As anyone who’s had acne knows, breakouts don’t erupt only on your face. In fact, about half the people who report facial acne also report acne in other areas, such as the chest and back.
“Just like the face, areas such as the chest, shoulders, back, and buttocks contain oil glands and hair follicles that can become clogged and inflamed,” says Maria Leszczynska, MD, a board-certified dermatologist at Westlake Dermatology in Austin, Texas.
Some causes of acne are beyond your control, including genetics, hormonal fluctuations, and conditions like polycystic ovary syndrome (PCOS), a hormonal disorder that affects women. But many treatments and management strategies can help clear your skin and prevent body acne.
The Back
The back is a prime spot for acne because it has a high density of oil glands and thicker skin, which makes clogged pores more likely, says Dr. Leszczynska. On top of all that, friction from tight clothes or straps from items like backpacks can create irritation that contributes to acne, she says, adding that you may notice several different types of acne, including blackheads, whiteheads, inflamed pimples, and even nodules (firm, painful lumps under the skin) or cysts (painful, pus-filled pimples).
The Chest
The most common type of acne on the chest is acne vulgaris. These lesions occur when hair follicles become clogged with oil (sebum), dead skin cells, and bacteria, leading to whiteheads and blackheads. Another type of acne to be aware of on the chest is fungal acne. “It can look like tiny red bumps,” says Sandy Marchese Johnson, MD, a board-certified dermatologist at Johnson Dermatology in Fort Smith, Arkansas. These bumps, which can also develop into whiteheads, occur when Malassezia yeast infects hair follicles, which is more likely when skin is damaged by chafing, hair removal, wearing tight clothing, or exposure to moisture and sweat.
The Neck
Neck acne can be particularly stubborn, and there’s a biological reason for that. “The neck contains oil glands similar to the face and chest, making it vulnerable to hormonally driven acne,” says Monique Chheda, MD, a board-certified dermatologist practicing in McLean, Virginia. “Women, in particular, often experience acne along the jawline and neck, which can correlate with their menstrual cycles,” she explains.
Wearing accessories around your neck — such as collars, scarves, helmet straps, and athletic gear — can cause friction and irritation of hair follicles. Hair products like conditioner or styling gel can also migrate onto the neck and clog pores, Dr. Chheda says.
The Butt
Yes, “buttne” is a real thing. “On the buttocks, most cases of breakouts are caused by folliculitis,” says Leszczynska.
Folliculitis occurs when hair follicles become inflamed due to friction and pressure from sitting, which can look like a collection of small bumps around hair follicles, pus-filled blisters, or a single inflamed bump. Tight underwear or leggings can also clog pores, Leszczynska adds.
Arms and Thighs
Acne that pops up on arms or thighs is most often caused by friction from clothing, says Dr. Johnson. “It can often be misdiagnosed for keratosis pilaris,” she says. Keratosis pilaris is a harmless condition characterized by tiny bumps often found on the upper arms and thighs. Colloquially, it’s called “chicken skin” because of its texture.
Because keratosis pilaris and acne can look similar, it’s important to get an accurate diagnosis so you receive the right treatment. To improve your chances of a proper diagnosis, consult a board-certified dermatologist.
How to Treat Body Acne
The good news is that body acne is highly treatable. Options range from at-home care to prescription medications to in-office procedures. Lifestyle changes can also help prevent acne in the first place.
At-Home Skin Care
“Many of the same at-home approaches we use for facial acne are also effective for body acne,” says Chheda. She often recommends the following strategies.
Use salicylic acid body wash, lotion, or cream to exfoliate dead skin cells to keep pores clear.
Use azelaic acid lotion or serum to reduce inflammation, especially for people with skin of color who are at risk from scarring.
Use topical cream or gel retinoids to improve skin turnover and keep pores clear.
If a fungal skin infection is the source of your body acne, Leszczynska may recommend washing your skin with an anti-dandruff shampoo containing ingredients such as zinc pyrithione, selenium sulfide, or ketoconazole. “These ingredients have antifungal properties and can help reduce the yeast overgrowth,” she explains. Allow the anti-dandruff shampoo to sit on the skin for three to five minutes before rinsing, advises Leszczynska.
Prescription Medications
Depending on the cause of your acne, you may benefit from prescription medications, says Chheda. Topical or oral antibiotics are often used to treat inflammatory acne, while oral birth control or spironolactone (a water pill typically used for high blood pressure) can help manage hormonal breakouts. If you have a fungal infection, your dermatologist may prescribe a topical or oral antifungal treatment. In some cases, oral isotretinoin (an oral retinoid) can be prescribed to treat moderate or severe acne, especially cystic acne.
Medical Procedures
In-office procedures may be an option if prescription medications don’t provide the results you’re looking for. Chemical peels that use salicylic or glycolic acid to exfoliate and remove damaged outer skin layers, or the laser treatment AviClear (which reduces oil gland activity), may be an option for moderate or severe acne, says Chheda.
Lifestyle Adjustments
If you're prone to body acne, it's key to keep skin clean and reduce friction. So, be sure to change out of sweaty clothes promptly, says Johnson.
A shower after exercise can help, says Rosanne Paul, DO, a dermatologist at the Case Western Reserve University School of Medicine, in Cleveland. Avoid tight-fitting clothing in favor of looser, sweat-wicking fabrics that are less likely to irritate your skin.
Finally, treat your skin gently. “Avoid aggressive scrubbing or picking, as this can worsen inflammation and lead to post-inflammatory hyperpigmentation," adds Leszczynska. Post-inflammatory hyperpigmentation is skin discoloration that occurs following skin inflammation or injury, and is more common in people with darker skin tones.
When to See a Doctor
Although acne can be treated at home, it’s a good idea to see a dermatologist, especially if you don’t know the cause of your body breakouts. Leszczynska advises seeing a board-certified dermatologist if you develop painful cysts or scarring, or if you don’t see improvement after two to three months of consistent treatment.
The Takeaway
Body acne is common and can affect the neck, chest, back, buttocks, and arms and thighs.
Sweat, friction, and yeast are some of the causes of body acne.
Lifestyle adjustments, topical treatments, prescription medications, and in-office procedures can help manage body acne.
If you’re unsure what’s causing your breakouts, a dermatologist can identify the underlying issue and recommend the right treatment.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Jacquelyn Dosal, MD, is a board-certified dermatologist practicing at The Dermatology House in Park City, Utah. Her areas of expertise include acne, rosacea, integrative treatments of inflammatory skin diseases, as well as laser treatment of the skin and injectables.
Dr. Dosal writes cosmetic questions for the certifying exams for the American Board of Dermatology. She is also the deputy editor for the American Academy of Dermatology's podcast, Dialogues in Dermatology.
Jessica Migala is a freelance writer with over 15 years of experience, specializing in health, nutrition, fitness, and beauty. She has written extensively about vision care, diabetes, dermatology, gastrointestinal health, cardiovascular health, cancer, pregnancy, and gynecology. She was previously an assistant editor at Prevention where she wrote monthly science-based beauty news items and feature stories.
She has contributed to more than 40 print and digital publications, including Cosmopolitan, O:The Oprah Magazine, Real Simple, Woman’s Day, Women’s Health, Fitness, Family Circle, Health, Prevention, Self, VICE, and more. Migala lives in the Chicago suburbs with her husband, two young boys, rescue beagle, and 15 fish. When not reporting, she likes running, bike rides, and a glass of wine (in moderation, of course).
