I Don’t Have a Single Pimple on My Face, but My Body Is Breaking Out. What Gives?
"Acne can show up anywhere, but the most common areas for body acne are the back, chest, and butt," says Dr. David Lortscher, board-certified dermatologist and founder of Curology. "There are a few causes of body acne. Genetics, normal hormonal fluctuations, stress, diet, and other lifestyle choices can all contribute." He also notes that tight clothing—like your workout leggings—can also cause body acne, which is why you may see back zits cropping up along the line of your sports bra.
Part of why pimples pop up has to do with excess oil (aka "sebum") which is secreted by glands into the pores of your skin. "These sebaceous glands are more prominent on our chests and backs, which can explain the prevalence of body acne in these areas," explains Dr. Lortscher, noting that microorganisms like P. acne (a bacteria) and pityrosporm (a fungus) contribute to the inflammatory aspect of acne. "Our immune system works hard to fight against them via inflammation, [but] they love a warm, oily, moist environment, such as the one found on a sweaty back."
The unfortunate thing about this is that it can be far more stubborn to treat than the stuff that pops up on your face, so it's important to look at the process holistically. "No treatment is a cure, so the aim should be to control acne until your body’s susceptibility to have breakouts passes," says Dr. Lortscher. "Breakouts are highly variable based on an individual’s hormones, genetics and lifestyle. Dietary changes [like eating less dairy], oral antibiotics, and hormonal manipulations, such as birth control, have all been known to help prevent body acne." And, of course: No picking.
According to celebrity dermatologist Dr. Adarsh Vijay Mudgil, MD, medical director of Mudgil Dermatology, PC, body acne tends to be more cystic—which is why you'll often find those deep, rooted suckers lurking around your booty and shoulder blades. "Yes, hygiene can play a role, but ultimately oral medication is the most effective strategy, as this acne tends to be an 'inside out' issue," he says, calling out Accutane, oral contraceptives, sprinolactone as great options for managing hormones.
From a topical standpoint, Dr. Lortscher suggests avoiding comedogenic soaps, washes and moisturizers, and rinsing off right after sweating to avoid zits in the first place. If they do show up, he's a fan of treating them with a benzoyl peroxide wash, like Clean & Clear Advantage 3-in-1 Exfoliating Cleanser ($15), or a salicylic acid product, like Neutrogena Body Clear Body Wash ($6). "Typically, our bodies can tolerate stronger ingredients than our faces, so, even if your face does not tolerate exfoliation, your back, shoulders, and chest should," he explains.
And one more thing: Acne, wherever it decides to show up, is treatable. Frustrating? Yes. But with the right regimen, it can turn into NBD in no time.
Another thing that could be causing acne on your back, neck, and shoulders: Your shampoo and conditioner. And here's the (gross) reason you need to stop putting your sweaty workout clothes in plastic bags.
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