Body acne includes acne breakouts that occur on the chest,back, neck, shoulder, upper arms, and butt. Likeacneon your face, you can have non-inflammatory acne on your body, likeblackheadsandwhiteheads. You can also have inflammatory acne like papules (pimples), pustules (pus-filled pimples), nodules, andcysts.
Getting rid of body acne involves clearing pores clogged with oil (sebum), dead skin cells, and bacteria. Body acne treatments also help prevent future breakouts.A healthcare provider like a board-certified dermatologist (a medical doctor who specializes in skin, hair, and nail conditions) can help you find the best treatment option.
Depending on the severity of your body acne, treatment may include over-the-counter (OTC) skincare products, prescription medications, dermatologic procedures, or lifestyle changes.
Over-the-counter (OTC) washes and creams can help clear mild to moderate body acne by killing bacteria and unclogging pores. For best results, a dermatologist may recommend combining a few different methods.
Benzoyl Peroxide Cleanser
You can purchase OTC cleansers with up to 10% benzoyl peroxide. Research shows benzoyl peroxide foaming washes can help kill bacteria that cause body acne, specifically back acne.
Typically, you would lather the cleanser onto your breakouts daily and leave it for a few minutes to penetrate the skin before rinsing. You can continue using benzoyl peroxide cleansers to help prevent future breakouts.
Benzoyl peroxide can cause dryness, peeling, and irritation. Products with 5.3% benzoyl are typically less irritating if you have more sensitive skin. Benzoyl peroxide can also bleach fabrics and discolor towels and sheets.
A recent study has also found evidence suggesting benzoyl peroxide acne products may contain benzene, a cancer-causing chemical compound. The level of benzene in the products may increase when exposed to high heat. However, further research is needed to determine if benzoyl peroxide acne products are unsafe.
Salicylic Acid Cleanser
OTC body washes are available with up to 2% salicylic acid.Salicylic acidhelpsreduce oil production andsloughs off dead skin cells that can clog pores.This treatment is typically more effective at treating whiteheads and pimples.
Salicylic acid washes can be used daily and long-term to treat body acne. However, if you’re new to salicylic acid, it can dry out and irritate your skin. To help reduce irritation as your skin adjusts, considerusing a salicylic acid cleanser a few times a week andgradually building up to daily use. Salicylic acid can also cause side effects like irritation and stinging.
OTC Retinoid Cream
Differin (adapalene)is the only OTC retinoid availableand approved by the U.S. Food and Drug Administration (FDA)to treat acne. Retinoids are vitamin A derivatives that help increase cell turnover, which helps exfoliate dead skin cells and unclog pores.
You can apply Differin gel to body acne daily on clean, dry skin—preferably before bed since it makes skin sun-sensitive. You can also use Differin after benzoyl peroxide or salicylic acid body washes.
During the first two weeks of use, you may notice increased skin irritation. This should go away after the skin adjusts. If you have this initial irritation, try applying Differin every other day.
Retinoid side effects can include skin irritation like redness, dryness, burning, and itching. However, Differin is less irritating compared to prescription-strength retinoids. Differin is also not considered safe for pregnant or breastfeeding people.
Prescription Skincare and Medications
For moderate to severe body acne, you may need to see a dermatologist for stronger, prescription-strength skincare or medications.
Azelaic Acid Topicals
Prescription azelaic acid treatments include Azelex cream, Finacea Gel, and Finacea Foam.Azelaic acid helps unclog pores, reduce inflammation, and kill acne-causing bacteria.
Research has found applying 20% azelaic cream to the chest and back twice daily helped improve skin after 12 weeks. Applying 15% azelaic acid foam twice daily also appeared to improve body acne. Azelaic acid can also help fade dark spots caused by healed body acne.
While using azelaic acid, you may experience side effects like itching, burning, tingling, and dryness. You should only use azelaic acid topicals for as long as your dermatologist recommends, which could be a few months or more long-term.
Topical Retinoids
Prescription retinoids are more potent than OTC retinoids. However, they work the same way to treat body acne by increasing cell turnover to unclog pores. Tretinoin, a prescription-strength topical retinoid, has been FDA-approved to treat acne since 1971.
