Many people are well-versed at tackling a common face pimple. Whether it's applying pH-balancing toners, face mapping, or even learning the art of careful pimple popping, developing a battle plan can make breakouts much less stressful. Less discussed, however, is body acne, which can set up shop on your back, chest, butt, and pretty much anywhere skin is.
If you've seen an uptick in body breakouts this past year, don't worry. That's completely normal, and if it's any consolation, you're certainly not alone. "With the pandemic and a range of economic and social issues we're going through, it's a stressful time right now. That's manifesting in different ways, and body acne is a huge one," says Ife Rodney, MD, board-certified dermatologist of Eternal Dermatology.
So how do you treat it, especially if it crops up in hard-to-reach places? We tapped expert dermatologists to get some insight.
What is body acne?
When it comes to back and chest acne (also called folliculitis), most people get either large pustules (whiteheads) or cysts, says Renee Rouleau, celebrity esthetician and skincare expert. "Pustules are no different than your everyday pimple, but cysts are deep under the skin, never come to a head, and can be painful. It's important not to pick at cystic blemishes since the body usually reabsorbs the infection from within."
Body breakouts often crop up in the same areas, like the center of the chest, buttocks, and upper back. "Since these areas have many oil glands, we are more likely to see acne there," explains Dr. Rodney. You may also experience different variations of body acne, including fungal acne, which is a yeast infection that usually occurs after excessive sweating.
What causes body acne—and why is there so much of it right now?
Let's get the most obvious one out of the way: stress. It goes without saying that we've all faced an unprecedented amount of stress lately, so it's only natural that your skin takes a toll. "When we're stressed, we trigger more androgen production, which creates more inflammation and oily skin," says Dr. Rodney. "Excess oil clogs our pores, creating acne. So while the stress itself does not create acne, it makes a bad situation worse."
But there's also other factors that are likely at play, especially if your body acne is persistent. That's where acne mapping comes in. "Body acne often suggests a significant hormonal component," says Dr. Rodney. "Hormonal acne tends to show on the chest and back, similar to where hair would grow."
Acne Mechanica (friction acne), on the other hand, will usually show up on the shoulders, neck, and buttocks. "Spending more time in a seated chair can increase friction and occlusion in certain places," explains Sara Perkins, MD, board-certified dermatologist and Hims & Hers Medical Advisory Board member.
In addition to a sedentary lifestyle, being too active can also trigger the same thing. "A lot of people are currently working out more as we try to get our bodies back in good shape post-quarantine," says Dhaval G. Bhanusali, MD FAAD, a board-certified dermatologist in New York City. "This is a huge cause of body acne, especially if you don't immediately shower after sweaty sessions."
How do you treat body acne?
As with all acne, you'll need to be strategic when tackling body breakouts. "Remember that it will take some time to clear things up. Then you'll want to tackle both the internal and external factors that cause your body acne," says Dr. Rodney.
First things first: Start with changing your soap to an acne-fighting body wash that contains ingredients like salicylic acid and benzoyl peroxide, says Dr. Perkins. "Benzoyl peroxide washes are my top choice for body acne, but you need to leave them on for three to five minutes prior to rinsing to get the best effect. Other options include salicylic acid and glycolic acid, both of which are chemical exfoliants that remove dead skin cells and help to prevent clogged pores."
Things to avoid? Oil-based shower gels or moisturizers, which can promote excess oil production. You should also be wary of haircare products, which could be comedogenic. "Look out for panthenol if you're acne-prone," warns Rouleau. "I learned that my conditioner used a lot of this, and the residue that it left on my back was a huge trigger for me."
You may be tempted to use your anti-acne facial products on your body, but take note: "Because the skin on your face is usually more sensitive than that on your body, acne-fighting products may not be as effective on your body," says Dr. Rodney. "You should probably use products specific to your body that will contain more potent active ingredients." If you don't have any, try an OTC antibacterial or anti-yeast formula, like Head and Shoulders, as a body wash.
Good hygiene also takes priority. "When someone struggles with acne on their face, I usually tell them to be very diligent about changing their pillowcase to avoid reintroducing oil, dirt, and bacteria onto the skin. The same concept applies to body acne," says Rouleau. Showering immediately after exercise (or any sweating in general) and wearing loose or moisture-wicking fabrics is key.
If your body acne is cystic and hormonal (or it's simply not going away), you may need to consult with your dermatologist to develop a customized treatment plan. They may recommend a prescription alpha hydroxy acid (AHA) or beta-hydroxy acid (BHA), birth control, or a diuretic like spironolactone to keep your hormone levels in check.