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Acne is a common condition that typically develops in areas of skin with a lot of oil-producing glands, such as the face, chest, and back.

Back acne, or “backne,” may involve blackheads, whiteheads, or pus-filled bumps called cysts.

The treatment for back acne depends on its severity and may involve over-the-counter (OTC) products, prescription medications, or treatments such as light therapy.

This article looks at what back acne is, what causes it, and how to treat it.

Back acne refers to pimples or cysts on the back. It can involve:

  • Blackheads: Each bump has a dark dot in its center.
  • Whiteheads: Each bump has a white center.
  • Papules: Each small bump has no distinct “head.”
  • Cysts: These painful or tender lumps look similar to boils and are a severe form of acne.

Back acne is not a specific medical condition, but it has some unique challenges when compared to acne on the face. For example, it can be more difficult to see and reach back acne to apply treatments.

Why does acne occur on the back?

Like the chest and face, the back has a high density of sebaceous glands. These produce sebum, an oily substance that forms a protective coating for the skin.

Sebaceous glands are attached to hair follicles or pores. If sebum or dead skin cells clog a pore, it can cause a blockage. This blockage may lead to inflammation or trap bacteria in the pore. This is how acne lesions develop.

A type of yeast, Malassezia, can also cause lesions that look similar to acne. The yeast tends to overgrow in humid, sweaty environments. Because clothing, backpacks, and slings often cover the back, it can be an ideal environment for this microbe to grow.

If the yeast gets into the hair follicles, it can cause a condition known as pityrosporum folliculitis. If antibacterial treatments have not worked for back acne, a person may have pityrosporum folliculitis instead.

Below is a range of OTC and prescription treatments a person can consider.

Cleanser

According to the American Academy of Dermatology Association (AAD), people with mild-to-moderate back acne may benefit from combining acne-friendly skin care with OTC products that target the lesions. Individuals with more severe back acne may need prescription drugs.

A person should wash the skin with a mild, non-irritating cleanser every day and after getting sweaty. They should also avoid harsh soaps and astringents and keep from scrubbing the acne — this increases the inflammation.

When acne flares up, people can use a benzoyl peroxide wash. This ingredient kills bacteria and helps reduce lesions. It works best when a person leaves the wash on their skin for a few minutes before rinsing it away. This is because the skin on the back is thicker than on the face, so it may need extra time to absorb.

The AAD writes that a concentration of around 5.3% is less likely to cause side effects such as irritation, dryness, and peeling.

A person can consider Differin Daily Deep Cleanser, which contains 5% benzoyl peroxide. This product is suitable for sensitive skin, and a 4 fluid ounce (fl oz) bottle costs $12.47.

Retinoids

To reduce acne, a person might also try a skin care product that contains 0.1% retinoid in addition to using a benzoyl peroxide face wash. Many OTC creams contain retinoids.

Another option is adapalene gel. Doctors recommend using this after showering and before going to sleep.

An applicator can help a person apply treatments to difficult-to-reach parts of the back.

One adapalene product a person can consider is the La Roche Posay Effaclear 0.1% Adapalene Gel, which is suitable for everyday use. The company writes it is suitable for sensitive skin and works to improve cell turnover, which removes and prevents dead skin cells from clogging the pores.

A 1.6 oz tube costs $30.99.

Moisturizer

If the skin on the back feels dry or tight, particularly after showering or bathing, a person might use an oil-free moisturizer. Look for products that are labeled “non-comedogenic.” This means that they do not clog pores.

The CeraVe Daily Moisturizing Lotion for Dry Skin aims to hydrate the skin with hyaluronic acid and restore the skin’s protective barrier with ceramides. It is non-comedogenic and suitable for acne-prone skin.

A person can use this moisturizer daily, and a 19 fl oz bottle costs $18.37.

Sunscreen

Sun exposure can make acne lesions darker and more noticeable. It can also cause them to last longer. The AAD recommends a person uses a non-comedogenic sunscreen with an SPF of 30 or above whenever a person has their back exposed.

Oral contraceptives

If a person’s acne seems linked to the menstrual cycle, they may wish to consider trying oral contraceptives, which is an effective treatment in females.

Although hormonal acne is not a term used by doctors, hormones can play a part in the formation of acne. During puberty, rising testosterone levels can increase sebum production, and conditions such as polycystic ovary syndrome (PCOS) can cause an overproduction of androgens like testosterone.

Oral contraceptives can decrease androgen levels.

However, oral contraceptives often have side effects and may not always be effective in managing acne.

A person should speak to a doctor to understand whether oral contraceptives will be effective and safe for them to use. They should also continue to work with a dermatologist and keep up their skincare routine while using birth control for acne.

Oral antibiotics

Drugs such as doxycycline and erythromycin can reduce the amount of acne-causing bacteria on the skin. A dermatologist will likely recommend the shortest possible dosage because overuse can lead to antibiotic resistance, and antibiotics can kill healthy bacteria in the gut.

Isotretinoin

This medication aims to treat excessive oil, inflammation, clogged pores, and bacteria.

According to the AAD, 85% of people who take isotretinoin experience permanent clearing of acne after one course. The common side effects can include dry skin, eyes, nose, and mouth, itching, and headaches.

