Acne is an extremely common part of growing up for millions of people around the world. In fact, according to the American Academy of Dermatology Association, approximately 85 percent of people between the ages of 12 and 24 experience at least minor acne. So if you fall within that group, rest assured, you're not alone.
Still, while the conversation around facial acne has improved over the years, people don't always talk about the breakouts on areas you don't see as often. This is especially true for body acne, from back acne to butt acne (also called "buttne"), as well as shoulder acne, even though the latter category is not uncommon.
"Shoulder acne are lesions or blemishes that can be tender when inflamed and can create comedones, either whiteheads or blackheads," Roberta Moradfar, board-certified advanced aesthetics nurse practitioner and founder of Efface Aesthetics, tells POPSUGAR. So what exactly is the cause of shoulder acne, and how can you get rid of it? We asked Moradfar and board-certified cosmetic dermatologist Shauna Ryder Diggs, MD, to break down everything you should know about the condition.
What Causes Shoulder Acne?
Shoulder acne can be caused by a multitude of factors, from your lifestyle to your clothing. "Instances such as wearing restrictive clothing that can cause friction to the area (think: bras, backpack straps, purse straps) may be one of a few reasons why shoulder acne develops," Moradfar says. "Environmental factors such as heat and humidity as well as biological factors like hormonal changes, excessive sweating, and overactive sebaceous glands can also cause excess sebum production in the area."
If you take any medications that interact with your hormone levels, these may also play a factor. "Taking hormonal birth control or steroids for bodybuilding or medical treatment may also cause a flare-up," Dr. Diggs says.
Signs of Shoulder Acne
The signs of shoulder acne are similar to those of any normal acne flare-up, but it's important that you know what to look for when considering shoulder-acne symptoms specifically. "Red, tender bumps; plugged pores; blackheads; oily, scaly skin; whiteheads; and larger cysts are signs to watch out for," Dr. Diggs says.
Once you've identified the condition, Dr. Diggs says, it's just as important with shoulder acne, perhaps even more so, that you don't pick at the bumps. "Certain areas of the body tend to scar more than others - shoulders are one of those that scar more easily," she says. Moradfar adds: "There is, however, a noticeable occurrence of PIH (postinflammatory hyperpigmentation) that is noted amongst skin type 6 or Black skin. The higher the skin type, the more PIH manifests. This is significant because although successful treatment of PIH may occur with shoulder acne, there are higher skin types that will continue to display previous evidence of these blemishes once the actual pimple is gone."
To mitigate the risk of stubborn postacne hyperpigmentation, do your best to avoid any trauma to the area by not picking in the first place.
How to Treat Shoulder Acne
In addition to wearing looser-fitting clothing, treating the skin with specific active ingredients may also be helpful. "Shoulder acne can be treated by reducing bacteria on the skin, increasing exfoliation, and calming inflammation," Dr. Diggs says. "Using topical antibiotics, benzoyl peroxides, and vitamin A retinoid creams, often in combination, can cause acne to peel off and eliminate infection."
Ingredients such as azelaic acid and ointments such as Clindamycin are also usually some of the first-line treatments of choice when treating moderate inflammatory acne. For a natural at-home treatment, tea-tree oil is also a solid option. But if you have more intense symptoms, there are some additional options. "For more severe inflammatory acne, oral antibiotics such as doxycycline and minocycline are prescribed," Moradfar says. "Those with cystic acne are usually placed on Accutane, which is usually a short course but comes with a long list of adverse reactions and requires strict supervision under the care of a physician. For women who are experiencing body acne due to hormones, spironolactone can be prescribed to help block androgens from stimulating oil glands."
One lesser-known recommendation is light therapy, which Dr. Diggs is a strong proponent of. "Light therapies using IPL (intense pulse light) reduce redness and P. Acne bacteria," Dr. Diggs says. "The StellarM22 device by Lumenis has a special Acne filter for its IPL handpiece that can be used to treat the entire shoulder and back area in a serial fashion to clear the skin." If your acne is more stubborn and won't go away at home, this professional treatment costs upward of $200 per session and may be an option worth exploring to keep your shoulder acne at bay.
Should you want to address your shoulder acne, keep these tips in mind and know that there are options available for you at any time.