Body Acne 101: What Causes It & How to Clear Up Your Skin

Whiteheads, blackheads and other forms of acne don’t just form on your face. From your back to your arms, shoulders, thighs and butt, it’s common for pimples to develop elsewhere on your body. 

Dealing with body acne can be a stressful, frustrating process. Although it’s easy to hide some blemishes under clothing, body acne can often be severe enough that over-the-counter creams and other products just aren’t up to the job of controlling it.

Add the annoyance of having to apply creams, body washes and other products to your back, shoulders and other hard-to-reach areas into the equation, and even a mild case of body acne can be a serious pain. 

Luckily, options are available to treat body acne, from bacne to acne that forms on your thighs, butt and shoulders. 

Below, we’ve explained how and why body acne forms, as well as the key factors that could be causing you to experience body acne breakouts. We’ve also listed a variety of options that you can use to treat body acne, from over-the-counter products to prescription medications. 

What Causes Body Acne? 

Body acne develops the same way as facial acne, when a combination of natural skin oils, dead skin cells and other substances cause blockages to develop in your hair follicles. These blocked follicles become pimples, and in some cases can become red, inflamed and painful. 

To explain this process in more detail, we need to take a step back and look at the main factors that are involved in maintaining your skin. 

Sebum and Body Acne

Have you ever run your finger across your skin and felt an oil-like substance? This is called sebum, and it’s a type of naturally-occurring oil that’s produced by your body to keep your skin moisturized and protected.

Sebum is produced in your sebaceous glands — the small, oil-producing glands that are located just beneath the surface layer of your skin. Sebum has a variety of roles, from helping your skin and hair to retain moisture to potentially protecting against certain types of bacteria. 

While sebum is essential for healthy skin, it can also cause acne to develop. If your body makes too much sebum, the excess can mix with other particles and become stuck inside a hair follicle, forming a plug that can develop into a pimple. 

A range of factors can affect your sebum production — from your genetics to your age. One factor that’s closely linked to sebum production is your level of certain hormones, particularly progesterone androgens like  testosterone.

Your body’s production of these hormones fluctuates over the course of a menstrual cycle. 

You may notice an increase in your acne in the days before your period starts. This is due to elevated progesterone levels during the second half of your cycle in combination with the steady level of androgens that you have been producing throughout the month.

We’ve explained this process in more detail in our guide to hormonal acne, along with what you can do to control the hormones that often contribute to acne breakouts.

Other Factors That Cause Body Acne

Sebum and hormones aren’t the only substances that are responsible for causing you to experience facial and body acne. Others include dead skin cells, which can collect on the surface of your skin, and bacteria that can infect pimples and cause them to become inflamed and painful.

Your skin is constantly renewing itself through a process called cellular turnover. According to the American Academy of Dermatology, your body gets rid of between 30,000 and 40,000 old skin cells every day. Of course, that tends to slow as we age.

During this process, the epidermis — the outermost layers of skin — replaces old cells with new ones developed in the stratum germinativum, a basal layer of your skin.

This turnover process is essential to keeping your skin soft, elastic and protected. However, it produces a byproduct: old skin cells. 

Over time, old, dead skin cells can collect on the surface of your skin. These cells can mix with the sebum that’s secreted by your sebaceous glands and get stuck inside hair follicles, leading to whiteheads, blackheads and acne breakouts. 

Finally, certain forms of bacteria, such as propionibacterium acnes, or P. acnes, can aggravate facial and body acne. These bacteria live on the skin. When they’re trapped inside a hair follicle that’s clogged by sebum and dead skin cells, they can multiply rapidly and cause an infection.

The end result of this process is a painful, inflamed acne breakout that can occur anywhere on your face, back, shoulders, arms or elsewhere on your body. 

Acne Mechanica

Most body acne is caused by sebum, hormone fluctuations, dead skin cells and bacteria. However, some body acne can develop as a result of heat, sweat and pressure on your skin caused by clothing, straps or other items that rub against your body. 