Severe side effects include suicidal thoughts, aggression, difficulty moving the limbs, and severe skin rash. However, these side effects are rare and occur in less than 1 out of 1,000 people.

A person should talk with a doctor about whether isotretinoin is right for them.

Antiandrogen therapy

Antiandrogen involves taking medications that suppress testosterone, such as cyproterone acetate and ethinylestradiol or spironolactone.

Dermatologists may consider it for females who do not respond to oral contraceptives or have polycystic ovary syndrome (PCOS).

Light and laser therapy

A dermatologist may recommend and perform laser or light therapy for acne. This involves exposing the skin to a special type of light during regular sessions for a set period.

There are different types of light therapy:

  • Red, blue, or infrared light therapy can treat pimples but not whiteheads, blackheads, cysts, or nodules.
  • Photopneumatic therapy can help unclog pores — treating whiteheads and blackheads but not cysts.
  • Photodynamic therapy can successfully treat severe acne, but it is more expensive.
  • At-home light therapy devices can treat pimples, but the light is less intense than the one a dermatologist uses.

For lesions that leave noticeable scars, a dermatologist can use procedures such as laser treatments, microneedling, and chemical peels to reduce their appearance.

People must visit dermatologists or plastic surgeons with the appropriate qualifications and experience for treating acne and reducing scars. Visiting someone or a clinic that does not have such expertise and the best equipment can result in disappointment and more harm.

Below is an overview of the treatments included in this article.

Prescription-onlySuitable for long-term prevention and care
Cleansernoyes
Retinoidsnoyes
Moisturizernoyes
Sunscreennoyes
Oral contraceptivesyesdepends on the individual
Oral antibioticsyesno
Isotretinoinyesno
Antiandrogen therapynono
Light and laser therapynodepends on the individual

The acne-friendly skin care routine outlined by the AAD can help prevent back acne as well as treat it. A gentle cleanser, non-comedogenic moisturizer, and adequate sun protection can be an effective route for a person to take.

Other skin care strategies that can prevent or reduce acne and skin irritation include:

  • regularly washing bed linens, towels, and pillowcases
  • regularly washing clothes, particularly tight-fitting ones, such as bras or binders
  • avoiding wearing things that rub against the back, such as backpacks
  • exercising in loose-fitting clothes made from natural fibers, such as cotton
  • showering and changing clothes immediately after exercise or using cleansing wipes
  • washing workout clothes and equipment after each use

Acne affects many people. Certain factors that can contribute to or raise the risk of its development include:

Puberty

Teenagers often develop acne, possibly due to the increase in testosterone during puberty. Testosterone plays a key role in stimulating the growth and development of the testicles and penis in males and maintaining bone and muscle strength in females.

Experts believe that testosterone causes the sebaceous glands to overproduce sebum, increasing the likelihood of blocked pores. Acne may improve when the person enters adulthood.

Family history

A person is more likely to develop acne if one or both parents have had it.

If both parents had acne, a person might be more likely to develop it at an early age. If a person’s parents had acne as adults, the person might also be more likely to have it during adulthood.

Sex

Males are more likely to develop acne than females, according to a 2022 overview of acne.

Other triggers

Other factors that may cause acne or trigger outbreaks include:

  • certain medications, such as steroids and some forms of hormonal birth control
  • cosmetic products that are not non-comedogenic
  • regularly wearing items, such as backpacks, that rub or irritate affected areas of the skin

There is also some evidence that dietary factors can worsen or improve acne. According to the AAD, some studies have shown that a low glycemic index diet reduces acne. This involves eating “slow-burning” carbohydrates, which do not cause blood sugar to spike, and avoiding unhealthy foods such as bread, doughnuts, and potatoes.

Also, some studies have found an association between cow’s milk and higher rates of acne. However, the link is unclear, and there is no evidence that other dairy products, such as yogurt or cheese, cause acne.

Below are answers to the top frequently asked questions about back acne.

Will back acne go away by itself?

The UK National Health Service (NHS) writes that acne often goes away when a person is in their mid-20s.

However, a person should talk with a doctor about their back acne to discuss treatment and how to manage acne at home to reduce the risk of scarring.

Does scrubbing your back help acne?

No. Scrubbing acne can increase inflammation, cause scratches or wounds, and increase the risk of scarring. People can gently exfoliate their skin once a week to remove dead skin cells and dirt from their back.

Should I moisturize back acne?

Yes. Using a gentle, non-comedogenic, and fragrance-free moisturizer can help to keep the skin hydrated. This helps repair the skin’s moisture barrier, which acne can impair. Dry skin can cause an overproduction of sebum, which contributes to the formation of acne.

Back acne, or backne, occurs when dead skin cells and oil from the sebaceous glands block pores, causing inflammation. It can be harder to see and reach acne on the back in order to treat it. However, a range of effective OTC and prescription treatments are available, and using an applicator can help.

To prevent acne and help to reduce it, a person should adopt a regular, gentle skin care routine. They should also change out of sweaty clothing after exercising, change bedsheets regularly, and avoid harsh soaps and comedogenic products.

In addition, back acne can worsen if a person regularly wears clothing or accessories that rub against their back, such as a tight-fitting bra, a backpack, or binders.

A person should speak with a dermatologist about severe or persistent acne. Some acne-like lesions result from different health issues, which require different treatments.

Read the article in Spanish.