Why does body acne happen?

What happens inside the pore?

A hair follicle is the opening where a hair grows. Sebum, the natural oil your skin produces, can collect there with dead skin cells and form a blockage. Acne commonly affects the chest, back and shoulders as well as the face. Surface blockages produce blackheads and whiteheads; inflamed spots can become swollen, tender or filled with pus. Deeper inflammation can produce larger lumps beneath the skin.4

During puberty, hormones called androgens enlarge oil glands and increase oil production. Hormone changes during periods, pregnancy and menopause can also contribute to acne. Breakouts can continue or first appear in adulthood. A close relative with deep, painful acne increases your risk of that type of acne, although family history cannot predict exactly how severe your breakouts will be.15

What can make body breakouts worse?

Oily skin and hair products can worsen acne, even when their packaging would like a promotion to "essential". High humidity can also provoke flares. Some medicines, including steroids, hormones and certain seizure medicines, can contribute; a medication review with your clinician can help identify a possible trigger.25

Acne is not caused by dirt. Stress does not cause acne either, but it can worsen existing breakouts, and too little sleep can also make acne worse. Food is less clear cut: dairy and foods that raise blood sugar quickly can provoke flares, but chocolate or greasy meals are not an established explanation for everyone's acne.256

Are all body bumps acne?

No. On the buttocks, folliculitis, keratosis pilaris and boils are more common than true acne. Folliculitis is irritation or inflammation of a hair follicle. Friction, tight clothing, shaving and waxing can trigger it, and bacteria or yeast can also be responsible. Sweat trapped by clothing or prolonged sitting can contribute to these buttock bumps.3

Keratosis pilaris develops when keratin, a skin protein, builds up inside hair follicles. It commonly affects the backs of the arms, thighs and buttocks and becomes more prominent with dry skin. A boil is a deeper form of folliculitis. These conditions need different approaches, so persistent bumps deserve a diagnosis rather than repeated rounds of acne products.37

What should you change first?

• Cleanse gently rather than scrubbing, which can irritate skin and worsen acne.
• Wear loose, breathable clothing, particularly during exercise. Shower after a workout, or change out of sweaty clothes if a shower is not possible.
• Choose skincare labelled noncomedogenic, meaning formulated not to clog pores, because "luxurious" is not a pore policy.
• For mild acne, ask a pharmacist about salicylic acid or benzoyl peroxide. Salicylic acid opens clogged pores; benzoyl peroxide reduces acne causing bacteria. Follow the product directions, and reduce use of a drying acne wash rather than forcing daily use.

When should you get medical help?

Acne treatment takes at least 6 to 8 weeks to start producing fewer breakouts. See a doctor if self treatment is not helping, or sooner for numerous spots, deep painful lumps, scarring or hot, swollen skin. Get help if breakouts affect your mental health, too. Do not squeeze spots or try to drain a boil yourself.137