Back acne (or “bacne”) is one of the most common yet ignored skin concerns. Just like facial acne, it can range from mild congestion to painful cystic breakouts and it can be just as stubborn. Even worse, the location often makes it hard to treat properly or monitor response. Despite all this, there’s some good news! There are actually highly effective ways to treat and prevent back acne. In this article. we’re going to explore the underlying causes of back acne and how to prevent it. We’ll also review the best products and treatments to get rid of back acne.
What is Back Acne & What Cases it?
This is a blanket that usually refers to pimples that develop on your back, shoulders and sometimes even the upper arms. Like on the face, back acne usually occurs due to a combination of clogged pores, excess oil (sebum), inflammation and sometimes bacteria. Although back acne is very common in teens, adults can also struggle with it. Regardless of age, back acne can be harder to manage because of its location and the thicker skin on this part of the body.
Understanding the cause of back acne is key to choosing the right treatment and prevention strategy. However, there isn’t usually a single cause for developing acne on your back. It’s often due to a combination of factors and the most common causes include:
- Overactive Sebaceous Glands: When your skin makes too much oil, it can mix with dead skin cells. This can clog pores. Furthermore, acne forming bacteria on the skin (P.acnes) thrive in this environment of clogged pores and excess sebum. This triggers inflammation and acne,
- Sweat & Friction (Acne Mechanica): This is a type of acne that occurs due to tight clothing, sports gear or backpacks. These can trap sweat and irritate the skin to trigger breakouts.
- Hormones: Just like with facial acne, excess androgen levels or increased activity of these hormones on the skin can increase oil production. This leads to breakouts and is common during puberty, menopausal and medications like progesterone only contraceptives.
- Lifestyle: Not showering after sweating, using comedogenic products or skipping exfoliation can all worsen back acne.
- Genetics: If you have a family history of acne or currently suffer from facial breakouts, you might have a higher chance of getting acne on your back.
- Health: Conditions like Polycystic Ovarian Syndrome (PCOS), Thyroid dysfunction and excess Cortisol production can all trigger back acne.
Types of Back Acne
Back acne can present in several different forms. Its important to try and figure out which type or types you have. This can help determine the best treatment to help get rid of back acne. In general, the main types of acne on the back are:
- Comedonal Acne: This typically presents as blackheads and whiteheads which are due to clogged pores. This type of acne is typically non-inflammatory but can progress if left untreated. Comedonal acne usually responds well to exfoliants like salicylic acid or glycolic acid which help keep pores clear. Retinoids can also be helpful in preventing future acne.
- Papules & Pustules: These are red inflamed bumps (papules) and pus-filled spots (pustules). They signal infection and inflammation within the pores. This form of inflammatory acne usually benefits from a combination of anti-inflammatory and antibacterial ingredients such as benzoyl peroxide, niacinmaide and azelaic acid. If it persists, prescription antibiotics or retinoids may be necessary.
- Nodules & Cysts: These are larger, deeper and often painful breakouts that can lead to scarring. These often require prescription treatments such as antibiotics, hormonal therapy or oral isotretinoin. In-clinic procedures like chemical peels or laser may help support long-term management.
- Acne Mechanica: These type of acne breakouts are often due to tight clothing, sports equipment or backpacks. It type often improves with lifestyle changes (e.g. breathable clothing and showering after exercise) as well as gentle exfoliation.
Best Skincare Products for Back Acne
Unless your acne is severe or painful, over-the-counter treatments are a great starting point for most people. These products are generally easy to access and can be highly effective for getting rid of mild to moderate back acne when used consistently. The best ingredients to look for when choosing skincare products for back acne include:
- Beta Hydroxy Acids (BHAs): Salicylic acid and other BHAs are exfoliants that help dissolve oil and dead skin inside pores. This helps unclog pores and is ideal for blackheads and whiteheads. It can also help prevent development of inflammatory acne lesions like papules and pustules. BHAs can also help improve skin texture and fade post inflammatory hyperpigmentation.
- Benzoyl peroxide: This is a powerful antibacterial agent that kills the bacteria involved in acne formation and helps reduce inflammation. It’s particularly effective for mild to moderate inflammatory lesions like papules and pustules. Benzoyl peroxide can also help prevent progression to cystic acne when used regularly.
- Niacinamide: A multi-tasking antioxidant, niacinamide calms inflammation and supports the skin barrier. It’s suitable for all types of back acne but particularly beneficial for mild inflammatory lesions.
- Sulphur: A natural mineral with keratolytic properties, sulphur helps to dry out superficial acne by absorbing excess oil and gently exfoliating dead skin cells. It also has mild antibacterial effects, making it effective for managing mild inflammatory acne and preventing clogged pores.
- Zinc: This trace element has soothing, anti-inflammatory properties that can calm redness and irritation. It also helps to regulate oil production. Zinc is commonly used in both topical treatments and supplements for acne-prone skin. It’s especially helpful for sensitive or reactive skin types with inflammatory back acne.
- Azelaic Acid: A gentle but effective anti-inflammatory and antibacterial agent, azelaic acid also helps prevent blocked pores and reduces pigmentation from old breakouts. It’s suitable for all skin types and is especially useful for those with sensitive skin or for treating acne alongside post-inflammatory hyperpigmentation.
- Retinol: This over the counter form of vitamin A increases cell turnover, prevents clogged pores and supports collagen production. While not as potent as prescription retinoids, it’s still effective for treating comedonal acne and improving overall skin texture as well as evening out tone.
