The face and upper neck are the most commonly affected, but the chest , back and shoulders may have acne as well. The upper arms can also have acne.
Aside from scarring, its main effects are psychological, such as reduced selfesteem and, according to at least one study, depression. Acne usually appears during adolescence , when people already tend to be most socially insecure. Early and aggressive treatment is therefore advocated by some to lessen the overall impact to individuals.