Written By: Chloe Wilson BSc (Hons) Physiotherapy
Reviewed By: SPE Medical Review Board
Arm and shoulder acne is a common problem that can be very unpleasant.
There may be a scattering of small white or blackheads, a covering of large pus filled spots or anything in between.
Acne is commonly thought of as only affecting the face but nearly three quarters of acne sufferers will also have problems on their shoulders, back and chest.
Here we will look at the common causes of shoulder acne that may also affect the back, chest and arms and the best ways to treat them – which products work best and what lifestyle changes that can help.
If you only have one or two lumps around your shoulder, chances are it's not actually shoulder acne but something else going on - check out the Shoulder Lumps article to find out more.
Shoulder and arm acne can be caused by excessive production of oils that clog pores (common in puberty), friction, excess keratin or an allergic reaction.
Acne can develop on any part of the body that has hair follicles or sebaceous (oil-secreting glands) – which is basically anywhere other than the soles of your feet and your palms. It most commonly affects the face, in fact over 90% of acne sufferers have facial acne, but 60% have back, chest of shoulder acne which usually indicates that your acne is more severe.
Your back and shoulders have a number of sebaceous glands. These secrete an oily substance known as sebum. Sebum helps to protect the skin, keeping it hydrated and supple, but if the body produces too much sebum, it can clog together with dead skin cells and bacteria around hair follicles, blocking them which leads to the dreaded spots.
There are six different types of acne lesions that can form on your shoulders and arms:
But what causes the body to secrete excess sebum? It is not always entirely clear but is thought to be linked with hormones. During puberty, androgenic hormones such as testosterone cause the sebaceous glands to produce more sebum, which is why acne is particularly common in teenagers. Menstruation causes fluctuations in oestrogen levels which can result in acne, particularly on the back and arms. There can also be a genetic link.
Another type of back and shoulder acne is what is called acne mechanica. It is caused by friction over the skin, especially in hot conditions. Acne mechanica develops when heat is trapped against the body for a prolonged period and sweat blocks the hair follicle resulting in comedone formation. If there is also sustained pressure or repetitive friction, the pores are irritated and become inflamed, so papules and pustules develop.
Shoulder and arm acne mechanica may be caused by tight-fitting clothing, backpacks, purse/handbag straps or tight fitting bras as they can all trap sweat next to the skin. Soldiers are often affected, as they carry their heavy backpacks for long periods, especially when they are in hot, humid climates.
With Keratosis Pilaris, excess keratin (a protein) and dead skin cells stick together and block hair follicles causing pores to widen, forming multiple tiny bumps on the skin, most commonly on the upper arms or thigh. These bumps may be white, red or skin-coloured and can look a bit like goose bumps or plucked chicken skin. The skin tends to feel rough, like sandpaper.
There is a strong hereditary link with keratosis pilaris and this type of shoulder and arm acne usually first presents in childhood. It often gets worse during adolescence then improves towards and during adulthood. It is often associated with dry skin conditions such as eczema. It is extremely common, affecting 1 in 3 people but is completely harmless and not contagious.
Shoulder acne from keratosis pilaris tends to occur on the back of the upper arms. It usually improves during summer months and gets worse during the winter. Visit the Keratosis Pilaris Treatment section to find a whole range of treatments that can help.
Allergic reactions can also cause shoulder acne. Laundry detergent, fabric softeners, body lotion and moisturisers, shampoos and conditioners can all lead to outbreaks.
Treatment for shoulder acne tends to be similar, whatever the underlying cause or type of acne. The aim is to remove any excess oils, sweat and bacteria without irritating the skin. As the skin over the shoulder and upper back is tougher than on the face, you can use more powerful treatments than with facial acne.
Here are some things you can try to get your shoulder and arm acne under control:
You can find out more in the shoulder acne treatment article. Unfortunately, there is no quick fix for shoulder acne – it usually takes a few weeks of using these treatments to notice an improvement, so don’t give up too quickly. If there is no improvement after around six weeks, visit your doctor and see what they can recommend.
Other things that can cause shoulder acne include:
There are many myths about shoulder acne that are not true. Acne is NOT:
Arm and shoulder acne is usually not serious but it can make people feel very self conscious. It is not one of those things you just have to put up with and hope you will grown out of, visit the arm acne treatment section for ideas on things that can help.
There are lots of other causes of lumps and bumps around the shoulder which may be nothing to do with acne - have a look at the shoulder lumps article to find out more
Page Last Updated: 01/19/2023
Next Review Due: 01/19/2025
December 14, 2022
December 15, 2022
February 2, 2022