Neck AcneAcne on the back of the neck is more similar to body acne than it is to facial acne and presents unique challenges. Neck acne lesions can be painful and can have an abrupt onset and long lifespan.

This is not to be confused with the skin of the front of the neck, which is extremely sensitive and should be treated in the same way as facial skin.

Much like the body, the skin on the back of the neck is much thicker than the face and can produce lots of oil. Because of this, the skin on the back of the neck can often produce more severe lesions such as cysts and nodules, or large whiteheads. Neck acne tends to be more prevalent in boys and men, but girls and women can experience it as well.

Neck acne is caused by the same mechanisms that cause facial and body acne. Pores become clogged due to a build-up of cells which stick together and cause a plug. Then bacteria and skin oil, which would normally drain to the surface, get caught inside, causing redness and pus to develop.

Irritation can aggravate neck acne. Collared shirts that rub on the skin of the neck can make acne worse. This often creates a vicious cycle. Neck acne develops, and the sufferer will wear collared shirts to cover it. The collared shirts then cause irritation and aggravate acne, and so on.

  • Try wearing crew neck shirts or shirts without collars.
  • If you must wear collared shirts, as most of us must from time to time, try wearing soft cotton shirts which will be less harsh when rubbing against the skin.
  • Do not pick the area.
  • Try to stay aware of anything that might irritate the back of your neck and take action to stop the irritation if possible.
  • Become aware of other sources of irritation.

Don't worry too much

Our bodies are constantly in contact with various things and it is impossible to avoid irritation altogether. There is no need to obsess about avoiding irritation on the neck. Rather, simply be aware of small changes you might be able to make and leave it at that. The Neck Regimen should clear you up nicely and does not require you to avoid irritation altogether.

The Neck Regimen

The most effective topical treatment is The Neck Regimen, which uses the combination of 2.5% benzoyl peroxide and 10% glycolic acid. This powerful combination can clear up even tough to treat cases of neck acne. However, the process of The Neck Regimen is just as important as the products. It must be followed precisely to be effective.

Learn The Neck Regimen

Accutane (isotretinoin)

For severe, widespread, and potentially scarring acne, Accutane (isotretinoin) is an option. Isotretinoin is a systemic oral treatment which is taken for 15-20 weeks and produces long-term remission of acne symptoms in about 2/3 of people, but comes with a large range of side effects including causing severe birth defects, and must be administered in close partnership with your physician.21-22

Learn About Accutane (isotretinoin)

Ongoing treatment

Treatment must continue until your body outgrows the disease, which the majority of people do for the most degree after adolescence.16-17 Aside from Accutane (isotretinoin), there is no other oral or topical treatment for acne which produces long lasting remission of acne symptoms.18 However, ongoing treatment can get the skin completely clear and keep it that way for years if need be.

† Women of Asian heritage and men and women of African heritage can respond to some antibiotics differently – if you fit into any of these categories, check with your physician if you decide to take antibiotics for your acne.

  1. Titus S and Hodge J. “Diagnosis and treatment of acne.”
    American Family Physician. 2012: 86(8): 734-40.
  2. Bataille V, et al. “The use of the twin model to investigate the genetics and epigenetics of skin diseases with genomic, transcriptomic and methylation data.”
    Journal of the European Academy of Dermatology and Venereology. 2012: 26(9): 1067-73.
  3. Kligman AM and Plewig G.
    Acne and Rosacea. Berlin: Springer, 2000.
  4. Chen WC and Zouboulis CC. "Hormones and the pilosebaceous unit."
    Dermato-Endocrinology. 2009; 1(2); 81-86.
  5. Gilliland K, et al. "Androgen Metabolism in Sebaceous Glands from Subjects With and Without Acne."
    Archives of Dermatology. 1999; 135: 1041-1045.
  6. Dessinioti C and Katsambas AD. "The role of Propionibacterium acnes in acne pathogenesis: Facts and controversies."
    Clinics in Dermatology. 2010; 28(1): 2-7.
  7. Zouboulis CC. "Propionibacterium acnes and sebaceous lipogenesis: A love-hate relationship?"
    Journal of Investigative Dermatology. 2009; 129(9): 2093-2096.
  8. Pappas A, et al. "Sebum analysis of individuals with and without acne."
    Dermatoendocrinology. 2009; 1(3): 157-161.
  9. Tidman MJ. “Prompt treatment of acne improves quality of life.”
    Practitioner. 2012: 256(1752): 15-7, 2.
  10. Kurtalić N, et al. “Quality-of-life of adolescents with acne vulgaris.”
    Acta Medica Croatica. 2010: 64(4): 247-51.
  11. Alexis AF and Lamb A. "Concomitant therapy for acne in patients with skin of color: A case-based approach."
    Dermatology Nursing. 2009; 21(1): 33-36.
  12. Shah SK and Alexis AF. "Acne in skin of color: Practical approaches to treatment."
    Journal of Dermatological Treatment. 2010; 21(3):206-211.
  13. Taylor SC, et al. "Acne Vulgaris in Skin of Color."
    Journal of American Academy of Dermatology. 2002; 46: S98-S106.
  14. Halder RM and Nootheti PK. "Ethnic Skin Disorders Overview."
    Journal of American Academy of Dermatology. 2003; 48: 143-148.
  15. Davis EC and Callender VD. "A review of acne in ethnic skin: Pathogenesis, clinical manifestations, and management strategies."
    The Journal of Clinical and Aesthetic Dermatology. 2010; 3(4): 24-38.
  16. Cunliffe WJ, Goulden V and Stables GI. "Prevalence of Facial Acne in Adults."
    Journal of the American Academy of Dermatology. 1999; 41(4): 577-80.
  17. Knaggs HE, et al. "Post-adolescent acne."
    International Journal of Cosmetic Science. 2004; 26(3): 129-38.
  18. Rademaker M. “Isotretinoin: dose, duration and relapse. What does 30 years of usage tell us?”
    The Australasian Journal of Dermatology. 2012 Sep 26.
  19. Mohd NH and Aziz Z. “A systematic review of benzoyl peroxide for acne vulgaris.”
    The Journal of Dermatological Treatment. 2012 Jul 25.
  20. Savage L and Layton A. "Treating Acne Vulgaris: Systemic, Local and Combination Therapy: Benzoyl Peroxide."
    Expert Review of Clinical Pharmacology. 2010: 13(4): 563-580.
  21. Ganceviciene R and Zouboulis CC. "Isotretinoin: State of the art treatment for acne vulgaris."
    Journal of the German Society of Dermatology. 2009; 8 Suppl. 1: S47-S59.
  22. Rademaker M. "Adverse effects of isotretinoin: A retrospective review of 1743 patients started on isotretinoin."
    Australasian Journal of Dermatology. 2010; 51(4): 248-253.
  23. Poli F. "Acne on pigmented skin."
    International Journal of Dermatology. 2007; 46(Suppl 1): 39-41.
  24. Yeung CK, et al. "A community-based epidemiological study of acne vulgaris in Hong Kong adolescents."
    Acta-Dermato Venereologica. 2002; 82(2): 104-7.