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Neck Acne: Causes, Treatments, Prevention

Acne is a common skin condition that affects up to 50 million Americans each year. Neck acne, which involves breakouts on the skin around the neck and hairline, is often part of this broader pattern. Nearly half of those with facial acne also have breakouts on their upper body, including the neck, chest, shoulders, and back.

Neck acne can appear as whiteheads, blackheads, red bumps (papules), pus-filled pimples (pustules), or deeper lumps like cysts or nodules. You might notice breakouts along your hairline, under your jaw, or on the back of your neck. Some spots are small and painless, while others cause swelling and feel sore. Neck acne can be occasional or chronic (long-lasting). 

Neck acne may appear as red bumps on the side of the neck and under the jaw.

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Neck acne may appear as deeper lumps, like cysts, on the jawline.

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Acne can occur on the back of the neck, such as under the hairline.

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Acne occurs when the skin makes too much sebum (oil). This extra oil clogs pores, the small openings where hair grows. If your skin doesn’t shed dead cells correctly, the cells mix with the oil and block the pores further. Bacteria, yeast, or fungi can also grow inside clogged pores and cause redness, swelling, pus, and pain.

Several factors can raise your risk of developing acne, including age, hormone levels, family history, lifestyle, and environment.

Internal Factors

Internal factors affect how much oil your skin produces, how your pores react to buildup, and how your skin responds to inflammation. Some factors include:

  • Age and sex: Acne is more common in teenage males and adult females.
  • Genetics: If your parents had acne, you may be more likely to have it, too.
  • Hormonal changes: Shifts during puberty, menstruation, pregnancy, or menopause can increase oil production.
  • Health conditions: Certain conditions, like polycystic ovary syndrome (PCOS), can contribute to acne. PCOS is a hormone imbalance that affects people with ovaries and often causes excess oil and breakouts.

Some medications can cause internal effects that trigger or worsen acne. These include certain:

Lifestyle Factors

These lifestyle factors can increase your chances of developing neck acne:

  • Chronic stress, which disrupts hormones and increases oil production
  • A diet high in sugar, dairy, or chocolate
  • Lack of sleep, which raises stress and inflammation
  • Too much screen time, which may increase stress

External Factors

External triggers that may cause or worsen breakouts include:

  • Air pollution that irritates the skin
  • Friction from tight collars, helmets, straps, or clothing
  • Hot, humid weather that increases oil and sweat
  • Not washing your neck after sweating or using hair products
  • Phones or headphone cords that touch your neck and carry bacteria
  • Shaving with a dull razor or against the grain
  • Waxy or oily hair and skincare products, which can clog pores

See a healthcare provider if your neck acne is painful, widespread, deep, or not improving with over-the-counter (OTC) treatments after a few months. Signs of infection, such as pus, warmth, or swelling, also need medical attention. You may consider seeing a dermatologist, a medical doctor specializing in skin conditions.

Your provider will likely examine your skin and ask about your medical and family history. They may swab your skin to rule out infection or other conditions, and order lab tests, especially if they suspect a hormone imbalance. These steps help guide treatment, based on the type and severity of your acne.

Treatment for neck acne focuses on clearing breakouts, easing discomfort, and preventing scarring. Mild cases often respond to skincare and over-the-counter products. More severe or hormone-related acne may require prescription medications or in-office procedures.

Skincare and Over-the-Counter Options

Consistent skincare can help improve mild neck acne. Start with these steps:

  • Apply a warm compress 10–15 minutes before washing to reduce swelling and loosen buildup
  • Wash your neck twice daily with a gentle, non-comedogenic (pore-clogging) cleanser
  • Use oil-free sunscreen and moisturizer after cleansing

Over-the-counter products may also help treat mild to moderate acne. These come in cleansers, creams, gels, patches, and spot treatments. Start with one or two products to see how your skin reacts. Look for active ingredients such as:

  • Benzoyl peroxide: Kills acne-causing bacteria and reduces inflammation
  • Differin (adapalene): A topical (on the skin) retinoid that helps prevent clogged pores
  • Glycolic acid: Exfoliates gently and may fade dark spots
  • Hydrocolloid patches: Draw out fluid and protect healing pimples
  • Salicylic acid: Unclogs pores and helps shed dead skin cells
  • Sulfur: Dries out pimples and reduces oil
  • Tea tree oil: Has mild antibacterial and anti-inflammatory properties

Prescriptions and Medical Treatments

If OTC treatments don’t work, your provider may recommend prescription medications. These may include higher-strength versions of OTC ingredients or medications that target bacteria, reduce inflammation, and help clear clogged pores. Topical examples include:

  • Cleocin (clindamycin): A topical antibiotic that kills bacteria
  • Finacea (azelaic acid): Kills acne-causing bacteria, unclogs pores, calms inflammation, and fades dark spots
  • Differin (adapalene) or Retin-A (tretinoin): Retinoids that unclog pores and reduce inflammation
  • Winlevi (clascoterone): A cream that blocks the effects of hormones on the skin

Oral (taken by mouth) prescription examples include:

  • Antibiotics or antifungals: Reduce acne-causing bacteria or fungi
  • Hormonal treatments: Hormonal birth control or Aldactone (spironolactone) help regulate hormone-related acne
  • Retinoids: Medications like Accutane (isotretinoin) shrink oil glands and prevent clogged pores

For severe cases, providers may recommend a combination of therapies, such as retinoids, benzoyl peroxide, and an antibiotic, to target several causes at once.

In-Office Procedures

A dermatologist may recommend these in-office procedures to treat deep, painful acne or reduce scarring:

  • Chemical peels: Unclogs pores and helps fade dark marks
  • Laser or light therapy: Targets oil glands and bacteria
  • Manual drainage: Removes fluid from painful cysts
  • Microneedling or resurfacing: Improves skin texture and treats acne scars
  • Photodynamic therapy (PDT): Uses light-activated medication to reduce oil production
  • Steroid injections: Shrinks large, inflamed breakouts quickly

Emerging and Alternative Therapies

Researchers are developing and studying new and alternative acne treatments to deliver better long-term results with fewer side effects. Some treatments are still in early stages or show promise but need more research. Examples include:

  • Acupuncture: Uses thin needles to stimulate specific points on the body
  • Arazlo (tazarotene): A newer retinoid lotion that is less irritating
  • ASC40 (denifanstat): An oral medication that may reduce oil production
  • Cannabinoid creams: Made from compounds found in cannabis plants; these creams may reduce inflammation and oil production
  • Natural remedies: Ingredients like manuka honey, vitex, and bee venom

You can help prevent neck acne by following these tips:

  • Adjust your diet if you break out after eating sugar or dairy
  • Avoid tight collars or gear that traps heat and sweat
  • Choose non-comedogenic or oil-free hair and skincare products
  • Wash pillowcases and towels frequently, and workout clothes after each use
  • Wash your neck and hairline daily

Untreated neck acne can cause scarring, hyperpigmentation (dark spots), and infection. You’re more likely to develop scars or dark spots if you have darker skin, frequent breakouts, or moderate to severe acne. Starting treatment early and avoiding picking or squeezing can help reduce your risk of these complications.

Acne may also cause emotional distress, affect your self-esteem, and increase your risk of anxiety or depression.

Neck acne happens when oil, sweat, dead skin cells, or products clog your pores or irritate your skin. It often appears with acne on your face or back and can range from mild to severe. Washing regularly, avoiding heavy products, and managing sweat can help prevent breakouts.

Treatments may include gentle cleansing, over-the-counter products, prescription medications, or in-office procedures from a dermatologist.

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