Chest Acne: 10 Treatments to Clear Breakouts

Anna Giorgi
·11 min read

Medically reviewed by Casey Gallagher, MD

Home treatments can often help improve symptoms of chest acne. Prescribed drugs and topical treatments may help when these remedies don't work.

Chest acne is part of a group of conditions known as truncal acne, which may involve the back, shoulders, or chest. Truncal acne occurs in about 50% of people with acne. Like face acne, chest acne (commonly called "chestne") can appear as whiteheads, blackheads, pimples, or cystic acne.

<p>FG Trade / Getty Images</p>

FG Trade / Getty Images

The causes of chest acne are like other types of acne. It forms when dead skin cells block your pores. This results in too much bacteria, causing inflammation and pimples. However, the fact that chest acne covers a larger area and is often concealed by clothing can affect how it is treated.

This article describes chest acne causes, appearance, and treatments.



Chest Acne vs. Back Acne

Chest acne, back acne, and shoulder acne are forms of truncal acne, which affects your trunk, or torso. Acne in these areas can extend to other parts of the trunk. Many factors that cause chest acne are also common in back acne and acne on other parts of your body.



What Causes Chest Acne Breakouts?

Acne typically affects skin areas like your face and chest, which have a high density of sebaceous glands. These glands produce sebum (oil), a substance that helps your skin regulate temperature, maintain moisture, and prevent infections.

The causes of chest acne are generally thought to be similar to that of facial acne. However, there are differences between the skin on your face and the skin on your chest in thickness, pH (acidity vs. alkalinity), and the distribution of sebaceous glands. The skin on your trunk is more vulnerable to the following acne stimuli than the skin on your face:

  • Excessive sweating

  • Oils

  • Pressure

  • Friction from clothing

  • Occlusion (blockage)

Acne can be caused by one or more of the following factors:

  • Overproduction of oil in a follicle (pore)

  • A buildup of dead skin cells in the pore

  • Proliferation of bacterial growth in your pore

The following factors can make you more likely to develop acne:

  • Hormones: Increased androgen sex hormones can enlarge the sebaceous glands and produce more sebum. This naturally occurs during puberty (for all sexes) and pregnancy, though it can also happen at other times.

  • Family history: Research indicates that having parents who developed acne can increase your risk of having this condition.

  • Medications: Acne can develop due to certain medications like hormones, corticosteroids, and lithium.

  • Age: Acne is more common in teens, though it can develop at any age.

Related: What Causes Acne?

How Does Chest Acne Look?

The way your chest acne looks depends on the form of acne that develops. Scarring and pigment problems are common to truncal acne, though the conditions can look and grow differently.

Like other types of truncal acne on your face, back, and shoulders, chest acne can have many forms:

  • Whiteheads (closed comedones): Whiteheads are small lesions that occur when plugged hair follicles remain under your skin and produce a white bump.

  • Blackheads: Blackheads are non-inflamed blemishes that occur when a plugged hair follicle reaches the surface of your skin. The air discolors the sebum (oil) when it reaches the surface, creating a black spot.

  • Papules: Papules are inflamed lesions that appear as small, slightly raised pink bumps on your skin. They can be tender to the touch.

  • Pustules or pimples: Pustules are bulging papules clogged with sebum, cell debris, or pus. They appear as white or yellow pus-filled lesions that may be red at the base

  • Nodules: Nodules are large, painful, solid lesions lodged deep underneath your skin.

  • Severe nodular acne (also called cystic acne): Nodular acne appears as deep, painful, pus-filled lesions. It is the most severe form of acne.

  • Acne conglobata: Acne conglobata is a rare but severe form of acne. It is characterized by nodules and cystic lesions, interconnecting abscesses, scars, and grouped comedones.

Related: Three Stages of Acne and Treatment

How to Get Rid of Chest Acne at Home

You may be able to get rid of chest acne at home, depending on the type and severity of your chest acne. It is often possible to treat chest acne with treatments similar to those used for facial acne.

