What Is Acne Mechanica?

A Type of Acne Caused by Friction

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Acne mechanica is a form of acne that anyone can get, but it's especially common in athletes, students, and soldiers. This type of acne is triggered by excess heat, pressure, friction, or rubbing of the skin, often at the shoulders or the inner thighs.

Acne mechanica differs from other types of acne and isn't related to a hormonal cause. It does, however, respond to many of the same treatments and will often resolve with at-home remedies and prevention.

This article explains acne mechanica, its symptoms, and how you can tell the difference between acne mechanica and other causes. It offers some solutions for self-treatment as well as information about when it's time to see a healthcare provider.

Track and field athlete crouched on track, ready to run
Hero Images / Getty Images

Acne Mechanica Symptoms

Acne mechanica can develop anywhere on the face or body (like the back, shoulders, or buttocks). If you are already prone to breakouts, you're more likely to develop acne mechanica.

It varies in appearance from small, inconspicuous comedones to inflamed papules and pustules.  In the early stages, the skin may just feel rough or bumpy, even if you can't see actual pimples. But as acne mechanica progresses, these tiny breakouts can become irritated and progress to more obvious, inflamed blemishes.

Causes

The biggest difference between acne mechanica and run-of-the-mill common acne (called acne vulgaris) is the cause. While common acne has hormonal roots, the cause of acne mechanica is completely physical and it boils down to one word—friction.

Anything that traps heat against the body for a prolonged period of time, rubs, or puts pressure on the skin can trigger acne mechanica.

Items that can trigger acne mechanica include:

  • Athletic equipment, pads, and helmets
  • Straps from backpacks, bags, and purses
  • Hats and headbands
  • Bra straps
  • Tight-fitting clothes and undergarments
  • Face masks

All of these things trap and hold heat and sweat against the skin, causing the hair follicles (the pores) to become blocked. With continued rubbing, the pores become irritated and those tiny blemishes morph into larger, red pimples.

Athletic equipment is a prime culprit, especially for teen boys. Football or hockey pads, baseball caps, sweatbands, and helmets can trigger acne mechanica because they're heavy, stiff, and don't breathe. They can exert a lot of friction against the skin, and are often worn when sweating. This is a perfect recipe for acne mechanica.

Soldiers are another group that commonly get this form of acne. Packing heavy gear for long periods of time puts pressure on the skin, causing irritation and breakouts. It's especially common in young soldiers stationed in hot and humid areas.

Tight-fitting clothes and undergarments are among other offenders. Breakouts can develop under snug bra straps. Friction from too snug or sweat-dampened clothes can trigger breakouts on the inner thighs, for example, or breakouts on the butt.

It's not just clothing and gear that can cause acne mechanica. Violinists may notice an area of breakouts on the chin where their instrument rests. Talking on the phone for long periods of time regularly might cause breakouts on the side of the face.

Acne Mechanica vs. Common Acne

Acne mechanica and common acne look nearly identical. But most of the time you can figure out what is triggering your breakouts with just a little detective work.

Clues your acne is acne mechanica:

  • Your skin is relatively clear in other areas, but you're breaking out in strategic spots. For example, your face is clear except where your hatband rests. Or you only have pimples on one shoulder, and it's the same shoulder that holds your purse strap.
  • Your body acne suddenly developed after you began working out (and consequently hanging out in tight gym clothes).
  • You have acne during sports season that completely clears up in the offseason.
  • Your back and shoulder acne clears up during the summer but returns with the school year and your heavy backpack.

Acne mechanica often completely clears up when the offending culprit is taken away. This isn't always practical though. If you're a violinist or an athlete, you're not going to stop making music or playing your sport—nor should you. There are other ways to treat acne mechanica.

Acne Mechanica Treatment

Most cases of acne mechanica respond well to over-the-counter salicylic acid or benzoyl peroxide treatments. Try a facial cleanser or body wash containing one of these ingredients, and use it daily.

At-Home Remedies

Thoroughly cleanse the affected areas, but don't scrub. The added friction caused by scrubbing away at the skin can actually worsen breakouts. It's best to use a soft washcloth or simply your bare hands.

Benzoyl peroxide lotions are effective treatments for acne mechanica. Begin by applying just a few times per week, and gradually work up to twice a day. Allowing your skin to acclimate to the benzoyl peroxide will help minimize dryness, flaking, and peeling.

Be aware that benzoyl peroxide will bleach fabric. Wait until the product is completely absorbed before getting dressed, or wear old clothing you don't mind getting stained. Using white linens can also help minimize benzoyl peroxide staining.

When to See a Healthcare Provider

If over-the-counter products aren't working after 6 to 8 weeks of use, it's time to pay a visit to a dermatologist. You might need a prescription acne medication to get acne under control. Plus, your dermatologist will have additional suggestions to help clear your skin.

Prescription Medications

Acne mechanica may need to be treated with a prescription medication. Your dermatologist may want to try a drug that's commonly used to treat other types of acne.

These medications may include:

  • Topical antibiotics, such as erythromycin and clindamycin applied to the skin
  • Topical retinoids, including tretinoin
  • Oral antibiotics like doxycycline
  • Hormonal therapies, including oral corticosteroids

In most cases, acne mechanica can be treated at home or with a provider's prescription. In rare cases, a specialist procedure like a chemical peel or blue light therapy may be needed.

Preventing Acne Mechanica

Acne mechanica can be made worse when wearing synthetic fabrics that trap heat against the body. Whenever possible wear natural fabrics, like breathable cotton.

Since most sports uniforms are made from synthetic fabrics, try wearing a cotton T-shirt underneath. This is especially important under athletic pads, to help reduce the amount of friction on the skin.

If at all possible, try to avoid things that rub against your skin in the areas where you're prone to breakouts. Try a handheld bag instead of a backpack. Don't wear hats, tight-fitting caps, or headbands for long periods of time.

Make sure to wipe down sports equipment (with a facial wipe) and protective gear after each use and to wash your face or shower after sporting activities to rinse away irritating sweat.

Acne Mechanica and COVID Face Masks

The COVID-19 pandemic required the widespread use of face masks, and that's led to cases of acne mechanica from the constant irritation.These "maskne" cases are treated with the same interventions as other causes. Prevention includes keeping masks clean, and careful masking choices when it comes to fit and fabric.

A Word From Verywell

Acne can be a frustrating problem. But if you're patient and consistent with your treatments, you can see improvement of your skin.

As much as possible, try to avoid anything that rubs or puts pressure on areas that are prone to breakouts. Always shower as soon as possible after sweating, and use your acne treatments consistently.

If you have any doubt that what you're seeing is acne, have it checked out by a physician to ensure you're getting the right treatment.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Angela Palmer
Angela Palmer is a licensed esthetician specializing in acne treatment.