Kale cruciferous vegetable


Kale cruciferous vegetable

Chest acne doesn’t get as much airtime as its more famous cousin, facial acne, but it can be just as frustrating. It’s also more common than you might think.

If you’ve been seeking answers for your chest acne, look no further. This article covers what causes chest acne and how you can address it naturally.


How common is chest acne?
What causes chest acne?
Is it definitely chest acne?
What’s the treatment for chest acne?
Chest acne home remedies
Takeaway points

How common is chest acne?

Do you feel like you’re the only one dealing with a spotty chest? You’re not. Almost half of the people who have facial acne also have chest acne [1].

And in a study of 696 patients, more than 3% of people had acne on either their chest or their back, even if they didn’t have acne on their face [2]. It’s slightly more common in males, but lots of women have it too [3].

The reason you don’t hear much about chest acne is because facial acne gets all the limelight. Currently, there are 12,992 available studies on acne vulgaris, and just 57 of those focus on acne that appears on either the chest or back.

But it shouldn’t be ignored. We know that chest acne can be just as distressing as facial acne, especially during the warmer months (or in hot climates) when we all have more skin on show [4]. We also know that chest acne can lead to stubborn scars [3].

The good news is that the few studies on chest acne are illuminating—and it turns out you might want to take a different approach to clear up your chest.

What causes chest acne?

We don’t know why some people get acne on their chest as well as their face, but your unique genetic predispositions likely play a part [5].

It can be annoying to hear that, but consider that we all have something less than ideal. Some people are prone to joint pain when something in their body is awry, while others can get disabling autoimmune conditions. A propensity for pimples on your chest may be the hand of cards that you’ve been dealt. As you’ll learn, there’s a lot you can do to alleviate it.

First, let’s recap the four factors that are known to drive acne [6]:

– Overproduction of skin oil

– Abnormal skin shedding

– Microbial imbalance

– Inflammation

Here’s where things get interesting. Although you have sebaceous glands on your chest, your overall oiliness there is much lower compared to your face [7].

This means that unlike in cases of facial acne, overproduction of skin oil is unlikely to be one of the main triggers of chest acne. It’s also why Roaccutane—which works by reducing your skin’s sebum—isn’t as effective for breakouts on your chest [3].

So, if sebum is out the picture, what’s causing your chest acne? The research points to two of the other factors:

Inflammation. Remember, this isn’t just a result of acne—it can drive it too [8]. Low-level inflammation can stem from food sensitivities, impaired detoxification and hormonal imbalance.

Microbial imbalance. Loss of diversity in skin bacteria can trigger an immune reaction, leading to breakouts on your chest [9]. A happy skin microbiome is heavily dependent on your skin’s pH and which products you use.

Is it definitely chest acne?

There’s a chance your chest acne isn’t acne vulgaris. It can be confused with:

Fungal acne, or Malassezia folliculitis. Another form of microbiome imbalance, this is when you have an overgrowth of the Malassezia yeast on your skin. Head to Fungal Acne (30+ Studies): The Ultimate Guide to find out how to identify and deal with fungal acne.

Acne mechanica. This is a reaction of the skin to excess heat, pressure or friction [10]. Maskne—one of 2020’s many challenges—is an example of acne mechanica. On your chest, it can be driven by non-breathable or tight clothing (ill-fitting sports bras, I’m looking at you).

Certain medications, including corticosteroids, can also cause chest acne [11]. If you have any concerns, speak to your doctor.

What’s the treatment for chest acne?

At the moment there are no separate guidelines for chest acne, so it tends to receive the same treatment as facial acne [3].

Topical products such as retinoids and benzoyl peroxide are options, but research shows that most patients receive antibiotics to combat acne on the chest and back [12]. You can understand why. Chest acne can be much slower to respond to treatment, so starting with the big guns probably seems like the right thing to do.

There are two issues with antibiotics:

1) Gut microbiome disruption. Antibiotics can be essential and even life-saving, but there’s no getting away from the fact that they’re hard on your gut. We know that a messed-up gut microbiome is one of the drivers of acne [13].

2) Antibiotic resistance. Half of the acne-triggering bacterial strains are resistant to topical antibiotics [14]. Even newer oral antibiotics are becoming less effective too [15].

Antibiotics can work for some people, but for others they may not work at all—or they can even wind up making acne worse [16, 15].

Brief aside: you should never stop medication without consulting your doctor first. If you have questions about antibiotics, talk to them.

The good news is that—whether you’ve been prescribed anything or not—there are easy, at-home steps you can take to support healthy skin on your chest and elsewhere.


Chest acne home remedies

As you learnt above, research suggests the two main drivers of chest acne are inflammation and microbial imbalance. So, to help clear your skin, you need to tackle these issues from the inside and the outside.

Let’s start on the inside:

1) Identify food sensitivities

Food sensitivities are a source of low-grade, skin-irritating inflammation [17]. The confusing thing is that food sensitivities don’t always cause digestive symptoms, so you may need to do some detective work to see if they’re an issue for you.

Have you noticed that your chest acne flares a day or two after eating a particular food? Start there. Eliminate the food for three weeks, and then eat it again and see if you notice a difference. The goal is always to keep your diet as diverse as possible, so don’t continue to restrict foods unnecessarily.

