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Acne on our face is something we talk about a lot. But what about the acne on our body? On our shoulders, back, decollete and even our butt?

This post is for those that dread the warmer weather due to the inflamed and red bumps covering their upper body and for those that don‘t know how to sit because right where the chair meets their buttocks a painful cyst has formed.

 

 

I feel you, because I have been there. I struggled with acne from my eleventh birthday onwards, and while my face was always the area most affected, my body did break out a lot as well. And still does if I am not careful.

So today I will share why body acne occurs, what you can do for prevention and when you really need to see a doctor about it!

 

 

What causes acne on the body

Technically acne on the body has the same pathway as acne on the face: A pore gets clogged, oil and bacteria get trapped underneath and a pimple forms. And whatever triggers breakouts on your face also worsens the ones on your body, think hormones, stress and whatever individual triggers other than that you might have. (More info: The effect of your diet on your acne)

The V of the chest, the shoulders and the upper back have a high density of oil glands, making them a common area for body acne to arise. Just like the lesions on your face the breakouts on your body are NOT a result of poor hygiene, but result of a genetic predisposition you have paired with contributing factors.

 

 

The difference between acne, folliculitis and pseudofolliculitis

Not all breakouts you see on your body are acne though. Quite often they are folliculitis or pseudofolliculitis instead.

Acne develops from a clogged pore inside which sebum from the sebaceous glands is trapped, which leads to bacterial overgrowth. Folliculitis on the other hand is an inflammation of the hair follicle, with bacteria invading from the skin surface. Folliculitis can appear anywhere on the body where you have hair – that is everywhere except your palms and soles – while acne happens where you have a high density of oil glands. Breakouts on your butt, quite catchingly called Butt-ne or Ass-ne, are more likely to be folliculitis than actual acne.

Pseudofolliculitis is again an inflamed hair follicle, but one that forms due to an ingrown hair rather than bacterial invasion, meaning it is most likely to appear in areas of hair removal. (Moe info: How to prevent ingrown hairs)

To be completely honest though, it doesn‘t really matter if the bumps on your back are acne or folliculitis, as the basic measures for prevention and treatment don‘t differ too much. Only when the steps you take don‘t really help solve the issue consulting a doctor is needed for a proper diagnosis and treatment plan.

 

 

Lifestyle changes to prevent body acne

I want to stress again that body breakouts are NOT a result of poor hygiene. You don‘t get acne because you aren‘t clean enough. Acne is a genetical disposition triggered mostly by hormones and that is true both for the body and the face.

But when looking at body breakouts, there are additional factors at play that you have a bigger influence on. So there is one lifestyle change that includes your shower routine, especially the shower routine after working out:

When working out, you sweat. And that is a good thing! When that sweat gets trapped on your skin for prolonged periods of time though, especially underneath tight fitting workout gear, it can lead to bacterial overgrowth that increases the risk for folliculitis. Pair that with friction, so tight clothing rubbing on the skin, and you are almost guaranteed to see breakouts. The technical term is Acne mechanica and it is often seen in athletes – in cyclists where the helmet fits tightly around forehead and neck, in hikers where the backpack and its straps cause friction and sweating and in everyday athletes like myself for example underneath the band of my sports bra and between the boobs. (More info: The best skincare routine for your workout)

The solution here is both easy and hard: Change out of your workout clothes as soon as possible and rinse off the sweat. Or, if that isn‘t possible, clean the sweaty areas with a wash cloth. Sounds easy, but is easier said than done – if I get home from a run and sit down to „just quickly check my phone“, hours can pass until I finally change out of my sweaty gear and I do pay the price in form of breakouts in the aforementioned areas.

Another preventative measure would be to wear loose fitting clothes from a breathable fabric, but again that isn‘t always possible. If I wore a loose fitting sports bra, I might as well not wear one at all, and that is not an option when doing high impact workouts.

Trapped sweat and friction is also the main reason for breakouts on your bum. I hate to break it to you, but the more you sit on your behind, especially when wearing tight fitting, non breathable clothes like athleisure, the more likely you are to get breakouts there. Sadly that is true both for extreme lounging on the couch as well as for long periods spend working on your desk, so just one more reason to schedule in regular breaks to get some steps in and relieve your butt cheeks from the friction and pressure.

