Shoulder acne explained: Why it occurs and how to treat it

As the weather warms and our sleeves get shorter, suddenly we’re all confronted with the prospect of showing a lot more skin. One thing some of us may have noticed creeping around our upper body is shoulder acne.

Shoulder acne can manifest in several forms, from small bumps to large, painful cysts. Regardless of how it presents itself, you’re probably here for the sole reason of getting rid of it.

Don’t worry, we’ve got your back (or shoulder, as the case may be): here’s what you need to know about shoulder pimples and how to treat this incredibly common form of acne.

What does acne on your shoulders mean?

No matter where it appears on the body, acne is an inflammatory skin disorder whereby hair follicles become blocked up with sebum (an oily substance secreted by the skin), dead skin cells, and bacteria [1].

Sebaceous glands play a crucial role in this process, as they are responsible for sebum production, which, when produced in excess, can lead to clogged pores and acne formation.

That’s why acne pimples tend to crop up in places across the body that produce more oil, such as the face, back, chest and, you guessed it, the shoulders [2].

Shoulder acne might be mild or severe, acute or ongoing, and can range from a few measly spots to deep cysts. It can also appear on the upper back, the base of the neck, shoulders, and upper arms.

What causes shoulder acne?

Acne lesions on the shoulders are usually the result of clogged hair follicles, but there are several other things that can trigger it. Here are some of the main causes.

Acne vulgaris

As we know, shoulder acne lesions are often caused by clogged hair follicles — that is, follicles that get choked up with excess sebum, dead skin cells, and bacteria.

This type of acne is known as acne vulgaris, which is the medical term for acne caused by the overproduction of oil. It also happens to be the most common form of acne. 

Acne vulgaris often rears its head during times of hormonal change (like puberty or getting your period) or as a result of hormone-altering drugs, medications or genetics.

If your parents had acne, for example, you’re more likely to experience it yourself.

Wondering what acne vulgaris on the shoulders looks like? It can range from milder forms of acne like whiteheads and blackheads to red and angry papules, pustules, nodules, and cysts.

Acne mechanica

While acne vulgaris is caused by internal factors, acne mechanica is caused by external ones such as pressure, heat, and friction. This could be tension from a backpack or a too-tight T-shirt, heat and sweat after a vigorous workout, or even rough fabric rubbing your shoulders.

If you only tend to get pimples as a result of something like hot weather or exercising, it's probably acne mechanica.

Keratosis pilaris

It may look a lot like acne, but keratosis pilaris isn’t actually acne at all. Also known as “chicken skin”, this skin condition appears as tiny bumps across the surface of the skin.

These bumps are caused by little build-ups of protein that turn into hard plugs, but they’re 100% harmless.

Other causes of shoulder acne

Other things that can cause pimples to crop up across your shoulders include:

• Rare but very severe inflammatory acne such as acne conglobate (where the acne forms abscesses and serious scarring) or acne fulminans (acne that appears very abruptly and is characterised by deep, painful nodules and even ulcers) [3][4].
• An allergic reaction to something, such as a moisturiser or laundry detergent.
• Lifestyle factors like smoking (this includes vaping!) and stress (yep, research has found a pretty strong link between both of these and acne) [5][6].

What kinds of acne can appear on your shoulders?

Much like on your face, you can get all kinds of shoulder pimples ranging from mild to severe — whether they're a result of acne vulgaris or acne mechanical.

Here are the types of acne most commonly found on the shoulders:

• Whiteheads: Tiny bumps with a white centre. Whiteheads contain sebum and a protein known as keratin (AKA the same stuff that strengthens your hair, nails and skin).
• Blackheads: Small black dots that often appear in clusters across the skin. Contrary to popular belief, blackheads don’t get their darkened appearance because they contain dirt. Instead, a blackhead is made up of oxidised sebum.
• Papules: Red dots that are smaller than 1cm across and don’t have a clear head. Sometimes they can be a little sore.
• Pustules: Red lumps with a distinct head filled with white pus.
• Nodules: A more serious form of acne that forms larger and often tender lumps beneath the skin.
• Cysts: Another form of severe acne that appears under the skin and contains pus. Cystic acne tends to leave scars.

How to get rid of shoulder acne

With the right products, shoulder acne is entirely treatable (yay!).

If you’ve got milder acne like whiteheads or blackheads, you can usually go for an over-the-counter (OTC) solution to get rid of your pimples and keep them from coming back. More severe acne, on the other hand, tends to respond best to medical or dermatological treatments.

Keen to get rid of your shoulder acne for good? Here’s how to do exactly that.

Use an OTC solution

In the battle against acne, you probably already know how important it is to cleanse your face. Well, it’s just as crucial when it comes to warding off body pimples. An OTC solution containing acne-fighting ingredients like benzoyl peroxide or salicylic acid is a great option if you want to treat shoulder acne.

Benzoyl peroxide works by dissolving keratin, which can block your pores and stop them from draining. It also happens to be antibacterial and anti-inflammatory, making it a bit of an acne triple threat. 

