Estylan Dan Arellano, DO
Jan 14, 2022 · 5 min read
Hi, I’m Dr. Arellano, one of your Curology dermatology providers. I’m a board-certified emergency physician with a passion for skincare—and I’ve had personal experiences with acne for over 20 years!
After 10 years, I stepped away from the emergency department (ED) to pursue a career in telemedicine with Curology. Although not the first thing that comes to mind when one thinks of the emergency department, up to 12% of all ED visits are due to skin complaints. Coming from one of the busiest emergency departments in San Diego seeing over 100,000 patients a year, I’ve had my fair share of dermatology experience. Like all Curology providers, I have extensive medical training on acne and anti-aging management.
Today, I’m sharing some insight about a common skin condition that’s often confused with acne vulgaris: acne mechanica.
Acne mechanica is a specific type of recurring acne that’s caused by a combination of friction and heat. Acne mechanica happens when skin is rubbed, stretched, or squeezed repeatedly.
Think of acne as having “mechanical” causes. The main triggers of acne mechanica are friction and pressure on the skin. Compare this with your “traditional” acne (acne vulgaris) in which diet, hormones, stress, and other factors can play a role.
Anyone can suffer from acne mechanica, but it is very common for active people who wear uniforms like athletes and soldiers. Football and hockey players often get it on their chin, forehead, and shoulders. Soldiers, especially those in warm climates, can get it from their equipment and uniforms constantly rubbing on their skin.
Another type of acne mechanica has become a common issue during the COVID-19 pandemic: maskne. That’s acne around the cheeks, jaw, and mouth caused by mechanical stress from mask-wearing, as well as clogged pores and a potential imbalance in skin microorganisms.
Basically, acne mechanica is caused by repeated rubbing and increased friction. It can occur anywhere on the body (including the thighs). Acne mechanica can happen on its own without an underlying outbreak, but it can also be seen in the presence of preexisting acne.
Acne mechanica can occur in many places on the body including the face, back, and chest. When heat and sweat are trapped on your skin, bacteria can thrive and pores can get clogged. . As the equipment or clothing rubs against your heated skin, it can cause irritation and new breakouts. This is often seen on the forehead, cheeks, chin, and jawline, as well as shoulders.
All of these things can cause heat and friction in the skin which can result in increased sweating and clogged pores, resulting in acne mechanica:
Athletic equipment like helmets, chin straps, and sports bras
Hats, headbands, and other headgear
Backpacks, bras, and other things with straps
Acne mechanica typically begins as small, rough bumps. If friction continues, these bumps can progress from pimples to deep cysts.
Acne mechanica symptoms
Small, rough bumps that may progress to cysts
Breakouts in patterns where the trigger comes into contact with skin
Breakouts that get worse with friction and heat
Because it’s triggered by external friction, acne mechanica tends to have a linear distribution. In other words, if your forehead breakouts line up with your bike helmet, it might be acne mechanica.
The best treatment for acne mechanica is prevention: reduce friction, heat, and moisture by removing the trigger. However, this may not be possible for everyone. Professional athletes can’t stop wearing protective gear, and wearing a face mask is still recommended (and, in certain instances, required).
But there are things you can do to help reduce acne mechanica. If you can minimize friction and extra heat on the skin, it will reduce irritation. In other words, you want to make sure your skin can “breathe.”
Quick tips to help prevent acne mechanica:
Wear loose-fitting clothes whenever possible.
Reach for moisture-wicking fabrics with the ability to quickly absorb sweat.
Place clean, soft padding between your equipment and skin. For example, you can use memory foam shoulder pads for your backpack’s straps which can minimize rubbing and skin irritation.
Disinfect your athletic gear and equipment before use.
After workouts, shower and change into clean clothes
Have your glasses adjusted to cause less pressure on certain parts of your face
In addition to addressing triggers, there are medications that can help with acne mechanica. Dermatology providers often recommended these treatments:
Salicylic acid, a beta hydroxy acid (BHA) that exfoliates the skin and helps prevent and treats blocked pores.
Benzoyl peroxide, a topical acne treatment that kills bacteria, unclogs pores, and helps with inflammation.
As with all breakouts, avoid touching/picking the area, and make sure you’re using skincare products without comedogenic ingredients.
The good news is that acne mechanica tends to clear faster than regular acne. After 6-8 weeks of making small adjustments to your routine and regularly using preventative acne treatments, you should begin to see your breakouts clear. However, if symptoms persist or worsen, consider seeing a dermatology provider for help.
If you’re feeling unsure about what your skin needs to better manage acne mechanica, talking to a Curology dermatology provider can help. You can get started with one at no extra cost when you start your Curology free trial.
Just take a quick skin quiz and snap a few selfies and one of our licensed medical providers will evaluate your skin. If Curology is right for you, we’ll send you a 30-day supply of your Custom Formula with a mix of active ingredients chosen for your unique skin concerns for free—just pay $4.95 (plus tax)* to cover shipping and handling.
PS. We did the research so you don't have to.
Damiani, Giovani et al. Dermatol Ther. 2021 Feb 19 : e14848 COVID‐19 related masks increase severity of both acne (maskne) and rosacea (mask rosacea): Multi‐center, real‐life, telemedical, and observational prospective study. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7995182/
Liu H et al. Cochrane Database Syst Rev. 2020. PMID: 32356369 Topical azelaic acid, salicylic acid, nicotinamide, sulphur, zinc and fruit acid (alpha‐hydroxy acid) for acne. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7193765/
Mills, OH Jr; Kligman, A. Acne mechanica. Archives of Dermatology;1975 Apr;111(4):481-3. https://pubmed.ncbi.nlm.nih.gov/123732/
Torjesen, I. “Skin-on-skin friction results in acne mechanica”. Dermatology Times, May 2019 (Vol. 40, No. 5), Volume 40, Issue 5. https://www.dermatologytimes.com/view/acne-mechanica-caused-skin-skin-friction
Wan-Lin Teo, MBBS, MRCS (UK), FAMS (Dermatology). Diagnostic and management considerations for “maskne” in the era of COVID-19. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7528820/
American Academy of Dermatology. Is Sports Equipment Causing Your Acne?https://www.aad.org/public/diseases/acne/causes/sports-equipment
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Estylan Dan Arellano, DO
Nicole Hangsterfer, PA-C