Acne is the occurrence of an inflamed or infected sebaceous gland on the skin. Acne vulgaris, which is the medical term for acne, is the most common skin disease. Acne is present on the areas of the body in humans that contain the most sebaceous glands. The most common areas in which acne is present are the face, chest and back. Areas include, but are not limited to, the forehead, cheeks, chin, neck and shoulders. Acne can appear anywhere on the body except palms, soles and the top of the feet. Acne is classified into three different types of acne: mild, moderate and severe acne. One hundred percent of people will experience acne sometime in their life. Acne is hereditary, which means it runs in the family. Therefore, if parents have it, it will probably be present in their children. How We Get Acne Our skin has pores that are connected to oil glands (known as sebaceous glands) located under the skin. Our body creates sebum (oil that is produced in our skin) which keeps our body and hair moisturized. This sebum is extracted from the body through openings called pores around our hair follicles. Acne occurs when sebum and dead skin clog the hair follicle. When this happens, it forms a plug within the pore. This plug is called a comedo. There are two types of comedones: an open comedo or a closed comedo. Types of Acne Mild Acne A blackhead is considered an open comedo. They are created when the hair follicle becomes clogged and the surface of the pore remains open. The sebum causing the clog reacts with the surrounding hair and turns black in color, hence the term blackhead. Whiteheads are tiny white spots on the skin. Because of their size, a microscope is most often required for them to be seen. Whiteheads form in a similar way as blackheads. The only difference is that whiteheads have dead skin and sebum blocking the opening of the pore. The sebum does not react with the surrounding air, thereby remaining white. It is because of this that whiteheads are also considered a closed comedo. A pimple is formed when both blackheads and whiteheads become infected by a common bacterium found on everyone’s skin called Propionibacterium acnes. The bacterium thrives in the presence of oil and rapidly increases in numbers causing the comedones to become infected and inflamed. The inflammation is what causes the pimple to look red and swollen. Blocked follicles that are infected with bacteria will eventually burst and cause an acne lesion. Moderate AcneTwo examples of moderate acne are papules and pustules. Papules are not like blackheads or whiteheads. Instead, they are closed and small, pink tender bumps, surrounded by skin inflammation. A pustule is a papule filled with pus. It is red under the surface and filled with pus on top. It is not a good idea to pop pustules because of the scarring that might be left on the skin afterwards. However, many consumers still do it because of the noticeable white or yellow dots in the center caused by the pus trapped inside. Severe AcneSevere acne, such as cysts are large bumps filled with fluid. Severe acne is very painful and visible on the surface of the skin. People are often left with permanent scarring after this type of acne heals. There are also nodules, pimples that are larger and more serious than papules. Nodules are solid pimples that are visible on the surface of the skin. However, nodules are not surface acne but instead affect deeper layers of the skin. Because they are deeply embedded, they tend to be more painful than the typical pimple. Nodules are also referred to as nodular acne or nodulocystic acne. The Role Gender Plays With Acne People of all genders, races and ages are prone to acne. Although anyone can get acne at any age, it is most common in adolescents and young adults. For most, acne appears with the onset of puberty because of the androgen hormones being released by the body. Girls tend to get acne at a younger age than boys. The reason for this is that girls hit puberty first. Although females get acne first, males suffer from more severe cases of acne for a longer period of time due to the higher quantities of androgen or testosterone that are present in their bodies. High androgen levels in males also cause the body to create more oil gland activity. The overproduction of sebum causes males to have more breakouts on the body compared to females. Acne in females can be triggered by their menstrual cycles. Hormonal disorders in females can also cause flare-ups of acne. Acne in females is also more likely to clear up at an earlier age than that of males. It clears up for males when they reach the end of puberty, usually around the age of 18 or 19. However, acne can also occur in babies, toddlers and children. Some babies are born with acne, due to hormones that might be passed down from the mother during the last stage of pregnancy. Parts of the Body: Where? Why? How? Like acne on the face, acne on the chest and back occurs due to sebum and dead skin cells clogging the hair follicle. Even though chest and back acne develop the same way as acne on other areas of the body, there are many factors that cause people to break out on their back and chest. One of the main causes of back and chest acne is irritation caused by prolonged pressure and friction by anything repeatedly rubbing on the skin, such as tight shirts and backpacks. Acne that is triggered by irritation on the skin is called acne mechanica. Back acne (coined by some as bacne) can also be a result of sweat. Sweat that is not washed off can mix with the natural oils and other toxins in the skin, causing pores to become clogged and irritated. Even the type of clothing can cause acne on the chest and back. Tight clothing does not allow the skin to breathe and traps in sweat. Synthetic material such as lycra and polyester also trap in sweat. The sweat is then combined with the natural oils released by the body. This creates a film over the skin, causing the pores to clog and create whiteheads and blackheads. This is why it is better to avoid working out while using synthetic materials and better to wear cotton or a material that allows the skin to breathe. Hygiene is very important in order to prevent chest and back acne. It is very important to shower and cleanse the skin every time after working out. Sheets that are not washed regularly can also cause acne. Natural oils released by the skin and dirt are absorbed by the sheets and cause buildup over time. Dirty sheets and dirty clothes can transfer dirt and bacteria into the hair follicle, causing it to clog and become infected. Women that use makeup on their neck are also more prone to chest acne. Makeup along with sweat can cause the pores to clog. A lot of the makeup women use is oil based, which can cause flare-ups in acne. The oil of the makeup along with the sebum that is secreted by the skin creates an excess of oil and therefore causes acne. To avoid this, try buying makeup products that are labeled as non-comedogenic. Items such as laundry detergent and body wash can also cause chest and back acne. For this reason, a fragrance-free and made for sensitive skin detergent should be used to wash clothes. When choosing a body wash, avoid grainy body scrubs as they can irritate the skin and create blemishes. Pores on the back tend to also be larger than those on the face, therefore they release more oils. Cases of severe acne, such as nodules and cysts, are more common on the back because of the excess oils being released. A very effective treatment for back acne is benzoyl peroxide, which penetrates the skin and delivers oxygen to the affected area. Bacteria cannot live in the presence of oxygen so it kills 99.9 percent of it. Resorcinol, salicylic acid and sulphur also help to treat acne breakouts on the back. Education As an educator, I challenge all of my students to keep advancing in the industry. You can never learn enough! The moment you think you are the best educator or professional – think again. Be open minded; give back to your industry and your community; and be an educator for not just your clients but yourself. I have taught students that range from the ages of 5 to 105, for over 20 years, and it never ceases to amaze me how knowledgeable one can truly be. I am just blessed to be able to learn from my students; they continue to teach me new things every day. Chau Q. Stone is a 31 year veteran in the aesthetic industry. Her extensive repertoire includes, but is not limited to, being a licensed cosmetologist, medical aesthetician, permanent cosmetic technician and makeup artist. She is CEO and director of education for Spa Source USA, the parent company of Spa Source Institute, SS Consultant Group, and MD Corrective Care. Stone received her formal training in Vietnam, Malaysia, Thailand, and certifications for over 18 years in the United States and Europe from the Matis Paris Institute in Paris, France; Essensa Provence France in Grasse, Thaogo; Piot Paris, Diego Dalla Palma & Lisap in Milano, Italy. This email address is being protected from spambots. You need JavaScript enabled to view it. Want to read more? Subscribe to one of our monthly plans to continue reading this article.