Back acne: How to see clearer skin

To reduce acne flares on your back, dermatologists recommend wearing sweat-wicking (or loose-fitting cotton) clothes when working out.

If you have acne on your back, or “bacne” as some people call it, you don’t have to wait for it to clear on its own. Treatment and the right skin care can help you see clearer skin more quickly.

You may even be able to clear your back on your own.

Who can treat back acne at home?

You may see clearer skin from treating it yourself if you:

• Have a few blemishes on your back (mild acne)
• Developed back acne recently
• Have a mix of whiteheads, blackheads, and pimples on your back, but nothing that’s painful or goes deep into the skin (moderate acne)

Anyone who has deep, painful acne on their back (or anywhere else) will need a dermatologist’s help.

OTC treatment for back acne that works

OTC stands for over-the-counter. It’s medical jargon that means any treatment which you can buy without a prescription.

Studies show that the following OTC acne products can help clear mild (or moderate) back acne when used along with acne friendly skin care:

Benzoyl peroxide (emollient foam wash): This helps to kill the bacteria that cause acne. Used daily, it can help control back acne and reduce flares.

Studies show that the key to getting results from a benzoyl peroxide wash is to leave it on your back for 2 to 5 minutes before rinsing it off.

Letting the benzoyl peroxide sit on your skin for a few minutes has two advantages:

1. This approach helps the medicine penetrate your skin. Skin is thicker on the back than on the face.
2. Rinsing it off prevents bleached clothes, sheets, and towels. Benzoyl peroxide is known to bleach fabrics.

You’ll find OTC benzoyl peroxide foaming washes in different strengths. Using a product that contains 5.3% benzoyl peroxide is less likely to cause irritated skin, dryness, or peeling.

If you feel that you need stronger medicine, you can start with a foaming wash that contains 10% benzoyl peroxide. That’s the strongest concentration of benzoyl peroxide that you can buy without a prescription.

Retinoid (adapalene 0.1% gel): Using this along with benzoyl peroxide can improve your results. This OTC retinoid can help unclog pores, which will help the benzoyl peroxide work better.

Dermatologists recommend applying adapalene after you shower or before going to bed. Again, you want to apply it daily.

How to apply medicine to your back

For treatment to work, you must get it on your back. Investing in a lotion applicator for the back can help you apply the medicine where you want it.

If you’re not sure where to find one of these, just search online for a “lotion applicator for the back.”

Acne friendly skin care essential

To get the results you expect from treatment, you’ll also need acne friendly skin care. Without it, your acne can flare, even when you’re treating it.

To help their patients with back acne get the best results, dermatologists recommend the following:

If you cannot shower immediately, use an oil-free cleansing wipe to gently wipe off your sweaty skin. You’ll also want to change out of sweaty clothes.

1. Develop these habits when working out or getting sweaty:
   • Wear loose-fitting workout clothes made of cotton or sweat-wicking fabric.
   • Wash workout clothes after each use.
   • Shower and change clothes ASAP after working out (or doing anything that causes you to sweat).

When shopping for sunscreen, choose one that says the following on the packaging:

• Non-comedogenic (or oil-free)
• SPF 30 (or higher)
• Broad-spectrum protection (UVA/UVB protection)
• Water resistance

2. Cleanse your skin gently. Scrubbing skin with acne may seem best, but this actually worsens acne. When washing your back and applying acne treatment, you want to be gentle.

3. Stop irritating your skin with harsh skin care products. Antibacterial soaps, astringents, and abrasive scrubs can worsen acne. Ditto for loofahs, back brushes, and buff puffs. For best results, you’ll want to use gentle, fragrance-free skin care products.

4. Use oil-free skin care products and cosmetics. The packaging may read “non-comedogenic,” “non-acnegenic,” “won’t clog pores,” or “oil-free.

5. Avoid using anything that rubs against your back, such as a backpack. Anything that rubs against your back can irritate your skin, causing back acne to flare. Swap a backpack for a handheld bag. If you carry a purse on your shoulder, place the strap on your arm.

6. Resist the temptation to pick and pop acne, even on your back. This will only worsen acne.

7. Protect your skin from the sun. People often believe that the sun’s rays will help clear acne, but the sun can actually worsen acne. The sun’s rays tend to darken acne and cause it to last longer.
   
   You can help clear acne by always wearing oil-free sunscreen when outdoors. You’ll want to apply sunscreen to all skin that clothes won’t cover.

8. Change your sheets and pillowcases weekly. Clean sheets and pillowcases are essential for clearing back acne. You may want to change pillowcases twice a week. By the end of a week, sheets and pillowcases are swarming with dead skin cells and bacteria.
   
   When washing sheets and pillowcases, be sure to use fragrance-free detergent. If you like fabric softener, it, too, should be fragrance-free.

When to see a dermatologist

It can take time to see results from treatment. If treatment works, you may start to see results in 6 to 8 weeks. Complete clearing can take 3 or 4 months.

If you don’t see any difference in 6 to 8 weeks, you may need a dermatologist’s help. With a dermatologist’s help, virtually every type of acne can be successfully treated.

References
Bikowski J. “A review of the safety and efficacy of benzoyl peroxide (5.3%) emollient foam in the management of truncal acne vulgaris.” J Clin Aesthet Dermatol. 2010;3(11):26-9.

Brand B, Gilbert R, et al. “Cumulative irritancy comparison of adapalene gel 0.1% versus other retinoid products when applied in combination with topical antimicrobial agents.” J Am Acad Dermatol. 2003;49(3 Suppl):S227-32.

Del Rosso JQ. “Management of truncal acne vulgaris: current perspectives on treatment.” Cutis. 2006 May;77(5):285-9.

Eichenfield LF, Andrew C. Krakowski AC, et al. “Evidence-Based Recommendations for the Diagnosis and Treatment of Pediatric Acne.” Pediatrics. 2013;131 Suppl 3:S163-86.

Leyden JJ, Del Rosso JQ. “The effect of benzoyl peroxide 9.8% emollient foam on reduction of Propionibacterium acnes on the back using a short contact therapy approach.” J Drugs Dermatol. 2012;11(7):830-3.