Pimples on the Neck: Why They Appear and How to Treat Them?

Updated on September 11, 2023

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Bearded man with pimples on his neck — Image by Vadiar via Shutterstock

Acne is a common skin condition affecting a large portion of the population. However, not everything that looks like pimples is acne. Many conditions can look similar to acne but are not. Correct diagnosis and prompt treatment are crucial to swift resolution. Read on to learn what other skin conditions present with pimple-like lesions that can mimic acne and how to treat and prevent them.

Pimples are pinkish-red bumps, some of which have white tops.
Acne is not the only cause of pimples on the neck. Other causes include infections, inflammatory rashes, and cancers.
Treatment and prevention are specific to the exact cause of the pimples on the neck.
If new pimples appear on the neck, see a doctor immediately.

What are pimples on the neck?

Pimples on the neck appear as red bumps that may have a white head. These lesions may also develop scaling or crusting on top. Depending on the cause, patients may complain of itching, soreness, or pain or have no symptoms.

Causes of pimples on the neck

Many different conditions resemble acne on the neck. Sometimes they are mistakenly treated as acne. If acne treatments are not working, a doctor may consider additional testing for a more accurate diagnosis. These tests may include bacterial or fungal cultures or skin biopsies. Conditions causing or mimicking acne include the following:

Folliculitis

Folliculitis is an inflammation of the hair follicles usually caused by bacteria, irritation, or fungi. A variant of folliculitis is hot tub folliculitis caused by the bacteria Pseudomonas. These pink bumps or whiteheads can be itchy or sore.

Ingrown hairs

These pink bumps result from using old, dull razors or friction. The hairs protrude out of the follicle and grow back into the follicle, which is common in patients with curly or coily hair. Some may have whiteheads.

Miliaria rubra or miliaria rubra pustulosa.

These bumps result from heat rash and appear due to clogged eccrine sweat glands. These itchy pink bumps may or may not have a white top. Miliaria rubra pustulosa lesions have white tops, while miliaria rubra are pink bumps.

Milia

These are tiny cyst-like bumps look like whiteheads. They occur as a result of clogged pores or trauma. They usually do not cause any symptoms.

Basal cell carcinoma (BCC)

This is the most common form of skin cancer caused by cumulative sun exposure. These pink, pearly bumps usually have no symptoms unless they are allowed to grow. As they enlarge, they may be sore to touch or bleed.

Keratoacanthoma (KA)

This is another type of skin cancer caused by cumulative sun exposure. These fast-growing, large, pink bumps can have crusted blood or a hard white top that develops in the center of the lesion. Since they grow rapidly, they are often tender or painful.

Molluscum contagiosum

This viral infection is contagious and spreads through direct contact with infected skin. These pink bumps may be itchy and cause the person to scratch and spread the infection to other parts of the body. These lesions can sometimes have a whiteish top that almost resembles a blister.

Contact dermatitis

It is a rash caused by direct contact with an irritant or allergen, usually a skin product. However, it can also result from contact with cleaning chemicals, plants, or laundry detergent. This itchy rash can present with several small pink-red clustered bumps.

Treatment of pimples on the neck

The treatment of pimples on the neck depends solely on the cause. They are all treated differently. People with pimples should see their doctor immediately for diagnosis and treatment. The sooner they receive treatment, the faster they will improve, and, in the cases of contagious conditions, the less likely they are to infect others.

Cause	Treatment
Folliculitis	Keep the area clean and free from friction. Topical and oral antibiotics treat bacterial folliculitis, while topical or oral antifungals treat fungal folliculitis. Sometimes topical steroids help reduce inflammation.
Ingrown hairs	Treatment involves topical or oral antibiotics, using a new razor, and shaving with shaving cream. Keeping the area clean, avoiding friction, and using exfoliants are also helpful.
Miliaria	In addition to topical steroids and oral antihistamines, staying cool is important. Cool compresses and cool showers help. Avoid sweating and stay indoors.
Milia	These are easily removed surgically with a tiny blade.
Basal cell carcinoma and keratoacanthoma	Surgery is the treatment of choice for skin cancer to ensure complete eradication and a lower risk of recurrence. Radiation is also an option for those who are not surgical candidates.
Molluscum contagiosum	Often, these resolve without treatment. However, liquid nitrogen or curettage are options to eradicate them quickly. Topical retinoids, salicylic acid, or imiquimod take longer but are effective treatments. Do not scratch because it may spread the infection to other parts of the body or others.
Contact dermatitis	The primary goal is to stop whatever is causing the rash; otherwise, treatment may not be effective. Treatment includes topical, injectable, or oral steroids to calm the inflammation.

Prevention of pimples on the neck

Prevention, like treatment, varies based on the cause of the pimples. Some conditions are preventable, while others are not. Furthermore, people may not appear contagious when they are, so exercise caution.

Some prevention tips include the following:

Cause	Prevention
Folliculitis	Keeping the area clean can prevent infection. Some have to use topical or oral antimicrobial long-term to prevent future infections. Avoid friction to the area. Shave carefully with a new, clean razor and shaving cream. Wash clothing, towels, and bed linens daily.
Ingrown hairs	Always use new, sharp, clean razors and shave with shaving cream. Keeping the area clean and using exfoliants are also helpful. The site may require long-term topical antibiotics to prevent future infections. Consider alternative hair removal techniques, such as a laser, and avoid friction.
Miliaria	Staying cool is important. Cool compresses and cool showers can help. Remove sweaty, wet clothes immediately. Stay indoors as much as possible and avoid sweating.
Milia	Use non-comedogenic products and exfoliants to prevent clogged pores.
BCC and KA	Use broad-spectrum sunscreen daily, reapply every 1–2 hours when outside, wear a wide-brimmed hat and UPF clothing, and avoid sun exposure as much as possible.
Molluscum contagiosum	Avoid contact with people who are infected. Wash immediately after coming in contact with an infected person.
Contact dermatitis	Avoid products with dyes and fragrances, especially with sensitive skin. Use gloves when using cleaning products or chemicals or doing yard work.

When to see a doctor?

If new lesions appear on the skin, it is always best to seek treatment from a doctor rather than guess or consult Google. However, people can be stubborn, so if, after treating themselves, the condition worsens, they should see their doctor immediately. Delaying treatment of some medical conditions, like infections, can have serious consequences. Additionally, people who develop a pimple on their neck should visit their doctor immediately if they have a fever, chills, or muscle aches.

Since many medical many conditions have a similar appearance to acne, misdiagnosis is possible. Not every lesion that looks like a pimple is an acne. There are various other causes of pimples, such as inflammatory, infectious, or cancerous lesions. If a new lesion or lesions appear on the skin, seek prompt medical attention from a doctor.