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Back Acne

Back acne is a common form of acne because of the high number of oil glands on the back. There are multiple causes of back acne. Pores can become clogged with sebum and dead skill cells, leading to acne. Hormonal changes can also cause back acne.

Last Modified: September 5, 2023
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What Is Back Acne?

Back acne is a prevalent type of acne that develops on the back, usually the upper back, upper shoulders and lower neck. Other than the face, the upper back has more oil-producing sebaceous glands than most other body parts, making it an easy place for acne to develop. It is colloquially known as “bacne.”

Acne can consist of:
  • Whiteheads
  • Blackheads
  • Pustules
  • Papules
  • Nodules
  • Cysts, in extreme cases

Back acne occurs when sweat, dirt, oil, dead skin cells and bacteria get trapped in the skin’s pores. The condition is highly associated with athletic activities that trigger sweating, along with friction from clothing and athletic gear. This combination gets trapped in pores, causing bacterial growth, irritation and inflammation under the skin’s surface.

What Causes Back Acne?

The body produces sebum in glands connected to hair follicles. When released, sebum travels up the hair follicles to add a protective layer to hair and the skin. Follicles and pores can become clogged with sebum and accumulated dead skin cells, sweat and debris. The more sebum your skin produces, the more likely this clogging becomes.

Dermatologists agree that acne usually has multiple causes. Overproduction of sebum, buildup of dead skin cells and sweat are the most prevalent. Genetics is also a significant risk factor for acne.

Hormonal changes can also cause back acne, especially during teenage years, because of a sudden rise in androgen levels. Although acne affects both genders at all ages, adult women are particularly susceptible to hormonal acne because of hormonal changes during pregnancy, menstruation, menopause and when dealing with reproductive health conditions such as polycystic ovarian syndrome, also known as PCOS.

How to Treat Back Acne

Be sure to talk to your doctor before initiating treatment. If you don’t already see a dermatologist, your primary care provider can help guide you through the initial steps of treatment and management of back acne.

Most cases of back acne clear up on their own. For mild and moderate back acne that doesn’t clear up in a few weeks, over-the-counter acne treatment products may control it. The American Academy of Dermatology Association recommends using a benzoyl peroxide foaming wash as a first-line treatment for acne.

Salicylic acid is another recommended treatment that can also be effective. The AAD suggests starting with a wash containing 5.3% benzoyl peroxide. This strength is least likely to cause dryness or irritation. However, if it does not seem to be effective, you might try using the higher 10% strength. Over-the-counter retinoid adapalene 0.1% (Differin and others) is also suggested.

When to See a Dermatologist for Back Acne

If your back acne doesn’t improve after eight weeks of a self-help regimen, it’s time to visit a dermatologist. If you don’t already see a dermatologist or your insurance requires a referral to see specialists, you may want to start by seeing your primary care provider. They can help guide you through the initial steps of treatment and, if necessary, can refer you to a dermatologist in your health insurance network.

When back acne is severe, a dermatologist may recommend prescription medicines. They include oral antibiotics such as erythromycin and doxycycline as well as topical treatments such as prescription-strength retinoids and antibiotic creams.

For women, oral contraceptives may be an effective acne treatment, especially if it seems linked to a menstrual cycle. If you are experiencing back acne, mention this during your next OB-GYN or women’s health visit. If other treatments fail, doctors may prescribe oral isotretinoin, also known by the brand name Accutane.

You may need to see a dermatologist if you don’t see any difference in your acne in six to eight weeks of OTC treatments, or if the acne grows severe. If you experience severe pain or inflammation or if you have signs of an infection, such as fever, your dermatologist can help.

Dermatologists can also determine whether you have acne or another skin condition. If it is severe back acne, they can prescribe appropriate medication, if needed.

As with other forms of acne, back acne can cause scarring and skin color changes, such as darkening or lightening of the skin, in severe cases. If you already have scars, various treatments can help with getting rid of acne scars. Among them:

  • Chemical peels
  • Skin grafting
  • Laser resurfacing
  • Microdermabrasion

If you’re already on medication for acne, but your condition worsens or fails to improve, your dermatologist will adjust any prescriptions to find the right dosage or medication that works for you.

Can Back Acne Be Prevented?

There is currently no foolproof approach for preventing back acne entirely because it is affected by so many different things. Genetics, hormones and external factors all play a role in causing acne.

Strategies that may help prevent breakouts or reduce acne and skin irritation include:

  • Regularly washing towels, bed linens and pillowcases.
  • Regularly washing clothes, particularly tight-fitting garments such as bras and undershirts.
  • Exercising in loose fitting clothes made from natural fibers such as cotton or sweat-wicking fabrics.
  • Avoiding accessories that rub against your back and shoulders such as backpacks. If possible, opt for handheld luggage.
  • Showering and changing into clean clothes immediately after exercising or using oil-free cleansing wipes.
  • Washing workout clothes and equipment after each use.
  • Keeping hair sprays and hair gels away from your back.
  • Resisting any urge to pick and pop pimples, even on your back.

In addition, opt for skin care products labeled “noncomedogenic.” Those that do not have this on the label may make pore clogging even worse.

Your lifestyle and diet can also have an impact on how much acne you experience. A balanced diet that includes fruits and vegetables and limits foods high in processed carbohydrates and dairy can lower your risk of breakouts, especially a type of back acne known as acne vulgaris. You may find that these changes have other positive effects on your health, too, such as lowering your risk of diabetes and heart disease.

Taking a holistic approach to caring for your skin and health can be beneficial. If you are concerned about your risk of back acne, talk to your dermatologist. Early intervention can help minimize scarring and other complications.

Please seek the advice of a medical professional before making health care decisions.