Common forms of retinoid creams and gels include:
- Tazarotene (brand names include Arazlo, Avage, Fabior, Tazorac)
- Tretinoin (brand names include Altinac, Altreno, Atralin, Avita, Refissa, Renova, Retin-A, Tretin-X, Vesanoid)
- Trifarotene (Aklief)
- Tretinoin and benzoyl peroxide (Twyneo)
Research shows applying topical retinoids to the chest, shoulders, and upper back once a day can help treat and manage moderate to severe acne. These topical should be applied to clean skin.
Retinoids can be very irritating and cause redness, peeling, and dryness. They also make your skin very sensitive to the sun. If you experience dryness and irritation, use a retinoid every few days and build up to daily use.
Isotretinoin
Isotretinoin (brand name Absorica) is one of the most effective ways to treat severe body acne. This oral retinoid is FDA-approved to treat severe acne nodules and is typically used for four to five months. Isotretinoin works from within the body to help reduce oil production, unclog pores, kill bacteria, and reduce inflammation.
Isotretinoin is often called Accutane. However, this type of isotretinoin is no longer available.
Isotretinoin can cause severe side effects and is only used when other treatment options fail. Like other retinoids, it can be extremely drying and cause dry skin, dry mouth, eye irritation, and nosebleeds. More severe isotretinoin side effects include:
- Stomach issues
- Rashes
- Night blindness
- Hair thinning
- Muscle or joint pain
- Cholesterol level changes
- Liver damage
Isotretinoin is also unsafe for pregnant people and can cause birth defects, miscarriage, and stillbirth. People who can become pregnant must agree to take a monthly pregnancy test or use two forms of birth control while taking isotretinoin.
Antibiotics
Oralantibioticscan help kill bacteria that cause severe pimples. These treatments are typically used for only three to four months to help avoid bacterial resistance—when bacteria become immune to certain antibiotics. Antibiotics that are FDA-approved to treat acne include Monodox (doxycycline), Minocin (minocycline), and Seysara (sarecycline).
Oral antibiotics used to treat acne can make your skin sensitive to the sun and are not considered safe for pregnant people. Other side effects are typically mild, but you may experience gastrointestinal effects like upset stomach, nausea, vomiting, and diarrhea.
The topical antibiotic Aczone (dapsone gel) is also used as an off-label acne treatment—meaning it’s used to treat a condition it wasn’t officially approved for. Depending on the concentration, you may apply dapsone gel to clean skin 1-2 times a day, typically for up to 12 weeks.
Research shows using 7.5% dapsone gel on body acne helped clear the majority of acne in 16 weeks. Dapsone gel can cause skin side effects like redness, dryness, increased oil production, peeling, and itching.
Birth control pills, Aldactone (spironolactone), or a combination of both can help treat hormonal body acne. These treatments are only available to people assigned female at birth.
Hormonal Birth Control Pills
FDA-approved oral contraceptives for treating acne include Beyaz, Estrostep, Ortho Tri-Cyclen, and Yaz. These combined hormonal birth control pills contain the hormones estrogen and progestin (a synthetic form of progesterone).
Taking these hormones helps lower androgen hormones like testosterone in the body. Androgens stimulate oil glands in the skin, so lowering levels of this hormone can help slow overactive oil production and subsequently, reduce the breakouts.
Birth control pills are taken daily and can be used long-term to help treat hormonal body acne. You may experience side effects like headache, nausea, tender breasts, or spotting between periods.Birth control pills may also increase some people’s risk of blood clots, heart attack, and high blood pressure. You should not smoke while taking birth controlto help reduce the risk of blood clots.
Spironolactone
Spironolactone is a high blood pressure medication used off-label to treat hormonal acne. Common brands include Aldactone and CaroSpir. Research shows spironolactone can effectively treat deep, cystic acne on the neck. Your dermatologist will determine how long you should take spironolactone to treat acne.
Spironolactone can cause side effects like painful periods, irregular periods, tender breasts, enlarged breasts, headache, fatigue, and dizziness.
You shouldn’t combine the medication with potassium supplements or potassium-rich foods like coconut water. Spironolactone can cause the body to retain too much potassium. If you consume high amounts of potassium while also taking spironolactone, you may develop hyperkalemia, or high potassium levels in the blood.
