (even follicles that weren’t initially exposed) and strongly resemble acne. Its manifestations are pretty diverse, but a carpet or ‘beard’ of zits is one form. Everything from fungi to staph bacteria could be the culprit. None of this is to say that your partner is ‘unclean’ or insufficiently hygienic. The human body is positively coated with all kinds of bacteria and things only get more interesting when we mix inside and outside. Some people are simply more vulnerable to certain kinds of bacteria or skin conditions than others.

Going back to my hypotheses that mix surface irritation, skin bacteria, and vaginal fluids? There’s a possibility that your spread of horrible acne might be folliculitis due to exposure to your partner’s vagina. If this is true, then it’s downright tragic because it suggests that your enthusiasm and love for their vulva might be making this worse.

Okay, I think that’s enough skincare, medical, and bacterial discussion. Let’s talk pragmatics.

1. Firstly, consider talking to a dermatologist or doctor about this if you can. Because I’m not qualified to offer actual medical advice and I could be way off base on my assumptions. Nothing beats the examination and assessment they can give you.
2. If you normally let yourself bask in the glory of sex with your partner after eating them out, consider… Well, consider not doing that once or twice. If their vaginal fluids are setting off a skin reaction, you want them on your face as little as possible. Washing with mild skin cleanser or soap shortly after devouring them can neutralize acidity and remove most of the fluid. If you do this, please take steps to assure your partner that you’re doing this because you think it might be a skin reaction, not concerns about their body, hygiene, or health.
3. If your partner shaves/trims their pubic hair ahead of becoming dinner, that may contribute to skin irritation and abrasion. Full growth that’s been ground down and softened by daily living is less coarse than shaven or trimmed. If their preference is total deforestation (as I do to myself), consider methods that delay hair growth or thin out new hairs. Like waxing, laser hair removal, or even electrolysis. This is a sensitive topic (like your skin) and you do not have to approach it if you don’t want to. I’m giving suggestions that are friendly to growth and removal because I don’t know your partner’s preferred state, but I know how delicate this topic can be. Ignore any suggestion of mine at no peril.
4. If all else fails, barriers are an option. Dental dams are highly protective for oral sex on a vulva.

My first recommendation is still to talk to a doctor if you can.

As it stands, my hypothesis is still some kind of skin irritation driven by exposure to vaginal fluids and friction. The problem is we won’t know what kind of irritation it is without professional investigation. Nonetheless, I think that folliculitis, dermatitis, or some kind of acne meet your description of the condition. Folliculitis, dermatitis, and acne can resemble each other or even increase the risk of each other appearing. They’re common skin conditions of the face, and they’re exacerbated by exposure to bacteria, non-neutral pH, and friction. All of which are involved when dining at the Y. They also won’t be picked up by any STI test and they can occur even in the presence of excellent hygiene and habits.

That’s a lot of thoughts from me solely because I love medical challenges and anatomical interactions. As far as possible, I’ve tried to supply reliable sources, but I couldn’t find anything conclusive about your situation because it’s not commonly reported. As ever, this is a doctor’s field of expertise, but I hope I’ve provided good jumping-off points for you to consider.

Love, Summer

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