Back Acne: Causes, Prevention, and Treatment Options
Originally published November 12, 2015. Updated on December 13, 2021.
Acne occurs in any area of the skin with hair follicles, meaning that all hair-bearing areas of the skin are susceptible to acne breakouts. Acne is typically associated with the face, but other areas of the body can experience breakouts too. Pimples can arise on the chest, neck, shoulders, upper arms and even buttocks. More commonly, breakouts occur on the back. Like the face, the back has numerous oil-producing pores that can easily get clogged. Back acne is so common it even has its own nickname: “backne”. This form of acne affects more than half of all acne sufferers and can be not only an aesthetic concern, but also extremely uncomfortable and painful.
While back acne is easier to hide than face acne, having even a mild case can make people feel subconscious and uneasy. Fortunately, you do not have to live with backne! Learn more about what causes back acne and how to prevent or treat it.
What Causes Back Acne?
Acne on the back develops just like facial acne: the combination of excess oil, dirt, other debris, and bacteria become trapped in the pores creating lesions and blemishes. The type of acne that occurs depends on the pore’s reaction. For this reason, back acne can run a similar gamut of types including:
- Whiteheads, otherwise known as closed comedones, develop when clogged pores stay closed, forming a small white bump.
- Blackheads, or open comedones, occur when clogged pores open to the air. Impurities inside oxidize and turn black.
- Papules are lesions that appear as small pink bumps, the result of inflamed clogged pores.
- Pustules, commonly known as pimples, are pus-filled papules with an inflamed reddish base.
- Nodules form when bacteria is trapped in the pore, causing the formation of a hard, painful bump deep below the skin’s surface.
- Cysts also extend deep below the skin’s surface. This larger, pus-filled acne results in a painful lump that can lead to scarring.
Though acne can worsen from certain lifestyle activities or poor hygiene, the cause of acne has many factors.
The back is susceptible to acne thanks in part to sweat glands and friction from athletic gear, chairs or tight clothing. Acne Mechanica is the term for breakouts that are triggered by sweat and physical friction.
Sometimes, back acne is caused by prescription drugs. Drugs for depression and anxiety, corticosteroids and steroids all tend to cause acne.
Back acne may also be the result of hormonal changes and is often worse during puberty, menstruation or pregnancy.
Genetics also play a role in your likelihood of developing back acne. Those with oily skin and large pores are more likely to experience breakouts.
Back acne differs from facial acne in two significant ways:
- Skin on the body is more prone to clogging as it has larger pores and is thicker than facial skin.
- Oil-producing glands on the back tend to be more active than those located on the face, which most often leads to larger, more inflamed acne known as cystic acne.
How To Prevent Bacne
While there is no foolproof way to prevent back acne development, there are some simple and effective ways to limit breakouts. Preventing back acne requires reducing oil production, keeping skin clean, and minimizing irritation via sweat and friction.
Reducing friction against the back can keep skin clean and prevent pores from getting clogged. Consider the following:
- Wear clean, loose-fitting shirts with loose collars
- Wear removable layers to avoid sweating
- Avoid heavy backpacks or purses with wide straps
- Remove wet or sweaty clothing immediately after exercising
- Keep athletic pads or gear clean and dry, and wear clean cotton t-shirts underneath
- Keep sheets and pillows clean and dry
Preventative Skin Care for Back Acne
In addition to the above, the following skincare tips will help minimize back acne:
- Bathe or shower immediately after sweating to remove excess oils and debris before they can clog pores. If you are unable to shower immediately following a workout, carry cleansing wipes with you to use on the areas that you most often have acne breakouts.
- Avoid overusing topical steroids, unless prescribed by your dermatologist. Corticosteroids are known to cause acne and other skin changes and should not be used in excess.
- Avoid aggressive scrubbing, which can irritate skin and spur oil production.
- Avoid oil-based skincare products in favor of using body washes and lotions formulated for acne prone skin. All products that you are using on your skin should be designated as ‘non-comedogenic’, meaning they do not clog pores or cause acne breakouts. This should be printed on your products, likely near the ingredients list.
- Use an over-the-counter Benzoyl Peroxide wash to cleanse your skin in the shower. This helps with inflammation and to cut down on bacterial overgrowth. Be sure to note, however, that all products with benzoyl peroxide have the potential to bleach fabrics if they are not washed off thoroughly.
- Use a soft washcloth versus loofahs, brushes or exfoliators
- Avoid harsh astringents, abrasive scrubs or antibacterial soaps
- Select a body wash containing either salicylic acid or benzoyl peroxide
- Choose oil-free cleansers, moisturizers and lotions labeled as non-comedogenic
- Select gentle, fragrance-free products
Eliminate Acne-Inducing Habits
In addition to keeping your back clean and dry, consider the following habit changes:
- Avoid or minimize use of acne-causing medications. Talk to your doctor about alternative treatments.
- Don’t pick, squeeze or pop pimples. This can worsen acne, damage skin, and lead to discoloration or scarring.
- Avoid excessive sun exposure. UV rays can darken acne and inflame skin. Protect yourself with cool, light clothing and a non-comedogenic sunblock.
Treating Back Acne
It is important to understand that even with the best hygiene, skin care regimen and attention to prevention techniques, your skin can still have acne breakouts. To avoid prolonged discomfort from breakouts and potential scarring of the skin, if your acne does not respond to the prevention recommendations listed above, be sure to schedule with your dermatology provider.
Treating back acne, just like facial acne, can be challenging. Because everyone’s skin is different and responds differently to medications, there is not one treatment that works for everyone. If back acne is a problem for you, consider the preventative suggestions above. In addition, treat your acne with an over-the-counter acne cream or gel containing salicylic acid, benzoyl peroxide, sulfur or resorcinol. These products may be available as sprays, for easy application on the back.
Wait 4-6 weeks to let your skin respond to your new habits and product choices. If you see no change in your skin condition, it may be time to speak with a dermatologist. A doctor can prescribe stronger topical treatments and for severe acne, may prescribe oral medication.
With that in mind, your dermatologist will assess both your skin and acne breakouts to develop a personalized treatment regimen for you to follow. Some of the most common and effective regimens include:
- Topical Prescription Medications: Even if you have not had success with over-the-counter creams and washes, there are many prescription strength topical medications that are very effective in keeping back acne controlled. When treating back acne, topical medications are typically used in combination with other acne treatments due to difficulty of application, skin thickness and high oil gland activity.
- Oral Antibiotics: This can be a great option for inflammatory acne, especially in athletes and highly active individuals. Antibiotics are helpful in decreasing inflammation and the over-abundance of bacteria associated with back acne.
- Accutane: This prescription strength acne medicine is one of the most popular and effective ways to treat moderate to severe acne. Unlike traditional acne medications, Accutane has potential long-term benefits that continue after your course of treatment. This is one of the most important medications dermatologists prescribe to prevent acne scarring.
- CoolTouch Laser: CoolTouch® acne laser treatments safely and effectively treat acne, acne scars, and back acne with no downtime and minimal discomfort. The laser emits gentle pulses of energy that penetrate deep enough in the skin to shrink oil glands and decrease their capacity to produce acne without affecting the oils necessary for healthy skin. Learn More
- Blue-U light therapy. Blu-U is a unique treatment that involves the use of a high intensity, fluorescent blue light to the face. The fluorescent light technology kills the Propionibacterium (P. acnes), a bacteria that can worsen acne by causing additional inflammation and potentially allow acne to progress and spread.