Is laser the right procedure to fix severely clogged pores under my breast? (Photos)

Question

I previously went to my derm who was treating my acne (facial) and she said this is not really a major concern and everyone has this. But I am so incredibly insecure and no matter what I do, I can’t fix this at home. The left (1st pic) has less inflamed pores but when I pick at them, I extract I’m guessing sebaceous filament and it has almost a cheesy odour to it. The right (2nd) is the same in some areas but more raised and sometimes pop when I extract, like whiteheads. What can I do??

Anna Chacon, MD, FAAD · Answer

First, I want to reassure you that your concern is absolutely valid. Even though enlarged or clogged follicles in the under-breast area are common, that does not mean you have to simply ignore them if they are causing significant insecurity or discomfort.

From your description — dark clogged pores that express a cheesy-smelling material, plus some raised areas that occasionally form whiteheads and pop when squeezed — this sounds less like ordinary facial-type acne and more like a combination of:

Dilated hair follicles / keratin plugs
Sebaceous filament–like buildup
Occluded follicles from friction, sweat, and moisture
Possibly mild folliculitis or early hidradenitis-type changes if there are recurrent inflamed bumps

The odor you notice is often caused by trapped keratin, oil, sweat, and skin bacteria, not necessarily by poor hygiene.

Is laser the right first procedure?

In most cases, laser would not be my first choice for this problem.

Ablative or resurfacing lasers are generally used for scars, texture changes, or pigmentation, and they are not particularly effective for clearing dozens of chronically clogged follicles in a moist friction area like the inframammary fold. They can also carry a higher risk of post-inflammatory pigmentation or irritation, especially in skin that experiences constant rubbing.

What I would consider first
1. Benzoyl peroxide wash

Use a 4–5% benzoyl peroxide wash once daily in the shower on the affected area, leaving it on for about 1 minute before rinsing.

This helps reduce:

follicular bacteria,
inflammation,
and recurrent whitehead formation.

(Be aware that it can bleach towels and clothing.)

2. A topical retinoid

A prescription retinoid such as tretinoin, adapalene, or tazarotene is often much more effective than home extraction for preventing keratin from building up inside the follicles.

Because the skin under the breast can be sensitive, I would usually start 2–3 nights per week and increase gradually.

3. Salicylic acid

A 2% salicylic acid lotion or pad a few times per week can help dissolve the material inside the pores and reduce the urge to pick at them.

About picking and extracting

I know it is tempting, especially when material comes out and you feel temporary relief. However, repeated squeezing can actually lead to:

more inflammation,
dark marks (post-inflammatory hyperpigmentation),
thickened pores,
and eventually small scars or persistent bumps.

The fact that the right side has more raised lesions that sometimes pop like whiteheads suggests that at least some of these are true inflamed follicles, so aggressive extraction may be making that side appear worse over time.

When laser might help

If the main issue later becomes:

persistent dark spots after the bumps heal,
textural scarring,
or coarse hair contributing to recurrent follicle blockage,

then certain lasers (particularly hair-removal lasers) can sometimes be helpful. In fact, laser hair removal is often more useful in this area than a resurfacing laser if hair follicles are part of the problem.

One thing I’d keep in mind

Because the lesions are located under the breast, I would also consider whether there is:

significant sweating or moisture retention,
tight bras causing friction and occlusion,
or a history of recurrent painful nodules, draining bumps, or scarring, which would raise concern for hidradenitis suppurativa.

From your description, it sounds more like clogged follicles with intermittent folliculitis than classic hidradenitis, but that distinction is important if the bumps become painful, recurrent, or leave scars.

My overall opinion

Based on what you’ve described, I would not jump to laser treatment as the primary solution. I would start with a medical follicular-clearing approach:

Benzoyl peroxide wash daily
A topical retinoid several nights per week
Salicylic acid a few times weekly
Avoid squeezing or picking as much as possible
Keep the area dry and reduce friction with breathable bras and clothing

The encouraging part is that these lesions sound potentially very treatable without an invasive procedure, and many patients see substantial improvement once the keratin plugging cycle is interrupted, which is something home extraction unfortunately tends to perpetuate rather than resolve.

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser.  Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.  
Best,
Dr. Karamanoukian 
Realself100 Surgeon

Is laser the right procedure to fix severely clogged pores under my breast? (Photos)

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