This type of acne is called acne mechanica. It tends to develop on areas of your body that get rubbed against often, such as your shoulders, your forehead and your lower back. 

If you’re an athlete or live in a hot, humid area, you might be more prone to developing acne mechanica than others. Thankfully, like other forms of acne, acne mechanica is easy to treat and preventable. 

How to Treat Body Acne

Dealing with body acne can be stressful and frustrating, especially if you experience breakouts and inflamed, painful pimples often. Luckily, body acne is often manageable. 

A variety of options are available to treat body acne. For mild acne, over-the-counter cleansers, creams and body washes are often enough. You might also be able to get rid of very mild acne simply by changing certain skincare and hygiene habits. 

For moderate to severe body acne, the best option may be talking to a healthcare provider about prescription treatments. There are also specific medications available if your body acne is infected, inflamed and painful. 

We’ve listed these treatment options below, with more information on how each treatment works to treat and prevent pimples. 

Habits and Lifestyle Changes

If you only have mild body acne, you might be able to get clearer skin by making some changes to your habits: 

• Be careful with backpacks, bra straps and other clothes that put pressure on your skin. These can irritate your skin and worsen acne mechanica, especially if they’re worn for long periods or too tightly. 

• Wash your sheets and pillowcases every week. Sebum, dead skin cells and bacteria can all build up on your bedding. Wash your bedsheets and pillowcases weekly to clear away any acne-promoting substances and enjoy a fresher night’s sleep. 

• Be mindful of excessive sweating. Sweating won’t give you acne directly, but it can irritate skin that’s already prone to acne and make body acne worse.
  
  If you exercise frequently or live in a hot and humid climate, shower often to prevent sweat from affecting your skin.

• Can’t shower? Wipe down after sweating. If you don’t have the opportunity to shower, carry a pack of oil-free cleansing wipes with you and use them to wipe down acne-prone areas after you sweat. 

• Wear loose, breathable fabrics. Loose-fitting clothing made of sweat-wicking polyester or cotton will prevent sweat from sticking to your body and irritating your skin.

• Avoid getting sunburned. Contrary to popular belief, spending time in the sun doesn’t get rid of acne.
  
  Since sunburn damages your skin and increases your risk of developing skin cancer, it’s best to limit your UV exposure and use an SPF 15+ sunscreen.

• Start using non-comedogenic cosmetics and skincare products. Products labeled “non-comedogenic” or “oil-free” don’t contain any oils and are less likely to contribute to clogged pores.

• Don’t scratch or pop pimples. Popping body acne might be tempting, but it’s rarely a good idea. Popping or scratching at pimples increases the risk of infection and scarring, both of which you want to avoid. 

These changes can make a real difference if you only get occasional acne that’s not inflamed or painful. However, if you get severe or inflamed body acne, you may also need to use some form of medication. 

Over-the-Counter Products

Step into your local drugstore and you’ll be overwhelmed by countless cleansers, creams and other over-the-counter products promising to get rid of acne fast.

While not all over-the-counter acne treatments may be effective, there are several over-the-counter acne treatment and prevention products that are backed by real science. These include: 

• Benzoyl peroxide. Benzoyl peroxide is a topical anti-acne treatment that you can find as an ingredient in some over-the-counter acne creams. It works by killing the bacteria that contributes to inflamed, painful acne.
  
  Used on its own, benzoyl peroxide is often enough to get rid of mild to moderate acne on the face and body.
  
  
• Salicylic acid. Another science-backed over-the-counter acne treatment, salicylic acid is an exfoliant that helps to remove old skin cells from the skin’s surface, reducing your risk of developing blocked pores.
  
  Like benzoyl peroxide, salicylic acid is a common ingredient in over-the-counter lotions and body washes that you’ll be able to find in your local supermarket or drugstore.
  
