Summer is the season of back-baring tank tops, halters and bathing suits — especially during scorchers like the ones we've been experiencing lately. If you're a fan of the season, you probably look forward to breaking out your favorite trendy pieces, but if you struggle with back acne, the experience doesn't come without a side of apprehension.
We asked dermatologists for their tips about managing and treating back acne (also commonly referred to as "bacne"), so you can feel confident and be ready to rock any style from the beach to the street.
What causes back acne?
Dermatologists agree that acne in general is a multifactorial issue, meaning that it stems from several different factors. While it can be caused by hormones and skin types, external factors can also contribute to the development of acne.
One of the most prevalent causes of acne, especially on your back, is an overproduction of sebum or oil, explained Dr. Erin Boh, MD, PhD, professor at Tulane University School of Medicine, and Dr. Katherine Lee, MD at Stony Brook Medicine. Lee also identified buildup of dead skin cells as another common cause of back acne.
Aside from genetics, Dr. Aaron Secrest, MD, PhD, MBA, vice chair of business strategy for dermatology at University of Utah, mentioned breakouts could often be classified as “mechanical acne" (also known as acne mechanica), which stems from external factors like wearing tight, compressive clothes that causes pores to become clogged. “I see it a lot with patients where, a tighter sports bra or tighter clothing and athletic wear, can compress that skin on the back and [make] it easier for acne to erupt right there,” he said.
Dr. Neelam Vashi, MD, director of the Cosmetic and Laser Center at Boston University, noted stress and diet as other factors that contribute to back acne.
How is back acne different from face acne?
It’s tempting to hear the word “acne” and assume it's all the same, no matter where it occurs on the body. While each dermatologist admitted that the treatments can be similar, back acne tends to be more difficult to treat due to the thickness of skin and how difficult it can be to reach this area.
“The skin on the back is very thick and blemishes on the back are often deep and stubborn, so it’s more difficult for topical treatments to absorb deep enough and may require prolonged treatment,” Vashi explained.
The type of acne that appears in each area can also differ, which can impact the way treatment is approached. There are typically two different types of acne: comedones and pustules. Comedones are the blackheads and whiteheads you’re probably most familiar with that occur on the face most often. Pustules, meanwhile, are an inflammatory type of acne that you are more likely to find on your back, explained Boh and Secrest.
These differences can also play a role in the treatment options that are available. “We have more options on our face to treat acne because we get more types of acne on the face,” Secrest told us.
Misconceptions about back acne
Like most skin care issues, there are plenty of misconceptions about back acne floating around that dermatologists have heard their fair share of.
- Specific foods make you break out. Vashi and Secrest both mentioned your diet playing a role in your acne, but Secrest says it’s not always specific food. “It’s not near as comfortable as saying ‘It was pizza’ or ‘It was chocolate,’” he said. What it really comes down to is the glycemic index, a scale used to determine how much certain foods increase blood sugar levels. Secrest broke the scale down simply: “If it’s a high glycemic index food, your body has to do nothing. It can just take the sugar out of your stomach and turn it straight into energy. If it’s a low glycemic index food, it means that your body has to do a lot of processing in the gut to make it useful for your body. High glycemic index is really not good for acne and the easiest way to remember that is if it brings you happiness or joy, it’s probably a high glycemic index food,” he laughed.
- Stress isn’t a factor. You might notice that you start to break out around high-stress events or disruptions in your normal routine. Before you go pointing figures at the sugary soda or candy you indulged in, Secrest and Vashi emphasized stress as a factor in developing acne. It’s not to say that the sweets can’t be to blame because stress and diet often go hand-in-hand, Secrest said. “We live in a very stressful society and I don’t think we’ve acknowledged that enough,” he added, before recommending visiting The American Institute of Stress for stress-relief techniques.
- You don’t need to moisturize. Not moisturizing can have the opposite effect of what’s intended. “Your body will compensate and start over producing its natural oils and so…making sure your skin is hydrated and moisturized is helpful,” Lee told us. She and Vashi recommend looking for oil-free and non-comedogenic products.
- Using scrubs and exfoliators will help. This is also the opposite of what you should be doing. Lee and Vashi both say exfoliating can irritate the skin and make your acne worse.
- Acne only happens during puberty. Given the varying factors that can cause acne, adults can also have breakouts well beyond puberty, Vashi noted.
- Popping acne is helpful. Spoiler: Popping your pimples doesn't help. “Doing this can lead to infection, inflammation and possible scarring,” shared Vashi.
- Sunlight and tanning can heal acne. Both Vashi and Lee specifically mentioned this myth. They agree that sun exposure can actually worsen acne and make it last longer, leading to further scarring, dark marks and post-inflammatory hyperpigmentation.
How to treat back acne
Treating back acne at home comes down to two star ingredients: benzoyl peroxide and salicylic acid. “[Those ingredients] will help desquamate those top dead layers, keeping the pores open so the oils can get out onto the skin and not be collected under the skin,” said Boh.
There are plenty of body washes on the market with benzoyl peroxide and salicylic acid. No matter which one you choose, Secret recommends leaving it on for a bit instead of immediately washing it off, so the product has time to soak into the skin a bit. Another option would be choosing a leave-on product with one or both of these ingredients to provide a more targeted treatment to certain areas.
