Acne on the upper chest: What helps?

Why does acne appear on the upper chest?

Acne develops when hair follicles become blocked with excess oil and dead skin cells. Bacteria can grow inside the blockage and cause inflammation and pus. The chest is a common acne site, including in adults. Hormonal changes during puberty, periods, pregnancy and menopause can contribute, as can greasy skin or hair products.12

Chest acne can include blackheads, whiteheads, raised bumps, pus filled spots and larger cysts. Raised inflamed bumps can look pink or red on white skin and brown or purple on brown and black skin. Large, hard bumps beneath the skin are called nodules; these and cysts need more attention than a few surface spots.134

How should you treat mild chest acne?

The strongest acne product on the shelf is not automatically the best choice, despite packaging that seems ready to declare war. Strong treatments can be particularly drying for adult skin.2

1. 1Wash the affected chest gently with a cleanser morning and evening, and shower after exercise. Do not scrub: irritation can make acne worse.
2. 2Ask a pharmacist about salicylic acid or benzoyl peroxide for mild spots. A gentle cleanser containing salicylic acid is one option.
3. 3Use an oil free, noncomedogenic moisturizer. Noncomedogenic means designed not to clog pores.
4. 4Wear loose, breathable clothing, especially during exercise or sweating.
5. 5Use oil free, noncomedogenic sunscreen on exposed chest skin to protect against sun damage.

Look for 'noncomedogenic' on skincare labels, where a very long word is doing a fairly small job. Greasy cosmetics and hair products can contribute to clogged follicles, so include those products when reviewing what touches your chest.12

How long does treatment take?

Inflammatory acne often needs several months of skincare and treatment to become clearer. For severe acne, improvement can take two to three months after starting treatment. If good skincare and shop bought treatments have not helped after a few months, arrange medical care. Continue the prescribed maintenance routine after clearing, because acne can return.45

When should you see a doctor sooner?

Do not wait months if you have many spots, deep painful lumps, scars or acne affecting your mental health. Hot, swollen skin with redness can signal infection and needs medical assessment; redness can be harder to see on brown and black skin. Large bumps that connect beneath the skin or drain pus also need assessment. A rare severe form, acne conglobata, can cause connected deep lumps and significant scarring.16

Do not squeeze spots or try to drain a chest cyst yourself. Picking can cause scars, infection and further blemishes. An itchy acne like rash can also be folliculitis rather than acne, so a different appearance is a reason to have the diagnosis checked.45

What if skincare is not enough?

Prescription options include medicines applied to the skin, oral antibiotics and isotretinoin for severe acne. Women with stubborn chest acne can also discuss hormonal treatment, such as certain birth control pills or spironolactone. These require a medical review, including current medicines and health conditions. Spironolactone requires birth control if you can become pregnant because exposure during pregnancy can cause serious birth defects. If breakouts started after a medicine change, including testosterone treatment or stopping birth control, tell your prescriber.257