Medically reviewed by Minimalist Health Specialist -  Written by Arpita Singh (Beauty Expert)  on 25th Sep 2020

Is Back Acne Making You Uneasy? We have Solutions

Is Back Acne Making You Uneasy

What Does Back Acne Look Like?

One morning you wake up and find yourself struggling with an itchy back. You sit up and try to feel your back, wondering what went wrong overnight?

You get your answer. Bumps! Some small and some big. The skin has also turned rough and uneven. Well, that's bacne (back-acne) saying hello, before going on a full-fledged battle on your back!

Also, don't be under the impression that it has taken only a single night for the lesions to pop up.  

What Does Back Acne Look Like?

They may have been preparing to make an appearance from a week or two or more. 

Did You Know?

Bacne (or, Truncal acne) is the second most common acne form after the facial breakouts.  

You have got the maximum sebaceous glands on your face, shoulders, back and buttocks. These areas are favorite spots for acne to form and grow. Your back has got larger pores, and the acne developing here, are bigger than anywhere else occurring on the body. As a result, they can be more widespread and a bit too much to bear for long, without any adequate help. 

Why Does Acne Occur In General?

Here's a Quick Glance

You know, you have sebaceous glands beneath the surface of your skin, secreting oils (mainly, sebum). They connect to particular channels called follicles, which again open at the skin's surface in the form of minute holes, called pores.

A hair often rises out of each follicle and sticks up on the surface. Generally, the oils help to keep the skin moist.

Sometimes, due to the hormonal irregularities or unhealthy lifestyle practices, these are produced in excess and lead to pores clogging. The dead skin cells build up and accompany the process. The microbes do the needful, and a pimple is all set to go live on your skin. 

The Two Forms of Acne

1) Inflammatory acne:

The clogged follicles have open walls, and inflammation happens around the lesions.

Papules come as small, pink tender bumps, while pustules are white or yellow pus-filled, with a reddened base.

Nodules can pin deep beneath the skin and form hardened, painful lesions. Microbial activity hugely aggravates the situation of nodules. And lastly, you have the cysts.

The most critical type of acne, which penetrates the skin deeply, causing large, pus-filled, and severe acne. These usually leave a permanent scar. 

2) Non-inflammatory acne:

The oil and dead skin cells jam the follicles, which remain closed, form the whiteheads. However, if their tips open up and attain a black-point appearance, they are called the blackheads. 

What Causes Back Acne? 

  • The tight-fitting clothes trap sweat and dirt beneath them and push the same deeper into the pores. It sets the ground for acne to develop. Lying without a shirt on the gym floor is not a healthy practice. 
  • Any object which puts pressure on your back or generates friction and heat between its surface and your skin (on the back) is a potential cause for acne

Kara Shah, a board-certified general and pediatric dermatologist, Cincinnati, Quotes 

Heavy backpacks, sports gear, back braces, etc. can also lead to major breakouts on your back. And, this is particularly known as the acne mechancia

  • If you are following an unhygienic routine, you are putting yourself in danger. After a workout session, not taking immediate showers or not removing sweaty, dirt-ridden gym apparels causes breakouts.
  • Back acne is a common problem for teenagers, passing their puberty.

    For adult females, the lesions can still show up during menstruation and pregnancy. Males, too, experience acne on their back because of the excessive testosterone levels.

    The hormonal imbalance in the bloodstream can cause the hormones to shoot straight to its receptors present in the skin cells within the sebaceous glands. After this, they shed out of the pores. But their presence can actively increase oil production in the skin cells and lead to acne. 
  • Your genes can sometimes be the culprit. If you have got the acne tendencies as part of your genetic inheritance, they are bound to happen. 
  • The side effects of certain medications (mainly, anti-depressants) can result in acne.

    Laser therapies can spring up the pimples many often. The stress, your hectic schedules gift you can also be a contributing factor. 
  • According to Dr. Renita Ranjan, a dermatologist based in Chennai, aggressive shaving or waxing may increase acne.
  • The American Academy of Dermatology states that if one takes plenty of hyperglycemic food (ones made up of simple sugars) such as white bread, potato, pasta, white rice, etc., then the risks of developing acne rise all the more.