Products containing benzoyl peroxide often specifically state the percentage of the ingredient it contains. Percentages can vary, but Secrest recommends looking for products that use between 2 percent and 5 percent benzoyl peroxide. You can choose a product with 10 percent benzoyl peroxide, but just be wary that it's not any more effective than a 5 percent product and it's likely to dry out your skin more, he noted.
Before you incorporate a benzoyl peroxide wash into your shower routine, here's a bit of advice: Make sure you dry off completely before getting dressed. Secrest says the acne-fighting ingredient is known to bleach fabrics, so be sure to wash it off completely and towel off thoroughly before putting on your clothes to avoid any staining.
Finally, make sure you moisturize and use sunscreen! “Using sunscreen is essential to prevent acne and keep the skin healthy,” Vashi said.
While these treatments may suffice for mild acne, if you’re dealing with moderate to severe acne or cystic acne on the back, you should visit a dermatologist for the optimal treatment. They can provide effective prescription treatments for results you wouldn’t see from typical over-the-counter products.
What to avoid when treating back acne
Everybody is different and there is no one-size-fits-all treatment for curing acne, but there are a few things to avoid which can potentially hinder the process.
- Scrubs or physical exfoliation: Boh said exfoliating scrubs are “not useful” and can irritate the skin, which makes acne worse. Secrest agreed, adding that scrubs and physical exfoliators aren’t going to get rid of your acne any faster, so just be gentle and wait until your acne clears before exfoliating.
- Picking your acne: A lot of the hyperpigmentation and discoloration people deal with comes from acne scarring, so do your best to not pick at, squeeze or pop pimples.
- Tight-fitting clothing: If you’re working out often, do your best to avoid tight-fitting clothing that add additional friction to your back.
- Staying in athletic wear post-workout: Allowing the sweat to build up inside your clothes after a workout is another no-no. Lee and Vashi both recommend showering as soon as possible after working out.
- Carrying heavy bags. Toting around heavy handbags or backpacks is another source of friction that can lead to or irritate acne. Vashi recommends avoiding this, if possible.
- Using the same sheets and pillowcases for too long. Vashi recommends changing and washing your bedding regularly to manage back acne and avoid developing any new breakouts.
How long should you wait to see results?
Like any other skin issue, when treating back acne, dermatologists urge you to be patient when it comes to seeing results. Timelines range from six weeks to three months, but the consensus is you should wait longer before declaring a product doesn’t work and giving up on it or moving on to the next one.
“When dealing with back acne, it is important to be patient and remember that it can take time to see improvement from treatment. Sometimes the acne can get worse before it gets better. You may start to see results from treatment approximately in six to eight weeks, but complete clearing can take several months,” Vashi advised.
Best back acne treatments, according to dermatologist tips
Benzoyl peroxide works with CeraVe's classic formula of ceramides, hyaluronic acid and niacinamide to fight acne without drying out your skin. This cleanser boasts the ability to clear your skin of blackheads, whiteheads, cysts, pustules and pimples with daily use.
Designed specifically for breakout-prone skin, this moisturizer uses salicylic acid as its key ingredient to remove and prevent acne from occurring. It's a hit amongst Target and Walmart shoppers with a strong average from almost 2,500 shoppers across both sites.
Salicylic acid joins forces with tea tree leaf oil to create an acne cleanser that will also help manage inflammation. One reviewer who struggled with acne decided to try this cleanser and saw results after a full month of use (after almost giving up), which speaks to the expert tip of being patient to see results.
This acne wash is made to clear acne and prevent new breakouts on the face and body with 10 percent benzoyl peroxide. According to the brand, it is the highest over-the-counter benzoyl peroxide wash available.
Apply this oil-free, lotion-like treatment to problem areas after cleansing, followed by a sunscreen during the daytime. It touts benefits like controlling excess oil, soothing skin and visibly calming redness.
If salicylic acid is your acne-fighting ingredient of choice, this cleanser from CeraVe is worth trying. It combines salicylic acid, lactic acid, hyaluronic acid — all the acids — with ceramides and niacinamide to give you a penetrating clean that isn't harsh on the skin.
Pair the above CeraVe cleaning with the matching moisturizing cream from the same line. It has over 12,200 verified five-star ratings on Amazon. One shopper who suffered from back acne said this cream is part of the routine that has her back looking smooth and feeling summer ready.
Made with two percent salicylic acid, this moisturizer is formulated to prevent and treat breakouts while also brightening the skin. According to a clinical study conducted by the brand, 93 percent of users saw "clearer, healthier, smoother & more radiant skin" within one week of using it.
From the brand that created the first over-the-counter, prescription-grade retinoid comes this acne-fighting cleanser. Designed to be gentle on sensitive skin, the formula contains 5 percent benzoyl peroxide.
Salicylic acid is the key ingredient in this cleanser. It contains a small percentage, which can be helpful for people who have sensitive skin. One Sephora reviewer called it their "holy grail for acne face cleanser."
While this lotion was created with the intention of targeting keratosis pilaris, the combination of salicylic acid and glycolic acid can also be beneficial for acne treatment. One Amazon reviewer said it cleared their "bacne" quickly and kept it clear for several months.
Formulated to cleanse skin without drying you out, this cleanser features salicylic acid to help prevent acne breakouts. Even though it's marketed as a face wash, you can also use it on your back. One reviewer said they stopped seeing new bumps develop after using it on their chest and back.
This three-step system from La Roche-Posay has everything you need to successfully manage acne. The cleanser and clarifying solution contain salicylic acid, while the targeted acne spot treatment contains benzoyl peroxide.