Acne on the Shoulders
The sun is out, the air is warm and bare skin is in vogue--but for some people, acne is a compelling reason to stay covered up. Acne, which the American Academy of Dermatology cites as the nation's most common skin disease, can leave its signature lesions not only on the face, but anywhere a hair follicle appears on the body. The shoulders are a common place for acne sufferers to experience breakouts.
Acne on the shoulders can vary in appearance and severity. The mildest form is known as comedones, also called blackheads and whiteheads; these blemishes are characterized by slightly raised bumps on top of hair follicles--sometimes with a visible black plug, in the case of blackheads. Papules are red, tender bumps that appear more inflamed than comedones. Pustules represent a moderate stage of inflammation and bear white pus at their openings, while nodules form large, painful lumps beneath the skin. The most severe form of shoulder acne manifests as cysts, which are sac-like lesions filled with dead skin cells, white blood cells and bacteria.
A number of factors can cause acne to form on the shoulders. When applied to the skin, comedogenic cosmetics--such as certain body lotions and sunscreen--can clog pores and lead to the development of blackheads and whiteheads. According to the University of Maryland Medical Center, shoulder acne may also form as a result of friction with backpack straps or from contact with natural oils on the hair. Environmental factors, including humidity and air pollution, may increase the likelihood of acne forming. When shoulder acne is accompanied by acne elsewhere on the body, hormonal and genetic factors may be the underlying cause.
Severe forms of shoulder acne--particularly nodules and cysts--can leave permanent scars on the skin, which some individuals choose to remove via dermabrasion, laser resurfacing, surgery, chemical peels and other costly procedures. In some cases, acne sufferers experience emotional and psychological repercussions from acne, including lowered self-esteem, self-consciousness, anger, social withdrawal, embarrassment, poor body image and lowered self-confidence.
Treatment for shoulder acne varies based on the severity of the acne and its cause. Acne formed by pore-clogging cosmetics can be remedied by using oil-free, noncomedogenic products instead. Lotions and creams containing benzoyl peroxide, tretinoin, topical antibiotics or adapalene can halt the formation of comedones when applied directly to the shoulders. For more severe forms of acne, systemic medications--such as doxycycline, tetracycline, erythromycin and isotretinoin--may provide relief.
Despite rumors to the contrary, diet--including greasy or fatty fare like chocolate, ice cream, pizza and fast food--is not known to induce acne, although certain foods may aggravate the condition for some individuals. Similarly, dirty skin does not cause acne. Although a gentle skin-cleaning regimen may improve the condition of acne, excessive scrubbing and frequent washing can over-dry the skin, worsening the inflammation associated with this disease.
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