    As these food items increase the blood sugar levels, which induce the secretion of insulin hormone. Insulin, in turn, causes the oil glands to produce more oil. And this directly impacts your skin. 
  • PCODs (polycystic ovarian diseases) can lead to truncal acne.
  • Seborrheic dermatitis is a skin condition that causes scaly patches and red skin, mainly on the scalp. It can lead to stubborn dandruff, which, for sure, results in acne. 

How Do You Keep Acne At Bay?

Precautionary Measures That You Can Follow.

By implementing a few changes here and there in your daily lifestyle, you can quickly treat mild to moderate acne. However, if you have a genetic predisposition to acne, it cannot be controlled. You can still work on lessening its spread and take proper steps to get rid of them

1) Personal hygiene and clothing

  • Wear clothes that hang loose on your body. They will not irritate the hair follicles, and your pores can breathe (i.e., function) freely. 
  • Use cotton or any gentle fabric that can wick the sweat out of the clothing article. 
  • After workouts, hop right in a shower and wash all the sweat and dirt off your body. Change into a fresh set of clothes. 
  • Also, do clean your gym wears. The pillows, bedding, and towels need to be washed at regular intervals.
  • Be cautious about the detergent you use. Fragrant detergents can be tough on your skin and disturb the hair follicles. This will lead to inflammation, which is almost like dropping a formal card to invite the acne. 

Good to know.

If your workout regimen consists of the cardiovascular and strength training portions, then try and change outfits in between the two.

2) Diet and food habits

Eat a well-balanced diet, and have a regular intake of complex carbohydrates and proteins. This may include green leafy vegetables, fruits, lean proteins and whole grains.

Also, you can add zinc, vitamins A & E, and antioxidants to your diet plan. 

3) Haircare routine

  • If you have long hair, always keep them off your back. Maybe tie it in a bun or ponytail. "The long hair transfers the dirt and oil to your neck and back," says Dr. Ranjan. 
  • While washing your hair, flip the entire of it to your front. Rinse in the forward direction to prevent the residue of conditioners and shampoos from dripping down to the neck and back as this may cause the blocking of pores. 
  • After washing your hair, rinse the body adequately. 
  • Pick the right shampoo and conditioner for yourself. They should be non-comedogenic, i.e., they don't clog the pores. Don't use hair products that contain sulfates. 

4) Skincare routine

  • Avoid using astringents, harsh antibacterial soaps, or aggressive scrubs on the back when covered in acne. 
  • "Chemical exfoliation can be beneficial to deal with acne," says Dr. Rajiv Sekhri, MD, dermatologist, Noida. "If used in the right amounts, it sloughs off the dead skin cells, kills the bacteria, and brings your pores back to their healthy selves." 
  • Adopt a daily cleaning format for yourself. Wash your face in the morning and evening. Use a mild cleanser with the active acne-fighting ingredients, like benzoyl peroxide or salicylic acid
  • Dr. B.S. Chandrashekha, a dermatologist from Bangalore, says, "In the summer season, it is better to use lotions than body creams. As they have less oil content, and focus more on hydrating the skin."
  • Most importantly, skincare products or cosmetics labeled as non-comedogenic should only be used. Even the sunscreens you apply, should be able to quick or light dry.
  • Don't pick at the acne lesions. The skin on the back heals slowly. If you disturb the acne frequently, it can leave you brown spots or permanent scars.

5) Natural remedies 

  •  Aloe vera: A natural astringent, having antimicrobial qualities. It smoothens and rejuvenates the skin. 
  • Tea tree oil kills the extra acne bacteria.
  • Baking soda: It is known to exfoliate the skin and neutralize the pH of the skin.
  • Lemon juice contains citric acid and helps in effective cleaning of the pores. 
  • Apple cider vinegar mainly fights the acne bacteria and maintains the pH balance of the skin. 

Medications that you can take for acne

Over-the-counter treatments

If the natural remedies and preventive measures are not improving your acne, you should go for medical skincare product0s. Two of the most reliable ingredients that put a great defense line against acne are benzoyl peroxide and salicylic acid. 

Did You Know?

Both benzoyl peroxide and salicylic acid turn your skin sensitive to the sun. And, it is a fact that sun exposure can worsen acne in general. So, apply sunscreen sufficiently every time you step out during the day.

Also, both ingredients can cause purging. But the symptoms subside after a month or less.

1) Benzoyl peroxide (BPO)

It is primarily used for the treatment of inflammatory acne, which includes the red, pus-filled pimples. It is an oxidizing agent and produces an aerobic environment as it perforates deep into the pores, killing the bacteria associated with acne.

