Shoulder Acne

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. 

• Whiteheads: When a clogged follicle is completed blocked (i.e. no air reaches it), a white bump develops over it. AKA closed comedone
  
  
• Blackheads: Similar to whiteheads but instead of being closed over, they are open. As a result, they are open to the air and the sebum oxidises, turning black
  
  
• Papules: These develop when pores are so irritated that the hair follicle wall breaks down. A small, red, inflamed bump develops on the skin. They feel rough, tender and hard to touch

• Pustules: Similar to a papule but filled with white or yellow pus. Surrounding area is usually inflamed. These are what we typically refer to as zits or pimples. They are often painful and may get quite large
  
  
• Nodules: Irritated blocked pores where the lesion develops below the skin surface, forming a hard, painful nodule. They are larger than papules, usually over 5mm wide and deeper, forming under the skin rather than on top of it
  
  
• Cysts: Similar to nodules but filled with pus so they feel softer

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.

• Medication: Acne medication cream can really help to reduce inflammation and the amount of bacteria on the skin.  A good one to start with is benzoyl peroxide can really help, but beware that it can bleach clothing. Start with 2.5% strength as 5% and 10% can lead to irritation if you have sensitive skin.
  
  If over-the-counter medication is not working, you should see your doctor or dermatologist as you may benefit from stronger lotions, antibiotics or hormonal therapies
  
  
• Acne Products: There are a whole range of creams and lotions available that can help such as retinol cream or alpha hydroxyl acid. They work as exfoliants to remove dead skin and declog pores to help treat/prevent shoulder acne.
  
  It also helps to moisturise dry skin, especially if your shoulder acne is caused by keratosis pilaris, but try to avoid oil-based moisturisers. Look for products labelled as “non-comedogenic”. Visit the arm acne section to see our favourite products

• Shower Regularly: Showering in lukewarm water, particularly after exercise helps to wash off sweat, bacteria and oils and thus reduce the change of pores getting clogged up. Use oil-free body wash containing 2% salicylic acid. Avoid too much friction over the skin – opt for a soft cloth so you don’t make things worse.
  
  Make sure to completely wash off any soap, body wash, shampoo and/or conditioner so it doesn’t irritate or block your pores. Hot water opens up pores, cold water closes them. Don’t wash more than twice a day or else you can irritate the skin and dry it out which may make shoulder acne worse
  
  
• Clothing: Where possible, wear clean, loose-fitting, light-weight clothing, ideally made of natural fabrics like cotton to help reduce sweating. This is particularly important with T-shirts, tops and bras
  
  
• Laundry Detergent: Laundry detergents often contain chemicals which can irritate the skin. Try switching to a laundry detergent designed for sensitive skin, preferably one that is unscented
  
  
• Bedding: Change your sheets regularly, at least once or twice a week as dead skin cells quickly build up. Opt for 100% cotton sheets to reduce sweating, and don't forget to think about what laundry detergent you are washing them in
  
  
• Reduce Pressure: Try to avoid going for prolonged periods with pressure or friction over your shoulders/upper back e.g. backpacks and purse straps. If you need to use them, wear a cotton t-shirt to absorb sweat

• Home Remedies: Aloe Vera, apple cider vinegar, mint, lemon juice, tea tree oil, honey and turmeric masks and green tea rinse are popular home remedies for shoulder acne
  
  
• Don’t Squeeze: Avoid the temptation to squeeze any spots/pimples. I know it's tempting but it can cause further inflammation, it pushes the pus deeper under your skin and can cause permanent scarring