A little tip-off: a series of case studies have associated whey protein with chest breakouts [18]. If you regularly use whey protein, try eliminating that first. Pea protein is a good alternative for your post-workout smoothie.

2) Load up on fibre

There are no ends to fibre’s talents. Not only does it help to keep you regular—which is a critical step in your detoxification processes—but it also feeds the friendly microbes in your gut [19]. A happy gut = happy skin.

An easy way to up your fibre is to fill half of your plate with vegetables at every meal. For a bonus point, try and eat as many colours as possible. For another bonus point, include at least one vegetable from the cruciferous (also known as brassica) family every day too. This family includes broccoli, cabbage, Brussel sprouts, rocket and kale—and they’re extra good at helping your liver to detox [20].

3) Hydrate, hydrate, hydrate

I know you know this, but it’s worth repeating. Detoxification is hard work, and your liver gets through lots of water as it carries out its job. Water also provides the vehicle for your body to get rid of unwanted substances when you pee [21].

Aim for at least two litres daily. Filter your water if you can, and avoid drinking out of plastic. Water in plastic bottles contains microplastics, and guess what has to deal with those? That’s right, your liver. You make its life easier if you drink out of glass or stainless steel instead.

These steps will set you in the right direction. For more tips on supporting your natural detoxification processes, head here. To learn how to optimise your gut bacteria, go to this article.

Chest acne infographic

Right, moving on to how you can tackle chest acne from the outside:

1) Wash with water

We’re only just beginning to learn about the skin microbiome, but what we know so far is that your friendly skin bugs don’t like excessive washing.

Ponder this: do you need to use shower gel or soap on your chest? Could a rinse with plain-old water be enough?

The less soap you use, the more your skin bacteria can create their own balance—leading to calmer skin. If you don’t like the idea of skipping soap on your chest, look for a product that’s pH balanced, as that helps to create the right environment for microbial harmony [22].

In the spirit of less is more, don’t put heavy body creams and lotions on your chest either. Your bacterial friends like to keep it simple.

2) Consider your clothes

A group of researchers in the US studied whether staying in your gym kit makes your chest acne worse. Don’t you just love science?

Although it didn’t reach statistical significance in the trial, it did seem that exercising exacerbated chest acne. Whether participants showered within one hour of exercising or at least four hours afterwards, the effect was the same [23].

So, staying in your gym kit might not be so much of a problem as the friction of the clothes while you’re working out (remember acne mechanica from above?). You don’t want to stop exercising— but you can be smart about what you wear to avoid aggravating chest acne. Here’s how:

– Opt for natural, breathable fabrics such as cotton

– If you wear a sports bra, make sure it fits well and doesn’t rub

– Wash your gym clothes regularly at as high a temperature as possible

3) Use tea tree + aloe

Research suggests that tea tree oil can be as effective as benzoyl peroxide at clearing mild to moderate acne, with fewer side effects [24].

Tea tree oil is potent, which means you need a carrier to apply it to your skin. The usual carrier oils aren’t the best idea on acne-prone skin—so why not treat yourself to an aloe vera plant instead?

Mix one drop of tea tree oil with two teaspoons of fresh aloe vera gel and apply to your chest each evening. If your skin is particularly sensitive, rinse with water after a few minutes. Tea tree oil can take a little while to start working, so be patient and stick with it. Once your skin has cleared, you can gradually pare back your usage.

Together, these inside and outside approaches can cool inflammation and restore microbial balance—taking away the fire that fuels chest acne.

Takeaway points

 – Almost half of the people with facial acne also have chest acne. Chest acne can also appear on its own.

– Unlike facial acne, chest acne is unlikely to be driven by excess sebum.

– Two factors that seem to drive acne are inflammation and microbial imbalance. Some cases of chest acne can also be fungal acne or acne mechanica.

Antibiotics are often prescribed for chest acne, but they don’t work for everyone.

– To combat chest acne from the inside, you can identify food sensitivities, increase your fibre intake to aid detoxification, and drink at least two litres of filtered water daily.

– To alleviate chest acne from the outside, avoid using shower gel or soap on your chest, wear natural fabrics while working out and apply tea tree oil and aloe vera gel daily.

Fiona Lawson is a former national magazine editor turned registered nutritionist and skin specialist. She holds an MSc in Nutritional Medicine and a BANT-registered post-graduate qualification in Nutritional Therapy.

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Dr Thivi Maruthappu


Dr Thivi Maruthappu is the UK’s first and only dual-qualified Consultant Dermatologist and Nutritionist, and the pioneer of the (much-needed!) Nutritional Dermatology field. She runs busy NHS dermatology clinics, conducts academic research and delivers lectures worldwide. She’s also recently authored her first book, Skin Food, which aims to make holistic skincare accessible for everyone.



Porter magazine called her a ‘Global Skincare Expert’, and Caroline Hirons described her as ‘one of the best facialists in the world’. In the skincare industry, Marie Reynolds is in a league of her own. I had the privilege of experiencing one of Marie’s facials as a young journalist—and I can still remember every exquisite detail more than a decade later.

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