After removing his football
helmet, Walt, a high school football player, notices acne developing
on his forehead and chin where his helmet rubs his face. Jim, a
twenty-year-old soldier, is getting acne on his shoulders and back.
Sharon, a professional violin player, is bothered by acne on her
neck that appears just below her ear, where she tucks her violin
against her neck when playing.
What all of these people have in common
is acne mechanica, a form of acne caused or aggravated by
heat, covered skin, constant pressure and repetitive friction
against the skin.
Common sports-related causes of acne mechanica are:
Helmets and helmet straps, especially
those worn by football and hockey players and motorcycle riders
Shoulder pads and straps worn by
Tight uniforms made of synthetic
Tight headbands worn by soccer
players and runners
Straps and packs on backpacks
Other common causes of acne
Straps used by soldiers for weapons
Headbands worn for long periods of
Musical instruments, such as the
violin, tucked against the neck for hours
Tight fur caps worn for long periods
Tight clothing, such as jeans and
underwear made of synthetic fabric
Snug bra straps
Adhesive tape that remains on the
skin for several days (occasionally)
A typical outbreak of acne mechanica that developed on the thigh
of a 24-year old man who wore tight jeans. The acne consists of
papules on his thighs and
(Photo used with permission of the American Academy of
Dermatology National Library of Dermatologic Teaching Slides)
Some factors that increase the
likelihood of developing acne mechanica are:
Having sandpaper acne. Small,
undeveloped lesions (microcomedones) on the skin that are nearly
invisible but feel rough to the touch are called sandpaper acne.
When aggravated, sandpaper acne can quickly become the more active
and inflamed acne of acne mechanica.
Predisposition for non-facial acne.
Teens and people in their 20s who have a predisposition for
developing acne on the shoulders, back and buttocks have an
increased risk for developing acne mechanica when factors,
such as constant friction, are present.
Being a soldier in the tropics.
The heat and humidity of the tropics can also aggravate the skin,
especially for soldiers in their teens and 20s. When heat and
humidity are combined with the pressure and friction caused by packs
and weapon straps, this creates what is called “double whammy” and
greatly increases the likelihood of a soldier developing acne
The good news is that there are measures that may help prevent
acne mechanica. These include:
Wear a clean cotton T-shirt under a
sports uniform. Cotton absorbs perspiration and reduces friction
against the skin from the uniform.
Shower immediately after athletic
activities. Wash the chest, back and buttocks and areas that were
under straps, padding or tight uniform. Liquid cleansers
containing salicylic acid are useful for removing surface oils and
Avoid covering the forehead with a
headband or cap for prolonged periods
Applying a topical (applied to the skin) acne medication that
contains salicylic acid or benzoyl peroxide to the lesions as soon
as they appear is often effective. Another effective method is to
eliminate the cause of acne mechanica. This, of course, is
not always possible. A professional violinist cannot stop playing
the violin. Soldiers cannot stop carrying packs and weapon straps. A
dermatologist may be able to suggest other effective treatment.
content solely developed by the American Academy of Dermatology