  
• Azelaic acid. Azelaic acid is another exfoliant that can help to remove dead skin cells from your body, preventing body acne from forming.
  
  Although there isn’t much data on azelaic acid and body acne, a study from 2007 found that it caused a roughly 60 percent reduction in mild to moderate acne lesions over 45 days. 

Another study from 2018 demonstrated that Azelaic acid 15 percent foam reduced inflammatory and total lesion counts by week 16 in all subjects and about 90 percent of subjects experienced reductions in non-inflammatory lesions.

Just like the two treatments above, this is something to look for in your local drugstore. 

Prescription Medications

A lot of the time, body acne is treatable without the use of prescription medication. However, if you have moderate to severe body acne that doesn’t seem to disappear with over-the-counter products, it’s worth talking to a healthcare profession about using a prescription acne treatment.

There are several different prescription treatments for acne. Some work by stopping your body from producing excess sebum, while others target the bacteria responsible for causing acne to become inflamed. Your healthcare provider may recommend one or several of the following treatments:  

• Clindamycin. Clindamycin is a topical antibiotic that kills the bacteria responsible for turning whiteheads and blackheads into red, inflamed pimples. While it won’t prevent your skin from getting oily, studies show that it can treat and reduce acne breakouts.
  
  One study found that a cream that was a mix of clindamycin and benzoyl peroxide was more effective at treating acne than a mix of benzoyl peroxide and erythromycin. 
  
  We’ve covered the science behind clindamycin in our detailed guide. It’s one of three key ingredients in the hims & hers clinical-strength acne cream, along with tretinoin and niacinamide.

• Tretinoin. Tretinoin is a prescription topical retinoid. It works by speeding up your skin’s cellular turnover cycle, meaning you’ll replace old skin cells with newer ones in a shorter amount of time.
  
  Like clindamycin, tretinoin is an active ingredient in the hims & hers acne cream. We’ve explained how it works as an acne treatment in more detail in our guide to tretinoin and hormonal acne.

• Doxycycline. Doxycycline is an oral antibiotic that’s used to control the bacteria that’s responsible for making pimples. It won’t make your skin less oily, but it can help to get rid of pimples and painful, infected acne lesions.
  
  Your healthcare provider may recommend doxycycline if your acne is moderate to severe and hasn’t responded to other topical treatments.
  
  Our guide to doxycycline goes into more detail about how doxycycline works, as well as how it can be used to treat acne breakouts.

• Birth control pills. If your healthcare provider thinks your acne is caused by normal monthly hormonal fluctuations, they may recommend a combination birth control pill.
  
  As we’ve explained in our guide to birth control and acne, certain birth control pills can help to prevent acne. Your healthcare provider may prescribe the pill on its own, or alongside an antibiotic, a retinoid or topical anti-acne cream, or a drug called spironolactone.

• Spironolactone. Spironolactone is a drug that works by blocking the activity of  androgenic hormones in your body, particularly in the skin.
  
  If you have hormonal body acne, you may notice fewer breakouts after using this medication. Spironolactone is only used to treat acne in women.
  
  We’ve explained more about how spironolactone and other anti-androgen medications work to treat acne in our detailed guide to spironolactone.

• Isotretinoin (Accutane®). Better known by its brand name Accutane, isotretinoin is used to treat severe, persistent acne. It’s a powerful medication that works well, but it has serious side effects that you’ll need to be aware of before using it. 

In Conclusion

Dealing with body acne can be an annoying process, especially if it develops on an area of your body that’s visible to others. 

If you have body acne that doesn’t seem to go away on its own, try one of the treatment options listed above or talk to a healthcare professional about using a prescription treatment. Although it can take several months to fully clear up, body acne is almost always a treatable condition. 

Interested in learning more about how body acne develops? Our guide to hormonal acne goes into more detail about how your body’s production of certain hormones can lead to facial acne and body acne breakouts.