Salicylic acid is what’s known as a chemical exfoliant, meaning it has the power to buff away the dead skin cells that clog your pores.

Chemical exfoliants are often a better choice than physical exfoliants (like scrubs and loofahs) when combatting acne because they’re less abrasive and not as irritating to your skin. 

And, we’ve got a salicylic cleanser of our very own! Software’s Salicylic Acid Foaming Wash can be used all over the face and body, including on your shoulders.

Azelaic acid (an antibacterial and anti-inflammatory ingredient that can also break down dead skin cells) and retinoids (topical products used to treat acne and calm irritation) are other great pimple-busters to look out for in your anti-acne skincare.

Try a natural remedy

If you’re game to try them, numerous home remedies may clear up shoulder acne. Tea tree oil is a popular one and has been found to be effective when treating mild to moderate acne [7].

Similarly, witch hazel has been studied as an acne-fighting ingredient and is said to calm inflammation and irritation [8].

Other solutions that may help improve acne include apple cider vinegar (believed to fight acne-causing bacteria), colloidal oatmeal (known for its calming properties) and aloe vera (which is also soothing and actually contains salicylic acid).

Just note that these and several other natural remedies haven’t been examined a whole lot, so the evidence is limited as to how effective they are at combatting acne. 

Try a custom treatment

For more severe forms of acne, or when your current solutions aren't cutting it, you might want to try a custom solution.

Software's health practitioners create formulas that are personalised for your skin type and concern. All you need to do is upload selfies and share your skin goals with your online practitioner. Then, a pharmacist creates your custom bottle, which is shipped straight to you.

You also get access to professional, personalised advice on your skin, as well as ongoing, follow-up support from your practitioner as you use your treatment.

How to prevent shoulder acne from returning

Once your shoulder acne has cleared up nicely, how do you stop it from coming back? We’ve got a few tips up our sleeve:

Continue cleansing

Those acne-fighting ingredients we mentioned earlier, like benzoyl peroxide and salicylic acid? Keep using them long after your shoulder acne clears to remove dead skin cells, fight acne-causing bacteria and keep further breakouts at bay. 

Shower regularly

By having regular showers, you can wash away the sweat, excess oil, and bacteria that tend to build up in your pores.

This is especially important after you’ve had a sweaty workout sesh. A max of 2 showers a day is ideal, as any more than that will likely dry out your skin and lead to further irritation.

Be sure, as well, to take off sweaty clothes as soon as you can after a workout

Wear the right clothes

Wearing loose, breezy clothes made from natural fibres lets your skin breathe — thus minimising the chance of breakouts. On the flip side, tight clothing made with synthetic fabrics can create the perfect environment for pimples to form.

If you can, avoid wearing heavy bags with straps, as these can rub against your skin and lead to flare-ups. Tie up your hair where possible too, as it can irritate the skin on your shoulders.

Use SPF (but make sure it’s non-comedogenic)

If you’re trying to beat acne, sun protection is key. The free radicals from the sun’s UV rays can aggravate pimples, but a good sunscreen will protect your shoulders and lower the risk of them breaking out.

While we’re on the topic, go for a non-comedogenic sunscreen. In layman’s terms, this means it won’t block your pores.

Avoid the temptation to pick

Even if there’s a big, white, pus-filled zit sitting on your shoulder just begging to be picked, try not to give in. Scratching, picking, and popping your pimples can worsen the situation, either by aggravating the breakout or leading to scarring.

A good way to stop your urge to pick or pop your pimple is by using pimple stickers such as the Software AHA/BHA Pimple Patches.

Eat a healthy diet

What you eat impacts your skin health, so if you're trying to keep acne at bay, choosing the right foods can help. In fact, studies suggest that eating a diet that is high in sugar, oil and dairy can contribute to acne breakouts [9].

For a clear complexion, we recommend you steer clear of processed foods, alcohol, fried foods and excess caffeine [10]. Instead, reach for foods that are rich in fibre, omega-3s and antioxidants, as well as hunter-gatherer foods like nuts, seeds, leafy greens, and citrus fruits [11][12].

Of course, each person's skin is unique, and what's a trigger to one person may not be a trigger to another.

If you think your diet is the culprit of your acne, keeping a food diary and noting down how your skin reacts to certain foods can help you pinpoint any patterns.

What's the best way to deal with scarring left from shoulder acne?

The one thing that might be more frustrating than shoulder acne? Shoulder acne scars. In many cases, deeper forms of acne like nodules and cysts can leave patches of hyperpigmentation — that is, darkened skin where those pimples used to sit.

Hyperpigmentation can also happen if you pick, pop or scratch your pimples, or use an exfoliant that’s too abrasive — yep, we’re looking at you, loofah.

The good news is that scarring can definitely be addressed. For milder hyperpigmentation, at-home treatments can often help fade and reduce the appearance of acne scarring. These treatments include chemical exfoliants like salicylic acid and glycolic acid, as well as retinoids.

Deeper shoulder acne scars are best looked at by a qualified dermatologist, who can run you through the many treatments available. You might be looking at something like a chemical peel, laser therapy or even surgery if the scarring is serious enough.