Body Acne Causes and Treatment

I'm a woman in my 20s who gets acne on her back and chest. What is causing this (as I rarely get acne on my face), and what can I do to treat and prevent it?

It is not unusual for an adult or a teenager to develop acne on the chest and back. However, it is important to be sure that hormonal problems are not the cause of acne in these locations. Although internal hormone problems are not the most common cause of acne, an excess of testosterone can contribute to acne in these locations. Polycystic ovarian disease can also contribute to adult acne. I would suggest having your doctor order a serum testosterone and DHEA-S level to be sure that your hormones are in balance.

As dermatologists, we often combine prescription systemic antibiotics, such as doxycycline or minocycline, with surface medications. Typical topical medications are benzoyl peroxide as a lotion or cleanser, surface antibiotics such as clindamycin and erythromycin, tretinoin, Differin, and newer medications such as Aczone gel.

The only over-the-counter effective medication is benzoyl peroxide. However, you need to be careful to not let it overly dry your skin or stain fabrics. We do not feel that products such as Proactive are worth purchasing.

If excess testosterone is present, then investigation is needed to determine the cause. Oral spironolactone is a prescription oral medication that can block the effects of mild excess testosterone.

Poor skin hygiene can provoke acne if body areas remain hot and sweaty. It is best to shower each day and use a mild soap such as Dove. Do not overly wash or scrub your skin. Oil-free cosmetics and moisturizers are much better than standard products.

If the acne is very red or cystic, it is best to seek out the care of a dermatologist.