Medically reviewed by Katelyn Hagerty FNP
Last updated 10/15/2021
You already know acne is one of the most common skin conditions, yet pimples can plague the faces of adolescents and adults for a variety of reasons. And sometimes those bumps can get severe, as with scarring acne.
It can be easy to find solutions for facial acne, but what happens when your pimples appear as chest acne?
Acne is acne and the same everywhere, of course, but the solution to the problem can often be location dependent.
Read on to learn more about what causes pimples and how to tackle chest acne in particular.
Let’s start with some facts.
Chest acne (or truncal acne, as it is sometimes called) isn’t a different type of acne. It’s the same common skin condition — simply in a different place.
And of course, this type of acne shares the same central causes as the kind that appears on your face.
Acne is a bacterial infection. But to be a little more specific, it’s a bacterial infection as a result of four factors in your skin’s healthy function: oil production, dead cell disposal, inflammation and the infection-causing bacteria itself.
A pimple occurs when dead skin cells and natural oils (sebum) get stuck in your hair follicles, creating the perfect habitat for Propionibacterium acnes, or P. acnes.
This is why acne shows up on your face and back: It tends to form on the parts of your body where there are more oil glands.
Chest acne (like the rest of acne) starts with a clogged hair follicle — just on a different part of your body.
As for why your pores get clogged? Dead skin cells and excess oil production can be caused by a lot of factors, from diet and water intake to hormones, stress or even the weather.
Because hormones can cause the imbalance, chest acne tends to happen in adolescence. Of course, the condition as mentioned earlier can persist well into adulthood.
Oil, sebum, lipids: These are just names for a part of your everyday skin health that is often misunderstood. Oil is a crucial production element in the upkeep of your skin’s health.
The pores on your face, chest and back produce oil, or sebum, through a gland called the sebaceous gland. This gland’s sole purpose is to help your body wick away dead skin cells.
When everything works correctly, the sebaceous glands keep those dead skin cells from accumulating, which helps keep your skin looking healthy and glowing.
But if things go awry (which can happen if you produce too much oil) your pores can suddenly be overflowing with an oily buildup in which acne bacteria can multiply, form pimples and lead to acne breakouts.
When it comes to chest acne, it’s helpful to understand that while all acne is acne, the location of your acne can influence how you treat it.
There’s been a lot of research on and attention paid to facial acne, yet chest acne is often considered a left-behind subgroup.
And that’s not just our opinion. A 2019 article published in the Journal of Drugs in Dermatology noted that there’s a relative sparsity of research on the topic of chest acne, yet data shows that more than half of facial acne sufferers also have some acne on the back, shoulders or chest.
While chest acne isn’t as visible, the authors of the article noted above explained that truncal acne can still be serious — and lead to scarring and pigmentation issues.
Treatments for chest acne aren’t significantly different than those of facial acne, but there are a few things that should be kept in mind, like the relatively larger surface areas of the chest and back as compared to the face.
This might mean that some treatments are less ideal for the chest. Using antibiotics on a large area of skin, for example, could increase the risk of forming resistant bacterial strains.
Likewise, some treatments are hard to apply to areas of skin that may be covered by clothing or in contact with bedding or other surfaces throughout the day or night.
That said, your clothing could contribute to chest acne, if it’s not breathable and traps bacteria on your skin.
Whether or not sweat contributes to chest acne, though, is up for grabs. A 2008 study found no relationship between sweating and acne, though results were limited.
The American Academy of Dermatology Association, regardless, still recommends you not stay in sweaty clothing for long periods of time if you’re trying to reduce body acne.
Because chest acne hasn’t been deeply investigated in comparison with facial acne, in many cases treatment options are similar, and some of these methods have shown promise.
For instance, oral versions of antibiotics and the retinoid tretinoin have been noted for their effectiveness.
There are also over-the-counter cleansing products like sprays and body washes formulated specifically for chest, back and shoulder acne.
Here are some ways you can address chest acne, to get it under control:
Removing excess oil from your chest may be a simple solution, and the obvious first step in treating acne.
Products including blotting papers, toners with astringents like witch hazel and even clay masks all have been proven effective at removing oil from the skin on your face as part of a daily routine, but proper cleansing of the chest may just require a good scrub.
In 2016, the medical journal Molecules ran a list of acne treatments including a section on topical facial treatments that actually showed beneficial results.
Their list included: salicylic acid, alpha hydroxy acids, benzoyl peroxide, retinoids, antibiotics, corticosteroids and a few other less common treatments like B vitamins, sulfur, antiseptics and hydrogen peroxide.
