What causes back acne? Well, like most pimples, “bacne” (found on the back, upper arms and even the buttocks) is born when pores get clogged. Pores get clogged when too much sebum is produced, and this excess sebum is produced when our sebaceous glands really get going . . . which is about exactly the time we start caring how we look, of course. It’s nature’s best practical joke, puberty. So, when our pores get clogged with an excess of oil (the sebum), dead skin cells can get stuck in there too. This mess often attracts bacteria, and then it’s usually over: you’ve got acne.
Back acne can be especially tough because there are more sebaceous glands in this area than on most other parts of your body, and the skin is thicker — which tends to make it more resistant to treatment. As far as whether stress is to blame for your back acne, or hormones, or genetics — no one knows for sure. It’s possible that all of these could be factors, but it’s not proven. Because of this, most experts agree that rather than worry too much about the cause of acne, it is more beneficial to concentrate on its treatment. And so, for ways to get rid of back acne, read on.
Treating Back Acne at Home
If you want to get rid of back acne, wash regularly. Use an anti-bacterial soap, and try for washing twice a day. Be careful not to over-wash, though, because this can irritate your skin and dry it out. It is also important to shower as soon as possible after any activity that has caused excessive perspiration. When perspiration gets trapped against your skin, it can mix with oils and further clog your pores, which will exacerbate your back acne. This is not good.
Exfoliate on a daily to weekly basis to help get rid of dead skin cells that can worsen back acne. Because the skin on your back is thicker than the skin on your face, this is generally safe to do. Experiment with different types of exfoliators — washcloths, loofahs, brushes — and watch your skin for any worsening of the acne or extreme irritation. If you use a scrub, try a sugar-based one rather than one with salt — this will be milder on your skin. Also, reduce the number of times per week you exfoliate if you notice any bad reactions.
Use a medicated cream or gel like benzoyl peroxide or salicylic acid if you are going to get rid of back acne. It is best to choose one or the other of these, however, because they can interact negatively with each other if mixed. If you use a benzoyl peroxide (bp) product (some experts have found this to work better than salicylic acid), try to find one with 2.5% bp — this dose has been effective for many people. Apply to your back about ten minutes after washing, twice a day. Be sure you allow time for drying, as these medicated gels can have a bleaching effect and damage clothing. Also, because both benzoyl peroxide and salicylic acid tend to be drying, it is good to follow up with an alpha-hydroxy moisturizer.
To help get rid of back acne, keep your fabrics clean. This includes towels, pillowcases, bedsheets, t-shirts and bras – and anything else you can think of that might touch your back. Dirty stuff attracts bacteria, and bacteria is really good at starting back acne, so . . . laundry day might have to happen more often. If you’re anything like me, this may be a challenge. In that case, good luck. To avoid the possibility of irritation, be sure that your detergents and fabric softeners are hypoallergenic. Natural food stores are good places to find products that are environmentally friendly and chemical free.
If nothing seems to get rid of your back acne, see a dermatologist. As I mentioned before, back acne is tough to deal with. You should usually give any new skin regimen at least a few weeks before quitting (unless there’s irritation), but sometimes nothing you try will give you the results you want. Seek help, too, if you find that you are overly anxious, have low self-esteem or experience depression. There are several back acne treatments that a dermatologist will be able to offer that could make a huge difference for you.
Do Tight Clothes Cause Back Acne?
People with back acne often wonder if there’s something they are doing to cause the breakouts. There are many myths out there, some of them closer to what could be true than others, but no one thing that is the root of back acne. Wearing tight clothes (think spandex or a wetsuit) probably doesn’t cause back acne. That’s not to say, however, that doing so will help your situation. Clothes that don’t allow breathing room, or items that constantly rub against the skin, most likely aggravate any existing conditions — like back acne — by trapping sweat that will mix with skin oils. Obviously you can’t start going shirtless (very often), but there are measures you can take to reduce friction on your back. Wear loose-fitting clothing and collars, and, whenever possible, use a hand bag instead of irritating purse straps or clunky backpacks. After all, acne or not, do you really want to look like Mr. Backpack here?
Back acne can take the form of pimples, blackheads, or whiteheads, but often they come as deep, painful cysts — the most difficult to treat and most likely to scar. In this case, it is best to see your dermatologist, who may prescribe an aggressive topical treatment such as Retin-A or one of a number of antibiotics. Many doctors have found that the most effective treatment for cystic acne is the isotretinoin drug Accutane, an effective but highly controversial option. There are many factors to consider before starting a drug like Accutane, all of which should be discussed with your dermatologist, but the most important relates to pregnancy. Because of the high correlation between isotretinoin drugs and birth defects, Accutane should never be taken if there is any chance at all you could become pregnant.
If back acne has left you with dark discoloration or acne scars (either elevated or depressed), then cosmetic surgery may be an option for you. It is best to discuss this and any other concerns with your dermatologist.