Also, some limited animal research has linked high doses of spironolactone to breast cancer. However, this connection has not been proven in people.
Dermatologists often prescribe spironolactone and a birth control pill together for best results. This also helps prevent pregnancy since spironolactone can cause birth defects. It also helps decrease spironolactone symptoms.
Procedures
For more severe body acne, a dermatologist may recommend performing one of the following procedures:
- Corticosteroid injections:A dermatologist can inject a corticosteroid directly into painful cystic body acne. This steroid helps shrink cysts and decrease inflammation to promote healing and reduce pain. It also helps reduce scarring. These injections should be used sparingly, as too many injections can lead to skin pitting and hypopigmentation—light patches of skin.
- Chemical peels:These topical peels use high concentrations of exfoliating acids to resurface the skin, unclog pores, and remove excess oil. More intense peels are typically done once and can require weeks of healing. Side effects can include redness, peeling, temporary skin darkening, skin lightening, or scarring.
- Light therapy: These treatments involve shooting infrared, blue, red, or combined blue and red light at acne lesions. Light therapy is usually combined with topical medications. Results typically last for years, but some people may need laser treatments once or twice a year. Some redness and swelling are usually normal, while severe side effects include burns, blisters, or scarring.
- Photodynamic therapy (PDT):To help treat severe body acne, like cysts, a dermatologist will apply a solution to the skin for 15 minutes to three hours and then use a laser device on the skin. The solution helps make the skin more sensitive to light to help the laser penetrate deep into the skin. Results often last for years after a single treatment. PDT has similar side effects to chemical peels and other light therapies.
- Acne surgery:If medication is ineffective, a dermatologist may remove large cysts or nodules on the body with an incision and drainage procedure. This involves making a small hole to drain fluid and extract gunk. A dermatologist can also do an acne extraction, which involves using a sterile tool to unclog whiteheads or blackheads. These procedures carry a risk of infection and scarring.
Some dermatologist-approved lifestyle changes that can help treat and prevent body acne include:
- Shower right after you get sweaty:Change out of sweaty clothes and wash away acne-causing bacteria, oils, and sweat after exercise or sweat-inducing activities. If you can’tshower right away, wipe off your skin with an oil-free cleansing wipe and change out of your dirty clothes.
- Gently cleanse your skin:Avoid scrubbing your skin, which can lead to more irritation and acne. You’ll also want to skip abrasive cleansing devices like loofahs, poufs, and back brushes, which can also harbor bacteria.
- Use gentle, fragrance-free products.Harsh antibacterial soaps, astringents, and abrasive scrubs can exacerbate body acne. Make sure to choose skincare and cosmetics for the body that are oil-free and non-comedogenic (won’t clog pores).
- Don’t pick or touch your skin:Popping pimples and other acne lesions can cause further irritation. Touching your skin also introduces more bacteria.
- Protect your skin from the sun:Ultraviolet rays canmake acne worse and increase your risk of hyperpigmentation (dark spots).Apply sunscreen with a sun protection factor (SPF) of at least 30 and cover your skin with loose or ultraviolet protection (UPF) clothing.
- Avoid tight, irritating clothing or accessories:Wear loose-fitting cotton or sweat-wicking workout clothes to help your skin breathe. If you have back or shoulder acne, avoid wearing backpacks or purses that rub your acne-prone skin.
Living With and Managing Body Acne
Body acne can be painful and make you feel self-conscious about your skin. The good news is body acne is extremely treatable. However, it can take time for body acne treatments to work.
When you start a new acne treatment, you may notice some initial irritation or increased breakouts, known asskin purging.This is a temporary effect caused by your skin adjusting to skincare ingredients. Many body acne treatments take 6-8 weeks to see noticeable results, and it may take 3-4 months to completely clear up.
See a dermatologist if you have more severe body acne that doesn’t start to clear after six to eight weeks of treatment.
Body acne can be treated and managed like facial acne with various over-the-counter skincare products, prescription medications, and procedures. OTC retinoids, benzoyl peroxide cleansers, or salicylic acid cleansers can help clear mild to moderate body acne.
More severe body acne may require retinoids, antibiotics, dermatologic procedures, or hormonal therapy. Seeing a healthcare provider like a board-certified dermatologist can help you find the best body acne treatment for your skin.
