Medically reviewed by Kristin Hall, FNP
Written by Our Editorial Team
Last updated 3/10/2021
Nothing is worse than an unexpected breakout.
When you’re already stressed with work, school, or family obligations, the last thing you need is a pimple on your face. The trouble with acne is it doesn’t just happen on your face — it can happen on your shoulders, back and even your neck.
The neck is one of the most neglected areas of skin, even though it sees many of the same issues as your face. Unfortunately, breakouts on the neck can be harder to cover up.
Though neck acne may be a nuisance, it is just as treatable as any other type of breakout.
Below, we’ve covered the subject of neck acne including what it is and what causes it. We’ve also explored the various treatment options available for neck acne.
All types of acne develop through the same basic process — your hair follicles, or pores, become clogged with dead skin cells and excess sebum which creates a plug.
That plug can then become infected by bacteria residing on the surface of your skin to create a lesion.
Acne lesions take several different forms, including the following:
Whiteheads (closed comedones). Small white dots covered by a layer of skin.
Blackheads (open comedones). Small black dots on the skin’s surface.
Papules. Small, hard, red bumps on the surface of the skin.
Pustules. White or yellowish lesions filled with pus.
Nodules. Large, painful, inflamed bumps under the skin’s surface.
Cysts. Large, inflamed, pus-filled lesions deep under the skin.
The term neck acne simply refers to acne lesions that form on the neck. The delicate skin on the neck and chest is sometimes referred to as the decollete and, in addition to being prone to acne, it is often the first area of skin to show the visible signs of aging.
Acne can form on any part of the body where you have pores. It’s important to realize, however, that you have two types of pores on your body: oil pores and sweat pores.
Oil pores are also known as hair follicles. They are small openings in the skin that contain a hair and a sebaceous gland or oil gland.
These pores are found all over the body, but especially in the face. Sweat pores are found all over the body as well, but they are too small to see with the naked eye.
These pores produce sweat to help regulate your body temperature through evaporative cooling.
The face has a higher concentration of pores than other areas of skin which is why it is more prone to acne. That being said, the skin on your neck has oil pores as well.
Neck acne forms in the same way as acne on the face, though the triggers may be a little different.
Here are some of the most common causes of neck acne:
All forms of acne are caused by the same four factors: excess sebum production, clogged pores, bacteria, and inflammation. Some skin types simply produce more oil than others which may lead to an increased risk for acne breakouts.
The term “comedogenic” means pore-clogging. Certain products like makeup and sunscreen can clog your pores, combining with oil, sweat, and dead skin cells to trigger breakouts.
Harsh skin treatments like chemical peels and physical exfoliants can irritate or damage the skin, increasing the risk for acne. This can also be an issue with products that contain alcohol or other drying ingredients. When the skin is stripped of moisture, it produces extra oil to compensate which may exacerbate issues with acne.
Even if you’re using non-comedogenic products, they can still contribute to skin issues if you don’t wash them off before bed. Washing your face in the morning and evening should be part of your daily routine, not just to prevent acne but to keep your skin healthy.
If you use hair products like pomade or leave-in conditioner, it’s important to cleanse the skin on your neck to remove residue that could irritate your skin or clog your pores.
Hormonal acne is common during puberty and early adolescence, but it often manifests on the forehead, nose, and chin. In adulthood, hormonal acne typically forms on the cheeks, jawline, and neck.
It can be triggered by changing hormones related to menstruation, menopause, and birth control as well as stress.
While stress may not be a direct cause of acne, it can certainly be a contributing factor. Stress increases the production of androgens like cortisol which, in turn, may trigger the sebaceous glands to produce more oil.
Changing hormone levels induced by stress can also trigger inflammation in the body which could delay healing for active breakouts.
Neck acne can range from mild to severe, so there is no one-size-fits-all solution. Your best bet is to talk to a healthcare professional to determine what type of acne you’re experiencing and how best to treat it.
