About Acne Mechanica: What It Is and How to Treat It

Acne mechanica is a type of acne that occurs due to friction and pressure on the skin. This type of acne breakout can happen when the skin is rubbed, squeezed, or stretched.

While acne mechanica can occur as a complication of preexisting acne, it can also occur on its own without the presence of an underlying outbreak.

Like acne vulgaris, acne mechanica can cause inflammatory skin lesions, such as papules, pustules, and even nodules. Papules and pustules are the pink and red bumps that many people recognize as “pimples.” Nodules are painful, deep lesions that result from more severe inflammation.

Where it typically occurs

Acne mechanica can occur anywhere on the body where skin is frequently exposed to friction or pressure. This includes the:

• face
• neck
• arms
• legs
• torso
• buttocks

While both types of acne can lead to inflammatory cutaneous lesions, acne mechanica isn’t the same condition as acne vulgaris.

Unlike acne vulgaris, which is commonly caused by underlying hormonal changes, acne mechanica is directly caused by “mechanical” means.

Acne mechanica can develop when skin is repeatedly exposed to friction or pressure, such as when wearing certain clothing or sitting in certain positions for long periods of time.

The most common underlying causes of acne mechanica include:

• clothing, such as shirts with collars
• sports gear, such as football and hockey equipment
• accessories, such as hats and bras
• medical equipment, such as casts and surgical tape
• hands, when rubbing repeatedly against skin
• seating, such as chairs or car seats

Anyone whose skin is exposed to repeated rubbing is at risk for developing acne mechanica. However, it’s more likely to affect certain populations, such as:

• people who play sports and are required to wear tight equipment, such as professional or student athletes
• people required to be in one position for long periods of time, such as truck drivers or those on bed rest
• people who have tics that involve rubbing or squeezing the skin, such as those with autism spectrum disorder (ASD) or anxiety

Since acne mechanica can also be a complication of acne vulgaris, people who already have acne lesions may also be at higher risk of developing acne mechanica.

Acne mechanica is treated by first removing the underlying cause of the outbreak. In most cases, this means removing the source of pressure or friction.

With acne mechanica, it’s important to let the skin “breathe.” This means avoiding any skin coverings or bandages.

After removing the cause of the breakout, acne mechanica can then be addressed using either prescription or over-the-counter acne treatments, such as:

• Gentle soaps. Fragrances and other harsh chemicals can make acne flare-ups worse. Use only gentle soaps and cleansers to keep the skin clean, but don’t overdo it. Problem areas should only be washed once or twice per day.
• Benzoyl peroxide. Benzoyl peroxide is a common ingredient in acne treatments because it acts as a deep cleanser to remove dead skin and keep bacteria at bay. Benzoyl peroxide products can vary in strength, so it’s usually recommended to start with lower strength first.
• Hydroxy acids. Alpha-hydroxy acids and beta-hydroxy acids are both commonly used in skin care. However, salicylic acid is the most common beta-hydroxy acid used for acne. Like benzoyl peroxide, it’s best to start at a lower concentration unless a higher prescription is recommended.
• Antibiotics. Topical antibiotics, such as triclosan, may be used in cases where bacteria are suspected to be present with acne mechanica. Topical antibiotics are almost always prescribed with other medications rather than on their own.
• Vitamins. Topical vitamins, such as retinoids and nicotinamide, can be used to reduce inflammation and promote the growth of new skin. These products are available as both prescription and over-the-counter options.

Stronger prescription acne medications require a visit to a doctor or dermatologist. However, even if you choose to use over-the-counter acne medications, you should still discuss treatment with your doctor first.

In most cases, mild acne mechanica can be treated at home with some modifications and over-the-counter topical treatments. However, sometimes acne mechanica can resemble other conditions that may not respond to over-the-counter acne treatments, such as:

• acne vulgaris
• dermatitis
• keratosis
• polycystic ovarian syndrome (PCOS)
• rosacea

If you have acne mechanica that isn’t responding to at-home treatment, it’s time to visit a dermatologist. They can review your symptoms, diagnose other underlying conditions, and determine the best course of treatment for you.

For people who are at risk of developing acne mechanica, here are some best practices for how to avoid or prevent a breakout.

• Avoid wearing tight, rough clothing or accessories. If you have sensitive skin, limiting tight, rough clothing can help reduce irritation. Make sure that your hats, belts, bras, and other accessories fit comfortably, too.
• Remove your sports equipment sooner rather than later. If you’re an athlete, don’t sit in your sports equipment for longer than needed. Always remove sports equipment once your game, show, or practice is done and be sure that it’s sized appropriately for you. Try cleansing skin soon after removing the sports equipment to avoid more breakouts.
• Be mindful of how you’re touching your skin. Frequently touching or rubbing your skin can potentially lead to damage. For most people, absentmindedly touching skin isn’t harmful, but if it leads to acne mechanica, it can pose a problem.
• Consider taking more frequent breaks from activities. If your skin is constantly exposed to pressure, making small changes can help give your skin a break. Sometimes it’s as simple as getting up and stretching or purchasing support cushions to sit on.

If you notice that certain areas of your skin are becoming irritated due to pressure or friction, making the small changes mentioned above may help reduce the development of an acne mechanica breakout.

Acne mechanica develops when the skin is repeatedly exposed to friction or pressure.

Athletes, truck drivers, and other people whose skin is constantly exposed to rubbing, touching, or pressure are at a higher risk of developing acne mechanica.

Like acne vulgaris, acne mechanica can be treated with both prescription and over-the-counter options.

If you believe you may have developed acne mechanica, visit a doctor or dermatologist for an official diagnosis so that you can begin treatment right away.