Shoulder acne may be caused by hormonal changes, wearing tight clothing, and pressure from backpack straps, among others. Treatment may include home remedies and OTC or prescription medications.

You’re likely familiar with acne, and chances are you’ve even experienced it yourself.

According to the American Academy of Dermatology, about 40 to 50 million Americans have acne at any one time, making it the most common skin condition in the United States.

Acne occurs when the pores in skin become blocked by dead skin cells. Sebum (oil) production and the bacterium Propionibacterium acnes also play a role in causing acne.

Changing hormone levels, certain medications, and using comedogenic products can all contribute to the development of acne.

Acne is most commonly thought of as appearing on the face, but it can also occur in other areas, such as the shoulders, back, chest, and neck.

In this article, we’ll go into the causes and types of shoulder acne and what you can do to treat and prevent it.

Acne is most common in teenagers because of the hormonal changes that happen with puberty, but acne can affect people at a variety of ages.

Shoulder acne can occur for a number of reasons. While the acne itself is the same as the blemishes you’d get anywhere else on the body, some things can worsen shoulder acne. This includes things like tight or restrictive clothing and repeated pressure from backpack or purse straps.

Acne may also have a large genetic component, with genes playing a role in determining how the body responds to P. acnes bacteria.

Excess sebaceous secretions

It’s a misconception that poor hygiene or dirty skin cause acne. Instead, acne forms under the skin.

During puberty, the sebaceous glands often produce more sebum. Hormone medications like testosterone, some progesterones, and phenothiazine are known to increase sebum production, too, as well as Parkinson’s disease.

The excess sebum, dead skin cells, and other debris can become trapped in a pore and block it. That leads to acne lesions like comedones (whiteheads and blackheads) and, if inflammation develops, the inflammatory lesions we see in acne.

Acne mechanica

Acne mechanica is a type of acne triggered by outside forces like heat, pressure, and friction.

If you notice acne forming on your shoulders after a vigorous workout in tight clothes or after wearing a backpack on a hot day, acne mechanica is likely the cause.

Acne mechanica isn’t the same as acne vulgaris, which occurs as a result of hormones and other internal factors, like overly active sebaceous glands.

Keratosis pilaris

You may have heard keratosis pilaris called “chicken skin.” The harmless small red bumps often appear on the back of the arms or upper thighs as a result of dead skin cells clogging the hair follicle.

This condition isn’t considered a variation of acne, though the use of topical retinoids are thought to improve both keratosis pilaris and acne.

Not all acne looks the same. That’s because there are actually different types of acne:

  • Whiteheads (open comedones) are small bumps with a skin-colored appearance on them. They contain a buildup of keratin (which is naturally produced by the body) and oil.
  • Blackheads (closed comedones) occur when a pore becomes clogged. It’s often thought that their dark color is due to dirt in the follicle, but it’s actually because of oxidation of keratin and melanin.
  • Papules are small red bumps. They’re less than 1 centimeter in diameter. Papules don’t have a clear head.
  • Pustules are red bumps filled with pus or other fluid.
  • Nodules and cysts are large, red, often painful acne lesions that occur in severe acne called nodulocystic acne.

There are a lot of acne medications and cleansers on the market, making it hard to choose the right one. We’ve got you covered.

Home remedies

Tea tree oil

Many over-the-counter (OTC) skin care products contain tea tree oil. It’s widely available at an affordable price point in most pharmacies and grocery stores.

A 2018 study found that using a cream made of aloe vera, propolis, and tea tree oil was more effective than an antibiotic at reducing the severity and total amount of acne as well as preventing scarring.

Warm compress

The American Academy of Dermatology recommends applying a warm compress to deep, painful pimples once a whitehead has formed. This will help along the healing process.

To do this:

  1. Soak a clean washcloth in hot water. Make sure the water isn’t hot enough to burn the skin.
  2. Apply the compress to the pimple for 15 minutes.
  3. Repeat as many as three to four times per day until liquid or pus releases.

Apple cider vinegar

The components of apple cider vinegar (ACV) — not ACV itself — may fight the bacteria that cause acne, but the research that’s out there isn’t high-quality. More research is needed on whether ACV itself can treat acne.

If you do decide to try ACV for acne, keep in mind it may burn or sting the skin since it’s so acidic. Always dilute it with 3 parts water and 1 part ACV before use.

Oatmeal bath

You may remember climbing in an oatmeal bath when you had chickenpox. This is because oatmeal (specifically colloidal oats) has soothing and anti-inflammatory properties. It’s particularly good for dry, itchy, or rough skin.

Anecdotally, an oatmeal bath might calm shoulder acne. Research is needed to confirm this, though.

OTC medication

If home remedies aren’t helping treat your shoulder acne, you may want to try an OTC acne product.

Benzoyl peroxide will kill bacteria inside the pore. Consider using a benzoyl peroxide spot treatment or wash. Be mindful when using it, though, as it can stain fabric.

Other OTC treatments include salicylic acid and topical adapalene (Differin).

Prescription medication

A dermatologist can prescribe medication in cases where home remedies and OTC treatments aren’t effective. These may include:

  • topical creams
  • antibiotics like doxycycline
  • topical retinoids
  • prescription-strength benzoyl peroxide

Certain birth control pills can also help control acne. These contraceptives contain estrogen and progestin. Keep in mind you may not see results for several months.

Spironolactone is another option for women with acne.

Isotretinoin may clear acne and keep skin clear even after the drug leaves the system.

Isotretinoin can come with side effects. A very small percentage of people taking the medicine report mood changes. It also elevates blood fats and can cause severe birth defects if taken while pregnant.

Your doctor can discuss its pros and cons for your particular case of acne.

The good news is that with a few easy tweaks, shoulder acne can sometimes clear up on its own.

Help prevent new flare-ups from forming by wearing loose, breathable clothing. This is especially the case if you have acne mechanica.

It’s also a good idea to:

  • Drink plenty of water to keep your skin hydrated.
  • Use a moisturizer with an SPF.
  • Try not to touch or pop pimples.

Shoulder acne can appear in several forms, including comedones, papules, cysts, and nodules.

Home remedies, OTC medications, and prescription drugs can help treat acne.

If you don’t see improvement with home treatment, reach out to a dermatologist for help. You can connect to a dermatologist in your area using the Healthline FindCare tool.