What’s good for your face may be good for your chest, yet you may want to consult a healthcare professional for guidance.
For example, if you have sensitive skin, a higher percentage of salicylic acid or benzoyl peroxide might be too strong, and you may want to err on the side of gentle, and use a product designed for facial skin, instead.
It may sound counterintuitive, but according to the American Academy of Dermatology, properly moisturized skin is less likely to spawn outbreaks of acne vulgaris and the acne bacteria, as excessively dry skin can lead to a buildup of dead skin cells, which normally are removed by your sebum as they fall away from the epidermis within your pores.
When a blocked pore stays blocked for long, the sebaceous gland can go into overtime, producing extra oil to push the dead stuff out.
Suddenly, you’ve got a huge excess of oil, which is a perfect environment for acne bacteria to breed in the pore.
Your skin may become dry from a number of causes, from the weather to your diet, age, skincare routine — or even because of excessive cleansing.
Adding a moisturizer can fix this. You may want to choose a water-based moisturizer over an oil-based one, depending on your skin type. You’ll also want something that’s marked as non-comedogenic — meaning it won’t block pores.
One proven hydrating ingredient common in moisturizers is hyaluronic acid — which has been shown in studies to help your skin retain moisture.
Proper moisture retention can help rebalance your skin’s equilibrium, especially if you’ve employed an aggressive cleansing routine, or if you’re experiencing dryness due to the weather, your diet or any other source of irritation.
Exfoliating to remove excess dead skin cells is important for the skin on your whole body, and not just your face.
You can do this through washing your face with a washcloth, for example, or you can use a chemical method with products like retinoids.
Sometimes a chemical exfoliant can actually be gentler for the skin.
Retinoids (which are synthetic vitamin A compounds like retinol and retin-A) help get rid of dead skin, and they have been proven to encourage your epidermis to regrow new cells faster.
Retinol is found in many over-the-counter products, but if your acne is severe, you might want to get a prescription for tretinoin, a stronger retinoid.
Tretinoin is a mainstay in acne treatment — and one healthcare professionals have relied on since the 1960’s.
Oral retinoids may provide long-term benefits without the irritation, and they may also help control excessive oil production.
Another advantage of oral retinoids is that they may be more effective for large areas of affected skin, like that on your back or chest.
Learn more about the various retinoid options, and see if they’re right for you.
Antibiotics like clindamycin work well with other acne treatments. A small 2009 study on 31 individuals revealed that combining clindamycin with benzoyl peroxide (an over-the-counter, topical antibacterial medication) reduced both the volume and severity of acne breakouts and pimples.
Another study from 2015 showed similar results: For the study, 100 teenage and young adult acne patients were divided into three groups and treated with one of three combinations: a mix of benzoyl peroxide and clindamycin; a mixture of the tretinoin and clindamycin; or a combination of benzoyl peroxide and a topical fluoroquinolone compound called nadifloxacin.
Both groups using clindamycin (the antibiotic) proved that it was an effective treatment, and both combinations delivered results (though benzoyl peroxide outperformed tretinoin overall). For chest acne, this can be a safe and effective way to address a large number of outbreaks.
That doesn’t mean tretinoin won’t deliver when used alongside clindamycin: A study from 2019 showed that when combined, clindamycin and tretinoin offered “continuous improvement” in facial acne in teenagers and young adults. And the combo could work similarly for acne elsewhere.
Your skincare routine alone does not determine how much sebum your pores produce. External factors, which can include a high glycemic diet, bad habits like poor hydration, and even work and home issues like general stress can cause serious skin issues by throwing off your pores’ natural rhythms.
One first step could be to consult with a healthcare professional about nutrition and stress, and to begin focusing on small habit changes, like changing your diet, for example. It’s been shown that foods low on the glycemic index and with low glycemic load numbers correlate to fewer acne breakouts.
For the record, it’s currently unclear if sugar intake and the related glycemic load and glycemic index ratings affect sebum production, yet plenty of research suggests that they’re related to acne problems, which are caused, among other things, by excess sebum.
Generally speaking, getting on a healthier diet, reducing stress and upping your water intake are good habits for every part of your body.
Chest acne is a skin problem just like any other, and it might be helpful to first address it with a healthcare professional.
They may prescribe oral medication or suggest other acne treatments, including topical products like tretinoin. Your healthcare provider might also suggest you combine methods.
What’s most important is that you find what works well for you, to help your skin stay clear and glowing.