Another contributing factor on the body that might not have the same impact on your face is Acne cosmetica, or breakouts caused by products that remain on the skin despite not being meant to go there, like your conditioner or other hair styling products. I know that there are different brands trying to sell you body acne safe hair stuff, but I think that is going a little far. If you suspect that your hair care is triggering breakouts because they occur where your conditioned hair touches your back or around the hair line, simply try rinsing this area with extra diligence, that should do the trick in most cases. and just for the record: That was never a contributing factor for me as an individual – not everything I mention will be an issue for everyone.

 

 

Products to prevent and treat body acne at home

When it comes to treating breakouts on the body, the same things that will work on your face will also do the trick on your back, chest and butt, obviously taking into account the anatomical peculiarities of each region: The back and shoulders have thicker skin than the face, the chest has thinner and more sensitive skin and some areas on your body are much harder to reach than others.

My approach would be the following: First, start using a body wash with either Salicylic Acid or Benzoyl Peroxide on the affected areas. Instad of lathering up and directly rinsing it off, try to let it sit on the body for around five minutes – I usually apply it to the body and then start shampooing my hair to achieve that. Added bonus is that a body wash with Salicylic Acid can also help improve the look of Keratosis Pilaris or Chicken Skin. (More info: How to get rid of Keratosis Pilaris)

The next step would be to use a topical product after the shower containing either Salicylic Acid or a Retinoid. You could do Benzoyl Peroxide as well, but I tend not to – I have had my fair share of ruined towels and sheets, I don‘t need any more of that. In addition to products you would also use on your face, there are a few that address the harder to reach areas like body sprays or, especially great for your gym bag, salicylic acids pads you can simply wipe over the area you want to treat. As far as retinoids go, I tend to opt for the ones specifically formulated for the body for my butt – I use prescription for my face and really would not want to risk any irritation. On top of that the body formulations contain additional moisturizing ingredients and are much nicer to spread as the area you will need to cover is usually bigger than yor face. My chest couldn‘t deal with prescription either, so I use a retinal for there, making sure it doesn‘t get trapped in skin folds, which again would increase the risk for irritation.

Just like on your face no aggressive exfoliation or stripping of the skin, skin that is breaking out needs gentle care, and these measures paired with the aforementioned lifestyle changes should do the trick. (More info: The five things you need to do to repair your damaged skin barrier)

 

 

When you need to see a doctor about your body acne

If despite following lifestyle tips and using the products you can get at home regularly and for at least six weeks you don‘t see improvement in your breakouts, if you get deep, painful cysts that heal with scarring or if you feel your body breakouts do affect your self esteem, it is time to see a doctor about them.

Acne is a skin condition that can not be treated with hygiene and so called clean eating and if you break out it isn‘t because you are doing something wrong. It is because of genetic disposition and hormonal influence and can be addressed with prescription much better than it can with cutting out certain food groups, so go see a doctor for proper diagnosis and a treatment plan before you either develop an eating disorder or permanent scarring.

 

 

TL;DR

Body acne occurs for the same reasons as acne on your face, so due to a genetic disposition triggered by different contributing factors, most often hormonal influence. Breakouts on your chest, back and butt might not be proper acne though, but could also be folliculitis, an inflammation of the hair follicle caused by bacterial invasion of the skin surface. That one is often caused by friction and is responsible for breakouts you get after working out, when the sweat gets trapped underneath tight clothing for prolonged periods of time. Try to rinse off as quickly as possible after working out and change out of your sweaty clothes.

To treat existing and prevent new breakouts, the same things that work on your face will do, think Benzoyl Peroxide, preferably as body wash, Salicylic Acid, also available as spray for harder to reach areas, and retinoids.

If you feel regular use of those and preventing friction doesn‘t help, don‘t hesitate to see a doctor, as acne especially on the back can lead to permanent scarring that could be prevented with early treatment.

And always remember. Acne is a genetic condition and not caused by you doing something wrong, no matter if it happens on your face, your shoulders or your chest.

 

 

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