Prescription & Professional Back Acne Treatments
If your back acne is cystic, painful or unresponsive to over the counter treatments, it might be time to seek help from a doctor or specialist healthcare provider. They can carefully asses your skin and where appropriate provide prescription or in office treatments that can help get rid of your back acne.
Prescription treatments can help address some of the underlying causes and provide more comprehensive treatment for moderate to severe back acne. Some of the most widely used prescription treatments for back acne include:
- Topical Retinoids: These vitamin A derivatives help unclog pores and promote skin turnover. The most commonly used prescription topical retinoids for back acne include adapalene, tretinoin and tazarotene. They’re suitable for all types of acne.
- Topical Antibiotics: This includes drugs like Clindamycin which reduce acne causing bacteria and inflammation directly at the site of breakouts. They’re commonly prescribed with benzoyl peroxide or retinoids to prevent antibiotic resistance. Topical antibiotics are best for moderate inflammatory back acne.
- Oral Antibiotics: These are used short term for widespread or painful acne on the back and include drugs like Doxycycline. They work to reduce bacteria and inflammation but are typically combined with topical treatments to ensure transition and long-term maintenance.
- Hormonal Therapy: Treatments like the combined oral contraceptive pill or anti-androgens (e.g. spironolactone) regulate hormones that trigger excess oil production. They’re especially effective for cyclical or hormonally driven back acne in women.
- Oral Isotretinoin (Roaccutane): This is a powerful vitamin A derivative that targets all the major causes of acne including excess oil, clogged pores, inflammation and bacteria. Due to potential side effects, roaccutane is reserved for severe, cystic or treatment-resistant back acne. It also requires close medical supervision throughout treatment.
Professional in-clinic procedures can be a useful addition if your back acne is stubborn or if there is scarring or hyperpigmentation. Whilst there are a lot of treatments available, there isn’t adequate scientific evidence for most of them. In fact very few if any can get rid of back acne on their own so often they’re best part if a multi-pronged approach. As such a lot of background reading and expectation setting is needed! Some of the most effective professional treatments for back acne include:
- Chemical Peels: Professional peels like Jessner’s, salicylic or glycolic acid can help deeply exfoliate the skin, unclog pores and reduce active breakouts. They can also help fade post-acne pigmentation and improve skin texture over time.
- Light Therapy: Whilst more data is required, there’s evidence that specific wavelengths of blue and red light can help to kill acne-causing bacteria and calm inflammation. This can help reduce active lesions and support healing.
- Microneedling: This procedure uses fine needles to create controlled micro-injuries in the skin, stimulating collagen production and promoting renewal. Whilst it can’t treat acne, microneedling is helpful for back acne scarring and uneven texture.
- Laser: These target the deeper layers of skin to reduce oil gland activity, control inflammation and improve post-acne scarring or hyperpigmentation. Fractional and non-ablative lasers are commonly used on the back to enhance clarity and skin tone with minimal recovery time.
- Surgery & Extraction: In cases of large, painful cysts or nodules, surgical drainage or excision may be necessary to remove the lesion and prevent further inflammation or scarring. Dermatological extraction, can also help clear stubborn comedones or closed lesions. These interventions are usually reserved for resistant or severe back acne when other treatments and products have failed.
Tips for Preventing & Getting Rid of Back Acne
Preventing future breakouts involves a combination of good skincare, healthy habits and avoiding common triggers. Regardless of whether you have prescription or professional treatments, tackling back acne effectively requires a consistent skincare routine. This alongside a few lifestyle measures will ensure that you maximise your chances of getting rid of back acne and maintaining your results. Here are our top tips of tackling and preventing back acne:
- Gently Cleanse Skin Daily: Use a gentle but effective cleanser to remove oil, sweat and debris from the skin. It’s especially important to shower soon after working out or sweating. Avoid harsh scrubbing as this can worsen inflammation and disrupt the skin barrier.
- Exfoliate Regularly: Chemical exfoliants like salicylic acid, azelaic acid or enzymes can help unclog pores and prevent breakouts. They can also help improve skin texture and even out skin tone. Use them up to 2-3 times a week depending on your skin’s tolerance.
- Actively Treat Breakouts: Leave-on products with acne-fighting ingredients such as niacinamide, benzoyl peroxide or retinoids can reduce inflammation, kill bacteria and prevent new spots from forming. Look for formulations that are designed for body application or come in spray formats to make applying on your back acne easier.
- Wear Breathable Loose-Fitting Clothing: Minimise friction by avoiding tight straps, heavy backpacks or synthetic materials that trap sweat. This simple switch can reduce irritation and prevent flare-ups. Also change and wash clothes regularly (particularly bras and gym wear).
- Introduce Skincare Products Gradually: This will help reduce the risk of purging, irritation or sensitising your skin.
Whilst frustrating, back acne is a highly treatable skin condition with the right approach. From over the counter skincare products to prescription and professional treatments, there’s a range of options to help get rid of back acne. The best treatment will depend on your skin concerns, triggers and goals. You’ll also need to be patient and consistent. If your back acne is persistent or severe, try to seek medical help early to ensure you have access to the most appropriate treatment options. Just remember acne, including on the back, is often a chronic condition. So alongside getting of back acne your treatment should also focus on maintenance and prevention.
At City Skin Clinic, we are passionate about personalised skincare. Through our online skin clinic, our doctors offer safe and effective treatments using ingredients like Tretinoin, Spironolactone and Hydroquinone where appropriate. We treat a range of skin conditions including acne, hyperpigmentation, melasma and skin ageing. To start your personalised skincare plan, book a virtual video consultation or use our online consultation form. The journey towards great skin starts here.
