Neck acne can be the result of hormone changes, especially during adolescence, but can also be caused by polycystic ovary syndrome (PCOS), poor skin hygiene, or the use of oil-based skin products on the neck.

Preventing outbreaks of neck acne involves keeping the skin clean, avoiding oil-based products, and using ointments, lotions, or pills as prescribed by your doctor or other healthcare provider. Recommendations will vary based on the severity, type, and cause of acne.

person with neck acne with fingers on their neck

Main causes

The main causes of neck acne are:

1. Hormone changes

Hormone changes, primarily in adolescence, can lead to outbreaks of neck acne. This is most common between the ages of 12 and 18.

This is mainly due to the increased production of androgens, like testosterone, that stimulate the sebaceous glands to produce more sebum, leading to oily skin.

Oily skin can result in clogged pores, inflammation, and rapid growth of bacteria like Cutibacterium acnes.

What to do: keep your skin clean by washing with an antibacterial soap twice a day to help control oily skin. It is also recommended to see a dermatologist who can start you on treatments like topical antibiotics or retinoids.

2. Poor skin hygiene

Neck acne can also be caused by not cleaning the neck well enough, resulting in a buildup of oil and dead skin cells that can clog the pores.

Washing the neck too much, however, can also result in breakouts due to dry, irritated skin that triggers an increase in oil production to compensate for the dryness.

What to do: it is recommended to wash the skin a maximum of 2 times per day (in the morning and before going to bed) with a neutral or antibacterial soap recommended by your dermatologist.

3. Oil-based products

The use of oil-based products on the neck, like moisturizers, creams, sunscreens, or makeup, can clog the pores and trigger breakouts.

What to do: avoid using oily products on your neck and instead use noncomedogenic products that are water-based and do not clog the pores. These products should ideally be recommended by a dermatologist based on your skin type.

4. Extreme stress

Neck acne can also be caused by increased cortisol levels as a result of extreme stress.

This hormone can stimulate the sebaceous glands to produce more sebum, resulting in oily skin.

This type of stress is typically caused by situations like the loss of a family member, job loss or work stress, or the end of a relationship.

What to do: find ways to reduce and combat stress, such as walking, meditating, or devoting time to a hobby that you enjoy.

A dermatologist can also prescribe acne treatments in the form of creams, lotions, or ointments. It is important to talk to your primary care provider or a mental health professional if you are experiencing extreme or debilitating stress, as they can help determine the most appropriate treatment.

5. Diets high in sugar

A diet high in sugar or fat, including foods like white bread or flour, fried foods, cookies, and ready-made sauces, can also cause neck acne.

This is because these foods make the skin more oily, leading to inflammation and breakouts.

What to do: following a well-balanced, anti-inflammatory diet that includes fruits, fresh vegetables, and healthy fats like omega-3s can help prevent breakouts, in addition to drinking enough water.

6. Clothes that cause friction

Wearing clothes that cause friction, like high-neck blouses or scarves, can cause irritation and chafing of the skin that can lead to breakouts.

What to do: avoid wearing clothes that rub against the neck. Wear V-neck or crew neck shirts instead and choose cotton over other fabrics. Keep the skin clean by washing it twice a day with antibacterial products prescribed by a dermatologist.

7. Polycystic ovary syndrome

Neck acne can also be caused by polycystic ovary syndrome (PCOS), a condition involving increased production of androgens in the body, primarily testosterone.

Testosterone makes the skin oily, triggering breakouts on the face and body.

What to do: PCOS is managed by a gynecologist and typically involves the use of contraceptives (birth control) or other medications like spironolactone to control hormone levels and decrease insulin resistance, which is common in PCOS. This can help prevent breakouts, including neck acne.

8. Pregnancy

Neck acne can also occur during pregnancy due to hormone changes in the body that result in oily skin. This is most common during the first trimester.

What to do: wash your face with a neutral or gentle soap twice a day to help control oily skin. You can also apply a toner after washing and drying your face. Make sure it is alcohol-free and does not contain acids.

Make sure to check the safety of all skin care products and acne treatments with your OBGYN or midwife before using, as some are contraindicated during pregnancy. This includes topical and oral retinoids (like isotretinoin), which can cause birth defects in the fetus.

Learn more about pregnancy acne and how it is treated.

9. PMS

Premenstrual syndrome (PMS) is characterized by hormone changes, primarily involving estrogen and progesterone, that can increase sebum production and lead to breakouts.

What to do: keep your skin clean by washing it twice a day in addition to using topical products prescribed by your dermatologist. In some cases, an OBGYN or primary care provider may prescribe contraceptives (birth control) containing progestins like drospirenone or dienogest that can be used to treat acne.

10. Medication side effects

Skin inflammation can be a side effect of medications like corticosteroids, anticonvulsants, anabolic steroids, and antidepressants, leading to breakouts.

What to do: talk to your prescribing provider about possibly changing the medication or the dose. Do not stop taking any medications on your own without first talking to your doctor or healthcare provider.

Prevention strategies

Following certain skin care tips can help prevent breakouts of neck acne. These include washing the neck twice a day (morning and night) with a neutral or gentle soap and applying a toner and oil-free moisturizer afterward.

It is also recommended to apply an oil-free sunscreen (SPF 30 or higher) every day, even when it is cloudy, and to avoid fatty foods and foods high in sugar.

Treatment options

Neck acne can be treated with topical anti-inflammatory and/or antibacterial preparations, such as benzoyl peroxide or salicylic acid. These treatments should be prescribed by a primary care provider or dermatologist.

For more severe cases, your provider may also recommend the use of topical or oral antibiotics or retinoids.