Treatments for neck acne generally include over-the-counter (OTC) remedies, prescription acne treatments, and lifestyle changes.
If your acne breakouts are mild and occasional, over-the-counter treatments might be your first line of defense.
Spot treatments and skincare products enriched with acne-fighting ingredients can help speed along the healing process for active breakouts and prevent them from recurring. They include:
Benzoyl peroxide. Often sold as a spot treatment, benzoyl peroxide is an OTC acne treatment that helps reduce sebum production and counters the growth of bacteria that might contribute to acne formation.
Salicylic acid. A common ingredient in acne cleansers and masks, salicylic acid is a peeling agent that helps remove dead cells from the surface of the skin.
Azelaic acid. Similar to salicylic acid, azelaic acid helps remove dead skin cells that can clog the pores and kills bacteria that contribute to acne.
Acne cleansers. If you’re dealing with mild acne, it may help to use a cleanser made with acne-fighting ingredients on your face and neck. Just make sure it doesn’t contain any ingredients that will dry out or irritate your skin.
While mild forms of neck acne such as whiteheads and blackheads generally respond well to over-the-counter treatments, frequent and severe breakouts may require something stronger.
Prescription acne treatments are often made with the same active ingredients but in higher concentrations. Some acne treatments are only available by prescription.
Tretinoin. A topical retinoid, tretinoin increases the rate of cell turnover in the skin which helps prevent dead cells from clogging your pores.
Research shows that retinoids like tretinoin not only help treat active breakouts but may prevent new ones from forming.
Isotretinoin. An oral medication typically prescribed for severe forms of acne like cystic acne, isotretinoin works best with several months of daily use.
This medication requires close monitoring with a healthcare provider due to potential side effects.
Hormonal birth control. For cases of hormonal neck acne, hormonal birth control may be a good option.
This treatment helps balance the body’s hormone production, reducing androgen levels to even out sebum secretion.
Sometimes the best thing you can do for an acne breakout is let it run its course. Your skin needs time to heal.
That being said, there are a few things you can do in the meantime to support skin health and to prevent future neck acne breakouts from occurring.
Cleanse twice daily. Keeping your skin clean and free from excess oil and debris is essential for preventing acne breakouts.
Be sure to use warm water (not hot) and don’t scrub your skin too hard. Look for a gentle cleanser made with acne-fighting ingredients.
Wear SPF daily. Protecting your skin from sun damage is another important piece of the puzzle for preventing neck acne.
It’s easy to focus on the face when applying sunscreen, but don’t neglect the skin on your neck and chest.
An SPF of at least 30, water resistance, and is broad spectrum is recommended daily.
Follow a healthy diet. A balanced diet is the key to optimal health and a healthy body means healthy skin.
Be sure to include antioxidant-rich and anti-inflammatory foods.
Manage your stress. Make an effort to get a good seven to eight hours of sleep per night and take steps to manage your stress levels.
Mindfulness meditation, deep breathing exercises, and progressive muscle relaxation all help to reduce stress.
Wash your clothes. Your neck comes into frequent contact with the clothes you wear, so if your clothes aren’t clean it could contribute to neck acne. It’s particularly important to change your clothes after working out. Be sure to wash your bedding often as well.
If you’ve tried over-the-counter acne treatments and nothing seems to be working, you may want to talk to a healthcare professional.
Your healthcare provider can help you determine the underlying cause of your neck acne and prescribe a stronger treatment such as a prescription topical treatment or oral antibiotics.
Acne can develop on just about any part of the body, though it is most common on the face.
Even if you aren’t plagued by acne breakouts on your face, however, you could still be prone to neck acne.
The skin on the neck is often neglected in terms of skincare, but it requires the same degree of care and attention as the face to remain healthy and acne-free.
If you’re tired of dealing with acne breakouts on your face and neck, check out our guide to science-backed acne treatments. This guide goes into detail about the top acne treatments on the market and the science behind them.
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