Dealing with breakouts on the face is usually a top priority. After all, they’re what’s most visible—to you and others. But acne doesn’t discriminate, even when it comes to where it pops up on the body. Parts of the body that go unseen thanks to clothing, like the chest, shoulders, and back, aren’t immune to blemishes. There are even fancy terms for the condition: truncal acne and bacne. The truth is, many people who suffer from facial acne also experience breakouts elsewhere, but treating these breakouts often takes a backseat and that’s a mistake, says Valerie Callender, M.D., a board-certified dermatologist in Glenn Dale, M.D., F.A.A.D. and an Acne Store advisory board member. Here, she offers a plan to send body pimples packing. 

Q: What causes back and chest acne? 

A: We know that all acne is hormonal, whether it affects your face, back, or your chest. Hormones, typically male hormones called androgens, stimulate the sebaceous glands that are in your pores to produce more oil, which can cause the pore to clog and lead to acne. Many people will have both facial and truncal acne; others will have one or the other. In both cases, they generally have the same cause. 

Q: Can a sweaty workout cause body breakouts?

A: Look, sweat is a normal physiological function and working out does a body good, so I’d never discourage someone from exercising. Let’s start there. But, while sweat doesn’t cause acne, it may make matters worse. If you’ve perspired, you likely have oil and dirt just sitting on your skin—and of course that may cause irritation and may exacerbate a chest or back breakout. If you can’t hop in the shower right away post workout, try using disposable wipes to clean skin in a pinch. The less additional oils and dirt sitting on your skin, the less of a chance of truncal acne appearing. 

Q: Is truncal acne harder to treat than facial acne?

A: It can be, and that really comes down to simple anatomy: It’s easy to stand in front of the mirror, use your cleanser and moisturizer, apply your medication, and—if you have discoloration—apply a skin lightening agent directly onto your dark spots. In that case, treatment of chest acne can be similarly easy to do. But how are you going to get to your back? It’s tough to treat what you can’t see. You may have someone at home who can help, but that’s not always practical. 

Q: Can haircare contribute to a back or chest breakout?

A: Yes, it’s certainly possible. Acne happens when sebum, the official name for the oil secreted by your pores, and dead skin cells clog pores. Popular ingredients like argan oil and coconut oil, which are often found in shampoos and conditioners, are amazing for hair but could pose a problem if you are suffering from truncal acne. Those oils can trickle down and cause back or chest breakouts. My advice is to simply rinse well in the shower and make sure there’s no product residue left lingering on your skin. 

Q: So what types of back and chest acne remedies are best?

A: The best products for back and chest acne that I typically recommend are body cleansers with salicylic acid, glycolic acid, or benzoyl peroxide. The back can be hard to reach, so wet your skin in the shower and try just letting the product flow down your back. I usually tell patients to do this first and then concentrate on washing other areas of their body to let the cleanser sit on the back for a while before rinsing it off. 

Q: Are there leave-on products that get rid of chest and back acne?

A: Yes, and they range from lotions with glycolic or salicylic acid to the same benzoyl peroxide you might use on your face to simple-to-spread foams or gels. You really need to be consistent to see results, so find a product that’s easy for you to apply to the chest and back because you need to stick to it. 

Q: What kind of acne treatments are offered in a dermatologist’s office?

A: The exfoliating action of a chemical peel is excellent for acne and any post-inflammatory hyperpigmentation, or dark spots. Sometimes, I’ll recommend that patients not only use the leave-on products but also come to me for chemical peels every three to four weeks. If you apply a very light professional peel on the back, it will help with the acne as well as the dark spots. My favorite chemical peeling agent for acne is salicylic acid. Chemical peels are a great chest acne treatment as well, but since that area is more accessible, it’s easier to treat at home. Not so much for the back: Someone may have 20, 30, or even 40 dark marks or pimples on their back that can’t be reached, so having professional assistance can be very beneficial for the treatment of back acne.