What’s the Deal With Neck Acne?

What’s the Deal With Neck Acne? featured image
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Breakouts are a multi-faceted skin issue, and truth be told, there’s not a square inch of skin on the body that’s immune to them—the neck included. Typically, acne that takes up residence on the lower third of the face extending down onto the neck is nine times out of ten related to a hormonal imbalance. Pimples that seemingly pop up overnight on your neck (they take weeks to manifest and rise to the surface) look like acne anywhere else on the face and body, taking the form of whiteheads or red, inflamed blemishes. Since the skin on the neck is thin and delicate, it’s important to follow a dermatologist-recommended plan of attack to clear up neck acne fully. Here’s what the experts have to say.

  • Leslie Loss, MD is a dermatologist in Rochester, NY
  • Heidi Waldorf, MD is a dermatologist in Nanuet, NY

Why Breakouts Happen on the Neck

Both men and women are fair game for experiencing neck acne, and as Rochester, NY dermatologist Leslie Loss, MD explains, the causes differ from one sex to the next. “In women, acne can occur on the neck as well as the due to hormone shifts and changes, which is why it’s called “hormonal acne,” she says. “Men can also experience breakouts in the beard and neck area and the back of the neck, but theirs is more related to oils and hair-care products that clog pores. For some, shaving can worsen things, causing pseudofolliculitis barbe which looks like acne.”

Nanuet, NY dermatologist Heidi Waldorf, MD explains that acne on the neck happens in the same way as acne on the face. “It forms from a combination of inflammation, bacteria, abnormal sebum (oil), and ineffective cell turnover in the sebaceous glands and sebaceous follicles. The combination of the hair follicle and oil gland is stimulated by outside factors like hormones.” Stress, friction, and comedogenic hair products can also throw the skin’s balance off, leading to pimples.

Neck acne can take on almost any form of an acne breakout, just like on the face (and elsewhere).

Although most neck acne is usually cystic or pus-filled papules acne, Dr. Waldorf adds that it can also appear as comedones, papules, and pustules on the neck just as it can on the face and trunk. “The skin below the jawline and ears is the most common area affected by acne because the number and type of sebaceous glands are more like the face.”

How to Prevent Neck Acne

The neck is usually an afterthought in most skin-care routines, but if it’s an area where stubborn breakouts are a problem, you might think twice about devoting a little more time and TLC to your neck to keep it clear.

Dr. Loss recommends washing the neck, as well as the face, with a medicated wash. She also instructs her male patients who deal with recurring neck breakouts to avoid using oils on it, too. “Super short haircuts and using electric clippers to shave and trim the hair are a better choice over razor blades,” she adds.

You’ll also want to revisit your closet and take stock of what clothing items (yes!) may be instigating breakouts. Tight turtlenecks and scarves wrapped too snugly around the neck cause friction against the skin and potential irritations. Plus, if you’re not washing them regularly, any trapped oil or dirt can rub against the skin on the neck and cause breakouts.

How to Treat Neck Acne

The skin on the neck is thinner than the face and body, but it still calls for the same treatment plans.

However, Dr. Waldorf shares that because the neck is more sensitive to irritation from acne medications like retinoids and benzoyl peroxide than the face because the neck has fewer sebaceous glands, you may need to use them less often or in lower concentrations.

“The neck is also pretty responsive to medicated washes containing anti-acne ingredients such as benzoyl peroxide or salicylic acid,” Dr. Loss says. “Sometimes, a topical antibiotic lotion with clindamycin needs to be applied to the neck daily to acne-prone skin to help prevent breakouts,” she adds. “For females, if the acne is hormonal in nature, I sometimes prescribe a low dose oral contraceptive or spironolactone.”

One common acne ingredient that isn’t a first line of defense for persistent pimples on the neck is retinol and retinoids. “The skin is sometimes thinner on the neck and more sensitive, so retinol creams may not always be well tolerated,” Dr. Loss explains. Instead, in-office treatments are a better option if extra help is needed. She likes Forever Clear BBL to treat acne on the neck (as well as the face). “Sometimes, if the breakouts are related to hair-grooming practices, they may call for laser hair removal.”

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