Does Physically Irritating the Skin Cause Acne?

Yes, and It Is Such a Well-Known Problem that It Has Its Own Term: Acne Mechanica

Does Physically Irritating the Skin Cause Acne?

Article Summary

Physical irritation of the skin refers to anything that repeatedly touches or rubs against the skin. This physical irritation can lead to acne. In fact, it is such a common phenomenon that dermatologists refer to it with the term acne mechanica. If the irritation goes on for a longer time or if the irritation is more intense, more severe acne can result. Don't stress out about it too much, but try to leave acne-prone skin relatively untouched when you can.

   

Since the 1970s, researchers have published studies showing that acne can be aggravated by physical irritation. These researchers introduced the concept of acne mechanica to describe this phenomenon.
 

Today, dermatologists generally accept the reality of acne mechanica and recognize that friction, tension, rubbing, and persistent pressure can aggravate existing acne and can also induce acne on healthy skin.

Some common things that can cause acne mechanica include:
 
  • Wearing a facemask for a sport
  • Wearing tight hats that rub against the forehead
  • Constantly touching the face or resting your chin in your hands
  • Picking at acne lesions
  • Scrubbing with a washcloth or cleansing brush instead of gently washing with bare hands
  • Getting a close "buzz" haircut with clippers when the hairdresser is not gentle
  • Using "exfoliating" skin care products that contain irritating beads or seeds

So, as you can see, any repetitive physical irritation of the skin can potentially make acne worse. This is true on the skin of the face and the body. 

Since it is impossible to completely avoid any irritation, don't stress out about this too much. Instead, just become aware of obvious and avoidable sources of irritation, and eliminate them when you can.


Exfoliating Beads


How Acne Mechanica Was Discovered

Archives of Dermatology

The researchers, Mills and Klingman, introduced acne mechanica in a study they published in the journal, Archives of Dermatology, in 1975. They wanted to emphasize that any type of mechanical stress of the skin can intensify the symptoms of acne, so they devised a method to demonstrate that physical pressure can aggravate acne. These researchers simulated the effect of physical pressure by placing cloth-backed adhesive tape on the skin of ten teenage volunteers with moderately severe facial and back acne. They placed the tape on the skin over the shoulder blade in areas where the acne was less severe so they could see how mild acne symptoms were affected by the physical irritation of the tape. They removed the tape after a week to evaluate skin changes and then applied an identical piece of tape for another week. After one week the number of inflamed lesions increased in five of the subjects. After two weeks the number of inflamed lesions increased in seven of the subjects, with new pimples appearing on the skin where the irritating tape had been placed. The researchers also took biopsy samples that showed typical features of acne, such as inflammation of pores and the surrounding skin, after two weeks. This proved their point that acne can be aggravated by physical irritation. Clogged pores that had not been inflamed became inflamed after taping, indicating that the mechanical action of the tape on the skin worsened the acne.1 

Since acne mechanica was first introduced in 1975, other researchers reported on more examples of acne mechanica in case studies. A case study is published when doctors notice something in just one or a few people and report it. It is interesting to see how real people experience acne mechanica as the result of such varied physical irritants.

One case study reported on three females who developed acne mechanica after rubbing their skin with cosmetic agents.2


Another case study described three female dental patients and nine male orthopedic patients. These patients developed acne mechanica in locations where their skin was in constant contact with a dental splint or bed during their treatment.3


Shaving Back of Neck 

A third case study described 27 patients who believed their severe acne began due to trauma of the skin by a razor during a haircut.4


Acne Mechanica


Occupational Acne - Another Term for Acne Mechanica

Occupational acne is acne mechanica that is caused by a person’s job or some other activity they regularly participate in. Since acne mechanica is associated with repetitive physical contact, it is common in athletes, especially in football players. In addition to the heat and friction caused by contact sports, heavy protective equipment, such as that worn by football players, can cause eruptions of acne on the shoulders, upper back, back of the head, and chin. All of these areas receive high levels of pressure from the protective pads, helmets, and facemasks.5 

Researchers made the connection between football equipment and acne mechanica in a 1997 study published in the Journal of the American Academy of Dermatology, in which they examined 453 football players for acne.6


Occupational Acne - Fiddler's Neck


Another example of occupational acne is fiddler’s neck, which is seen in a quite different group of people: violin and viola players. These musicians play their instrument while holding it under the left side of their chin. A study published in 1978 described fiddler's neck in 23 violin and viola players and concluded that this condition was an example of acne mechanica.7


What Can Be Done About It?

As we can see, life can present us with physical irritation of the skin in many ways. While it is impossible to completely avoid physical irritation, it is nevertheless a good idea to pay attention to anything that might be repeatedly irritating your skin. If you can reduce the irritation, do so. For instance, stop using exfoliating scrubs, wash your face with only your bare hands and not with a washcloth or cleansing brush, and whatever you do, DO NOT PICK at your skin. If you cannot reduce the irritation—for instance, if you have to continue wearing a facemask for a sport—make sure to perform your daily anti-acne regimen carefully in that area to combat the irritation.

Tip: While the best defense against physical irritation is an effective daily anti-acne regimen, additional application of glycolic acid to physically-irritated areas of your skin can provide even more insurance against breakouts when that area has been irritated.

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Our team of medical doctors, biology & chemistry PhDs, and acne experts work hand-in-hand with Dan (Acne.org founder) to provide the most complete information on all things acne. If you find any errors in this article, kindly use this Feedback Form and let us know.

References:

  1. Mills, O. & Kligman, A. Acne mechanica. Arch. Dermatol111, 481–483 (1975).
  2. Seneschal, E. et al. Exogenous inflammatory acne due to combined application of cosmetic and facial rubbing. Dermatology 224, 221–223 (2012).
  3. Tan, S. et al. Acne mechanica. Brit. Med. J. 1, 130 (1976).
  4. Salami, T., Omeife, H. & Samuel, S.  Prevalence of acne keloidalis nuchae in Nigerians. Int. J. Dermatol. 46, 482–484 (2007).
  5. Basler, R. S., Hunzeker, C. M. & Garcia, M. A. Athletic skin injuries: combating pressure and friction. Phys. Sportsmed. 32, 33–40 (2004).
  6. Knable, A. L. Jr., Hanke, C. W. & Gonin, R. Prevalence of acne keloidalis nuchae infootball players. J. Am. Acad. Dermatol. 37, 570–574 (1997).
  7. Peachey, R. D. & Matthews, C. N. Fiddler’s neck. Brit. J. Dermatol. 98, 669-674 (1978).
See More References

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