Research indicates that the following acne treatment products can help improve or clear mild or moderate chest acne:

Benzoyl Peroxide

Over-the-counter (OTC) treatments containing benzoyl peroxide are used as a first-line treatment in treating acne. Benzoyl peroxide is the most commonly purchased OTC acne product.

Benzoyl peroxide is an antimicrobial, meaning it helps reduce the amount of acne-causing bacteria on your skin. It is available in concentrations ranging from 2.5% to 10% in creams, lotions, toners, gels, foams, and washes as leave-on or wash-off products.

Using benzoyl peroxide to treat chest acne presents the possibility of staining and bleaching clothing, other fabric, and hair, especially when applied on large areas like your chest.

Differin

Differin (adapalene 0.1% gel) is available as an OTC product in a strength weaker than that available by prescription. Differin is a topical retinoid. These vitamin A-based substances treat acne deep in your pores and prevent new pimples from forming.

Retinoids promote the shedding of dead skin cells. It boosts the production of new skin cells that push the dead cells and excess oil out of blocked pores.

Hydroxy Acids

Hydroxy acids include alpha hydroxy acids (AHAs) and beta hydroxy acids (BHAs). These products cause exfoliation or shedding of the surface skin to treat acne. At higher concentrations, hydroxy acids can be used as skin peels to remove scars and lighten discolorations.

In OTC topical acne treatments, these substances are available in creams, washes, lotions, and peel kits as the following ingredients:

Azelaic Acid

Azelaic acid is a topical acne treatment that is mildly antibacterial. It helps prevent pores from becoming clogged and allowing pimples to form. In its OTC formulation, azelaic acid can be purchased in 10% strength. It is also effective in treating dark spots that can remain after acne clears.

Lifestyle Changes

If you have acne or acne-prone skin, the following lifestyle changes can support topical and oral treatments. They can also help prevent acne from becoming worse:

  • Use a mild, nondrying soap to clean your skin gently.

  • Wash after exercising to remove sweat. Avoid scrubbing or repeated skin washing.

  • Avoid using rubbing alcohol or toners, which can dry your skin. Drying out your skin could promote the overproduction of oil in your pores.

  • Avoid oil-based soaps, cosmetics, and sunscreens on your chest.

  • Do not squeeze, pick, scratch, or rub pimples. This can lead to scarring, delayed healing, and skin infections.

Related: Treating Adult Acne

Prescriptions to Treat Chest Acne

When several months of using home and over-the-counter treatments do not improve your chest acne, you may benefit from working with a healthcare provider. They can provide stronger therapies available through acne prescription treatments.

Your prescription treatment depends on the type and extent of your chest acne. Since these medications work differently, finding the one that achieves results may take some trial and error.

Common prescription treatments for chest acne include the following:

Oral Antibiotics

Oral antibiotics are advised by the American Academy of Dermatology (AAD) for treating moderate and severe acne. These medications treat acne from within rather than on the surface.

They target acne-causing bacteria in and around the hair follicles to reduce inflammation and decrease the production of sebum (an oily substance made by the sebaceous glands).

The most commonly prescribed oral antibiotics for acne treatment include the following:

Oral antibiotics for acne should be taken for the shortest time possible (usually three months). This aims to reduce the development of antibiotic resistance (when bacteria develop defenses against antibiotics, making the drugs no longer effective).

Topical treatments are typically used at the same time and after the completion of oral antibiotics for the best results.

Oral Isotretinoin

Claravis (oral isotretinoin) is a systemic (body-wide) therapy reserved for the treatment of severe nodular acne. It is also used for treatment-resistant acne or the management of acne that is producing physical scarring and/or psychosocial distress.

While effective, the severity of medication-related side effects requires that people using this drug undergo routine monitoring of liver function tests and lipid panels to determine their response to this drug.

If you are capable of becoming pregnant, you are encouraged to use two forms of birth control while taking isotretinoin due to the possibility of severe fetal development effects.