BPO products (these don't need a prescription)

Concentration range

Frequency of application 

1. Body washes 

4% - 10%
If you are new with a BPO body wash, start with a 4% concentration.

Use it once daily.

Over time, you can increase it to 2 -3 times on a regular basis. 

2. Gels

2.5% - 10%

Initially, begin with the lowest 2.5% preparation.

Once or twice a day.

In the morning and at night. 

3. Creams/lotions 

2.5% - 10%

1 - 3 times, on a daily basis.

As part of morning and night skincare routines. 

4. Cleansing bars/soaps 

Usually, cleaning bars or soaps have a lower concentration of the active ingredient, BPO.

Once or twice a day.

In the morning and at night. 

5. Medicated pads and sponges 

2% - 5%

Once or twice a day.

In the morning and at night.

BPO takes a minimum of 3 - 4 weeks to procure the first signs of relief. For an overall recovery from the acne, it may take 8 - 12 weeks. 

Advice From Minimalist:

Benzoyl peroxide is a potent bleaching agent. Avoid using it before any strenuous physical activity, as the sweat may transfer the product to your hair.

As you apply BPO at night, you can wear an old t-shirt and use old pillow covers. This will help to protect your clothes and other objects from damage. 

2) Salicylic acid (SA) 

It is a beta hydroxy acid and is used to exfoliate the skin chemically. It breaks through the layers of dead skin cells on the surface and dives deep into the congested pores. It flushes the skin debris and sebum out, relieving the acne.

It is mostly used for treating non-inflammatory acne. 

SA products (these don't need a prescription)

Concentration range 

Frequency of application

1. Solutions 

0.5% - 2%

1 - 3 times a day.

To be used in the morning and at night. 

2. Gels 

0.5% - 5%

If you are a fresher with SA, start with a lower concentration.

Apply it once daily.

It is used in the morning and at night. If used for spot treatment, it can be even used midday. 

3. Lotions

1% - 2%

1 - 3 times daily.

In the morning and at night. 

4. Ointments 

3% - 6%

As per your requirements, or as guided by a dermatologist. 

5. Cleansing bars/soaps

0.5% - 5%

It depends on the severity of acne and how easily your skin adapts to the effects of salicylic acid. Use it wisely according to your needs. Or, take in a word from your dermatologist.

6. Medicated pads

0.5% - 5%

1 - 3 times a day.

In the morning and at night.

High concentrations (2%) of salicylic acid is used in the chemical peels. They usually occur in combination with alpha-hydroxy acids. It can be used 1 - 2 times a week, preferably at night. 

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Exclusive From Minimalist:

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For the first visible changes on the surface, SA may take 4 - 6 weeks. But to get the best of results, use it consistently for around 12 weeks.

How about using benzoyl peroxide and salicylic acid together in your skincare routine? 

Both ingredients, even if used separately, cause considerable dryness to the skin and result in its peeling. Therefore, if you have sensitive skin but wish to go with the potent combination of BPO and SA (for your severe acne), do consult a dermatologist first.

In case you don't have sensitive skin, you can very well incorporate the two ingredients in your daily regimen. Still, you need to be extremely careful about the dosage and the time gap between their applications. 

Word of Advice:

Applying the products on the same area of the skin can hugely irritate your skin even at different times of a day.

Excessive dryness, redness and peeling, are the symptoms that you could suffer from.

Please use SA for the overall management of acne, and BPO as an anti-acne mechanism for particular spots or areas.

There is always an option to use the two products on alternate days. It can help you to reduce the dryness that your back may experience.

Try using a SA cleanser in the morning and a BPO lotion at night. Prefer using lower concentrations initially. You may also use a BPO cleansing bar daily (1-3 times), and combine it with a chemical peel containing SA (using 1-2 times a week). 

The Bottom line

BPO "can dry your skin and your soul," as remarked by a customer. If we compare SA and BPO, the latter causes more dryness.

Taking the two as a combination can double the side effects. So, never try to use them more than the recommended guidelines.

Acne is a skin condition that will come to you at some point or the other in your lifetime. You cannot run away from it. However, you can mend the situations and turn them in your favor. Maintain a healthy lifestyle, and you will able to prevent them at your best.

Keep in mind to take all the necessary steps as soon as you find the first signs of acne appearing. Be quick to respond, and you will quickly realize that you could almost beat acne.