Hormonal Agents

For many females, certain oral contraceptives are effective in treating inflammatory acne when used alone or with other acne treatments, though the effects can take time. Treatment is only effective with the use of estrogen-containing combined oral contraceptives.

The following birth control brands have been approved by the Food and Drug Administration (FDA) for treating mild to moderate acne in females:

The following oral treatments may be effective for females whose acne is caused or made worse by hormones:

(Note that the term "female" used here relates to chromosomal, anatomical, or biological characteristics rather than gender identity.)

Topical Treatments

Topical prescription acne treatments are used alone or in combination with oral antibiotics. Most products come in various forms, including lotions, gels, foams, medicated pads, and/or toner-like solutions.

These products work in different ways to treat acne. Depending on the product, they may reduce inflammation, encourage the shedding of dead skin cells, or kill acne-causing bacteria. The most commonly prescribed topical treatments include the following:

Topical antibiotics:

Retinoid acid creams or gels:

Dicarboxylic acids: Azelex (azelaic acid)

Prescription-strength formulas of the following:

  • Benzoyl peroxide

  • Sulfur

  • Resorcinol salicylic acid

Combination treatments that include two acne-fighting ingredients in one application:

  • Acanya (clindamycin and benzoyl peroxide)

  • Benzamycin (benzoyl peroxide and erythromycin)

  • BenzaClin (benzoyl peroxide and clindamycin)

  • Duac (benzoyl peroxide and clindamycin)

  • Epiduo (adapalene and benzoyl peroxide)

  • Onexton (clindamycin and benzoyl peroxide)

  • Ziana (clindamycin and tretinoin)

Minor Procedures or Treatments

Depending on the type of chest acne you have, its location, and the extent of damage it causes, your condition may benefit from therapy with one of the following physical methods of treatment:

  • Removal of comedones (small flesh-colored, white, or dark acne blemishes that become stuck in hair follicles)

  • Cosmetic laser procedures: Pulsed dye laser, potassium titanyl phosphate (KTP) laser, fractionated and unfractionated infrared lasers, fractionated CO2 laser

  • Photodynamic therapy (PDT) (light treatments)

  • Glycolic acid peels

  • Salicylic acid peels

  • Intralesional corticosteroid injections for larger individual acne nodules (the direct delivery of a corticosteroid into a skin lesion)

Related: Coping and Living With Acne

Everyday Décolletage Protection

Everyday décolletage (the skin on your neck and chest) protection can guard this area from ultraviolet (UV) light and other environmental factors. Without protection, these factors can trigger a response that promotes inflammation. The effect can promote or worsen acne on your chest and other areas prone to breakouts.

Protecting your décolletage with sunscreen can significantly improve the symptoms of chest acne or enhance treatment. To achieve optimal results, sunscreens should have emollient, antioxidant, and sebum-controlling properties.

Using these products can help prevent post-inflammatory hyperpigmentation (darkened spots left after lesions heal) common with chest acne.

Taking the following precautions can help you protect your décolletage and reduce your risk of chest acne:

  • Wear protective clothing, sunglasses, and hats when outside during the day.

  • Use sunscreen with sun protection factor (SPF) of 15 or higher.

  • Seek out the shade when you are outside.

  • Limit time spent in the sun between 10 a.m. and 4 p.m.

  • Consult the reported UV index to avoid overexposure.

  • Avoid tanning beds.

Related: The 9 Best Sunscreens for Protecting Your Face and Body

Summary

Chest acne is a common problem that can occur in many forms. It can produce whiteheads, blackheads, pimples, or cystic acne, much like the types of lesions that appear with facial acne.

Chest acne forms due to the overproduction of sebum in the sebaceous glands in your chest. This oil supports a buildup of dead skin cells, allowing bacterial growth and resulting in pimples. Other factors, such as excessive sweating, friction from clothing, and certain skin-care products, can also support chest acne.

Chest acne can often be improved with OTC and/or prescribed treatments. However, finding the right combination of products that work for you can often take weeks to months. Seeking early treatment before your chest acne spreads to larger areas can give you the best results.

Read the original article on Verywell Health.